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MR spectroscopy of the breast

Spettroscopia a RM della mammella

  • Breast Radiology Senologia
  • Published:
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Abstract

This literature review assesses the clinical potential of proton (1H) magnetic resonance spectroscopy (MRS) of breast lesions. We here illustrate the basic principles of spectrum acquisition for volumes of interest, determined on the basis of dynamic magnetic resonance imaging (MRI) and of MRS postprocessing. We discuss the criteria for interpreting the spectrum with particular reference to the metabolic significance of the peak of total choline containing compounds at 3.2 ppm, a marker that is correlated with malignancy. We then summarise the findings obtained in lesion characterisation (with a possible gain in specificity with respect to dynamic MRI), the assessment of the effects of neoadjuvant chemotherapy and the correlation reported at high-field between the tumour tissue concentration of choline-containing compounds and the presence of lymph node metastases. Lastly, we outline the clinical use of this technique as the final phase of a complete breast MR examination after intravenous administration of paramagnetic contrast material for the dynamic study, with reference to its use by radiologists dedicated to breast imaging.

Riassunto

La presente rassegna valuta sulla base della letteratura le potenzialità cliniche della spettroscopia a RM delle lesioni mammarie con riferimento all’esperienza maturata per lo studio spettroscopico del protone (1H). Sono illustrati i principi fondamentali dell’acquisizione dello spettro su volume di interesse (determinato sulla base dello studio RM dinamico) e del postprocessing. Sono discussi i criteri interpretativi dello spettro con particolare riferimento al significato metabolico del picco dei composti contenenti colina a 3,2 ppm, marker correlato alla malignità della lesione. Sono riassunti i risultati clinici ottenuti nella caratterizzazione lesionale (con possibile guadagno in specificità rispetto all’imaging RM dinamico), nella valutazione dell’effetto della chemioterapia neoadiuvante e nella correlazione — dimostrata ad alto campo — tra concentrazione tessutale tumorale dei composti contenenti colina e presenza di metastasi linfonodali. Lo sviluppo clinico di questa tecnica come fase finale che completa l’indagine a RM mammaria con mezzo di contrasto paramagnetico è infine delineata con riferimento al suo utilizzo da parte del Radiologo dedicato alla Senologia.

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Authors and Affiliations

  1. Dipartimento di Scienze Medico-chirurgiche, IRCCS Policlinico San Donato, Servizio di Radiologia, Università degli Studi di Milano, San Donato Milanese, Milano, Italy

    F. Sardanelli & A. Fausto

  2. Dipartimento di Biologia Cellulare e Neuroscienze, Istituto Superiore di Sanità, Roma, Italy

    F. Podo

Authors
  1. F. Sardanelli
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  2. A. Fausto
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  3. F. Podo
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Correspondence to F. Sardanelli.

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Sardanelli, F., Fausto, A. & Podo, F. MR spectroscopy of the breast. Radiol med 113, 56–64 (2008). https://doi.org/10.1007/s11547-008-0228-y

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  • DOI: https://doi.org/10.1007/s11547-008-0228-y

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