Kumar Mahesh, Jagannathan N R, Seenu V, Dwivedi S N, Julka P K, Rath G K
Department of NMR, All India Institute of Medical Sciences, New Delhi, India.
J Magn Reson Imaging. 2006 Aug;24(2):325-32. doi: 10.1002/jmri.20646.
To evaluate the use of the water-to-fat (W-F) value obtained from in vivo proton ((1)H) MR spectroscopy (MRS) as a response indicator of cytologically confirmed patients with locally advanced breast cancer (LABC), and to monitor the therapeutic response of such patients to neoadjuvant chemotherapy (NACT).
Serial (1)H MR spectra were recorded both before and after the completion of chemotherapy in 33 LABC patients (with infiltrating ductal carcinoma (IDC)) at 1.5T. In addition, spectra from normal breast tissues of 28 healthy volunteers were recorded.
Malignant breast tissues showed elevated W-F values compared to normal breast tissues of controls. Statistically significant higher pretherapy W-F value (P < 0.01) was observed in patients compared to controls. In patients who received NACT resulting in the reduction of the primary tumor size, the W-F value showed a decrease that was statistically significant (P < 0.01). Analysis of the MR data further indicates that the W-F value had no correlation with the menstrual status of the patients. A comparison of pretherapy W-F value with pretherapy tumor volume showed a fair correlation (P = 0.05), while the posttherapy W-F value showed no such correlation with the posttherapy tumor volume.
This study demonstrates that simple, conventional in vivo (1)H MRS is a useful technique for monitoring the therapeutic response of breast cancer patients. The observed trend in the reduction of W-F value provides a noninvasive response indicator to monitor the clinical outcome of locally advanced breast cancer patients to NACT.
评估通过体内质子（¹H）磁共振波谱（MRS）获得的水脂（W-F）值作为经细胞学确诊的局部晚期乳腺癌（LABC）患者的反应指标，并监测此类患者对新辅助化疗（NACT）的治疗反应。
在1.5T条件下，对33例LABC患者（浸润性导管癌（IDC））化疗前后进行连续¹H MR波谱记录。此外，还记录了28名健康志愿者正常乳腺组织的波谱。
与对照组正常乳腺组织相比，恶性乳腺组织的W-F值升高。与对照组相比，患者治疗前的W-F值在统计学上显著更高（P < 0.01）。在接受NACT导致原发肿瘤大小缩小的患者中，W-F值出现了具有统计学意义的下降（P < 0.01）。对MR数据的分析进一步表明，W-F值与患者的月经状态无关。治疗前W-F值与治疗前肿瘤体积的比较显示出适度的相关性（P = 0.05），而治疗后W-F值与治疗后肿瘤体积无此相关性。
本研究表明，简单、传统的体内¹H MRS是监测乳腺癌患者治疗反应的有用技术。观察到的W-F值降低趋势提供了一种非侵入性反应指标，以监测局部晚期乳腺癌患者接受NACT的临床结果。
