Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G. Martino, University of Messina, Italy.
J Magn Reson Imaging. 2019 Oct;50(4):1033-1046. doi: 10.1002/jmri.26700. Epub 2019 Mar 7.
Proton magnetic resonance spectroscopy (MRS) is a promising noninvasive diagnostic technique for investigation of breast cancer metabolism. Spectroscopic imaging data may be obtained following contrast-enhanced MRI by applying the point-resolved spectroscopy sequence (PRESS) or the stimulated echo acquisition mode (STEAM) sequence from the MR voxel encompassing the breast lesion. Total choline signal (tCho) measured in vivo using either a qualitative or quantitative approach has been used as a diagnostic test in the workup of malignant breast lesions. In addition to tCho metabolites, other relevant metabolites, including multiple lipids, can be detected and monitored. MRS has been heavily investigated as an adjunct to morphologic and dynamic MRI to improve diagnostic accuracy in breast cancer, obviating unnecessary benign biopsies. Besides its use in the staging of breast cancer, other promising applications have been recently investigated, including the assessment of treatment response and therapy monitoring. This review provides guidance on spectroscopic acquisition and quantification methods and highlights current and evolving clinical applications of proton MRS. Level of Evidence 5 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2019.
质子磁共振波谱（MRS）是一种很有前途的非侵入性诊断技术，可用于研究乳腺癌的代谢情况。在进行对比增强 MRI 后，可以通过在包含乳腺病变的 MR 体素中应用点分辨波谱序列（PRESS）或激发回波采集模式（STEAM）序列来获取光谱成像数据。使用定性或定量方法测量的总胆碱信号（tCho）已被用作恶性乳腺病变检查的诊断测试。除了 tCho 代谢物之外，还可以检测和监测其他相关代谢物，包括多种脂质。MRS 已被广泛研究作为形态学和动态 MRI 的辅助手段，以提高乳腺癌的诊断准确性，避免不必要的良性活检。除了在乳腺癌分期中的应用外，最近还研究了其他有前途的应用，包括治疗反应评估和治疗监测。本文综述了质子 MRS 的光谱采集和定量方法，并重点介绍了当前和不断发展的临床应用。证据水平 5 技术功效：第 5 阶段 J. 磁共振成像 2019 年。
