Sharma Uma, Jagannathan Naranamangalam Raghunathan
Department of NMR & MRI Facility, All India Institute of Medical Sciences , New Delhi, India.
BJR Open. 2019 Jul 2;1(1):20180040. doi: 10.1259/bjro.20180040. eCollection 2019.
Breast cancer is a significant health concern in females, worldwide. proton (H) MR spectroscopy (MRS) has evolved as a non-invasive tool for diagnosis and for biochemical characterization of breast cancer. Water-to-fat ratio, fat and water fractions and choline containing compounds (tCho) have been identified as diagnostic biomarkers of malignancy. Detection of tCho in normal breast tissue of volunteers and in lactating females limits the use of tCho as a diagnostic marker. Technological developments like high-field scanners, multi channel coils, pulse sequences with water and fat suppression facilitated easy detection of tCho. Also, quantification of tCho and its cut-off for objective assessment of malignancy have been reported. Meta-analysis of H MRS studies have documented the pooled sensitivities and the specificities in the range of 71-74% and 78-88%, respectively. Inclusion of MRS has been shown to enhance the diagnostic specificity of MRI, however, detection of tCho in small sized lesions (≤1 cm) is challenging even at high magnetic fields. Potential of MRS in monitoring the effect of chemotherapy in breast cancer has also been reported. This review briefly presents the potential clinical role of H MRS in the diagnosis of breast cancer, its current status and future developments.
乳腺癌是全球女性面临的一个重大健康问题。质子（H）磁共振波谱（MRS）已发展成为一种用于乳腺癌诊断和生化特征分析的非侵入性工具。水脂比、脂肪和水的含量以及含胆碱化合物（tCho）已被确定为恶性肿瘤的诊断生物标志物。在志愿者的正常乳腺组织和哺乳期女性中检测到tCho限制了tCho作为诊断标志物的应用。高场扫描仪、多通道线圈、具有水脂抑制功能的脉冲序列等技术发展促进了tCho的轻松检测。此外，还报道了tCho的定量及其用于恶性肿瘤客观评估的临界值。对H MRS研究的荟萃分析记录了汇总敏感性和特异性分别在71 - 74%和78 - 88%的范围内。已证明纳入MRS可提高MRI的诊断特异性，然而，即使在高磁场下，检测小尺寸病变（≤1 cm）中的tCho也具有挑战性。也有报道称MRS在监测乳腺癌化疗效果方面的潜力。本综述简要介绍了H MRS在乳腺癌诊断中的潜在临床作用、其现状和未来发展。
