Evaluation of total choline from in-vivo volume localized proton MR spectroscopy and its response to neoadjuvant chemotherapy in locally advanced breast cancer

Results of the proton magnetic resonance spectroscopy carried out on normal , benign breast disease and locally advanced breast cancer patients are pre sented. The in-vivo MR spectra of malignant breast tissue of patients (n = 67) suffering from infiltrating ductal carcinoma are dominated by the water resonance, while the spectra of the unaffected contralateral breast tissue of these patients are mainly dominated by resonance arising from lipids wh ich is similar to the spectra of normal breast tissue obtained from volunte ers (controls, n = 16). In addition to the water and lipid peaks, in majori ty of the patients (similar to 80%) the water suppressed spectra showed a r esonance at 3.2 ppm due to choline containing compounds (TCho) before treat ment. In patients receiving neoadjuvant chemotherapy, absence/reduction in choline was observed in 89% of the patients. TCho was also observed in 2 of 14 benign lesions. The sensitivity and specificity of in-vivo MRS in detec ting TCho in malignant tumours was 78% and 86%, respectively. Observation o f TCho before treatment and its disappearance (or reduction) after treatmen t may be a useful indicator of response of locally advanced breast cancer t o neoadjuvant chemotherapy. (C) 2001 Cancer Research Campaign.