Article

Investigation of lipid composition of dissected sentinel lymph nodes of breast cancer patients by 7T proton MR spectroscopy.

Department of Radiology, University Medical Center Utrecht, The Netherlands.
Journal of Magnetic Resonance Imaging (impact factor: 2.7). 02/2012; 35(2):387-92. DOI:10.1002/jmri.22820 pp.387-92
Source: PubMed

ABSTRACT To determine lipid composition of excised healthy and metastatic sentinel lymph nodes of breast cancer patients, as lipids are a potential discriminatory marker for malignancy.
Ten breast cancer patients undergoing surgical nodal staging were included. (1)H-magnetic resonance spectroscopic images (MRSI) were acquired without water and lipid suppression (resolution 3.0 × 3.0 × 5.0 mm(3)). MRSI was compared to histopathology. Six groups of lipid resonances (5.4-5.2, 4.3-4.1, 2.8, 2.3-2.0, 1.6-1.3, 0.9 ppm) were identified. The intensity ratios of the total of these resonances to this total including the water resonance and of each lipid resonance to the total of all lipid resonances were determined. For statistical analysis, a mixed model was applied after logistic transformation. The results were expressed as ratios of the median values of these lipid compositions in metastatic to benign nodes.
In all, 6/32 (19%) of the excised nodes contained metastases. The ratios of the lipid resonances 5.4-5.2, 4.3-4.1, 2.8, 2.3-2.0, 1.6-1.3, 0.9 ppm between metastatic vs. benign were 0.3, 1.2, 0.2, 0.2, 1.2, and 0.9, respectively. Only the ratios of signals from unsaturated fatty acids to the total lipid signal differed significantly.
Metastatic axillary lymph nodes contained fewer unsaturated fatty acids than benign nodes. 7T (1)H-MRS may be useful for detecting axillary breast cancer metastases.

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Keywords

1)H-magnetic resonance spectroscopic images
 
breast cancer patients
 
excised healthy
 
intensity ratios
 
lipid composition
 
lipid compositions
 
lipid resonance
 
lipid resonances
 
lipid suppression
 
logistic transformation
 
median values
 
Metastatic axillary lymph nodes
 
metastatic sentinel lymph nodes
 
mixed model
 
potential discriminatory marker
 
resonances
 
statistical analysis
 
total lipid signal
 
unsaturated fatty acids
 
water resonance