title: 1H MR spectroscopy of invasive ductal carcinoma: correlations with FDG PET and histologic prognostic factors.
abstract: OBJECTIVE
  The purpose of this article is to assess the histologic prognostic relevance of choline levels obtained using (1)H MR spectroscopy with a 1.5-T MR unit in patients with invasive breast cancer and to compare the observed choline levels with the standardized uptake value obtained using FDG PET.
  
  
  METHODS
  Single-voxel (1)H MR spectroscopy and PET/CT were performed for 50 patients with invasive ductal carcinoma (1.5-3 cm in size). The normalized choline signal was calculated using an external standard method.
  
  
  RESULTS
  Proton MR spectroscopy detected the presence of choline in 44 cases. The average normalized choline signal was 1.1 (range, 0-3.9). The average standardized uptake value was 6.5 (range, 1.1-23). The correlation (r) between the normalized choline signal and the standardized uptake value was 0.52 (p < 0.0001). The normalized choline signal was significantly correlated with nuclear grade (p = 0.0002), triple-negative breast cancer status (p = 0.0009), and estrogen receptor negativity (p = 0.007). The standardized uptake value was significantly correlated with nuclear grade (p = 0.0002), estrogen receptor negativity (p = 0.002), and triple-negative breast cancer status (p = 0.009). No significant differences were found between the progesterone receptor-positive and negative groups or between the human epidermal growth factor receptor 2-positive and negative groups.
  
  
  CONCLUSIONS
  The choline levels obtained using (1)H MR spectroscopy with a 1.5-T unit were well correlated with the standardized uptake value obtained using PET/CT and with the histologic prognostic parameters (nuclear grade, estrogen receptor status, and triple-negative lesion status).
authors.affiliation: Division of Diagnostic Imaging, Breast Center, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan. e-tozaki@keh.biglobe.ne.jp
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Tozaki
authors.forename: Kazuei
authors.initials: K
authors.lastname: Hoshi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000378:metabolism; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000453:epidemiology* / Q000378:metabolism; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007564:Japan / Q000453:epidemiology; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data; D015995:Prevalence; D011379:Prognosis; D011522:Protons; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic
chemical_list: D014408:Biomarkers, Tumor; D011522:Protons; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18