title: Feasibility of MR metabolomics for immediate analysis of resection margins during breast cancer surgery.
abstract: In this study, the feasibility of high resolution magic angle spinning (HR MAS) magnetic resonance spectroscopy (MRS) of small tissue biopsies to distinguish between tumor and non-involved adjacent tissue was investigated. With the current methods, delineation of the tumor borders during breast cancer surgery is a challenging task for the surgeon, and a significant number of re-surgeries occur. We analyzed 328 tissue samples from 228 breast cancer patients using HR MAS MRS. Partial least squares discriminant analysis (PLS-DA) was applied to discriminate between tumor and non-involved adjacent tissue. Using proper double cross validation, high sensitivity and specificity of 91% and 93%, respectively was achieved. Analysis of the loading profiles from both principal component analysis (PCA) and PLS-DA showed the choline-containing metabolites as main biomarkers for tumor content, with phosphocholine being especially high in tumor tissue. Other indicative metabolites include glycine, taurine and glucose. We conclude that metabolic profiling by HR MAS MRS may be a potential method for on-line analysis of resection margins during breast cancer surgery to reduce the number of re-surgeries and risk of local recurrence.
authors.affiliation: Department of Circulation and Medical Imaging, Faculty of Medicine, The Norwegian University of Science and Technology, Trondheim, Norway. tone.f.bathen@ntnu.no
authors.forename: Tone F
authors.initials: TF
authors.lastname: Bathen
authors.forename: Brigitte
authors.initials: B
authors.lastname: Geurts
authors.forename: Beathe
authors.initials: B
authors.lastname: Sitter
authors.forename: Hans E
authors.initials: HE
authors.lastname: Fjøsne
authors.forename: Steinar
authors.initials: S
authors.lastname: Lundgren
authors.forename: Lutgarde M
authors.initials: LM
authors.lastname: Buydens
authors.forename: Ingrid S
authors.initials: IS
authors.lastname: Gribbestad
authors.forename: Geert
authors.initials: G
authors.lastname: Postma
authors.forename: Guro F
authors.initials: GF
authors.lastname: Giskeødegård
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001943:Breast Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery*; D002794:Choline / Q000378:metabolism; D016002:Discriminant Analysis; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D016018:Least-Squares Analysis; D009682:Magnetic Resonance Spectroscopy; D055432:Metabolomics; D008875:Middle Aged; D025341:Principal Component Analysis
chemical_list: D002794:Choline