title: Can magnetic resonance spectroscopy differentiate endometrial cancer?
abstract: OBJECTIVE
  To investigate whether the choline-containing compounds (Cho) obtained from three-dimensional (1)H magnetic resonance (MR) spectroscopy can differentiate endometrial cancer (ECa) from benign lesions in endometria or in submucosa (BLs-ESm) and is associated with the aggressiveness of ECa.
  
  
  METHODS
  Fifty-seven patients (ECa, 38; BLs-ESm, 19) underwent preoperative multi-voxel MR spectroscopy at 3.0 T. The ratio of the sum of the Cho peak integral to the sum of the unsuppressed water peak integral (Cho/water) and the coefficient of variation (CV) used to describe the variability of Cho/water in one lesion were calculated.
  
  
  RESULTS
  Mean Cho/water (±standard deviation [SD]) was (3.02 ± 1.43) × 10(-3) for ECa and (1.68 ± 0.33) × 10(-3) for BLs-ESm (p < 0.001). Mean Cho/water was (4.42 ± 1.53) × 10(-3) for type II ECa and (2.65 ± 1.17) × 10(-3) for type I ECa (p = 0.001). There were no significant differences among different stages of ECa (p = 0.107) or different grades of ECa (p = 0.142). The Cho/water was positively correlated with tumour stage (r = 0.386, p = 0.017) and size (r = 0.333, p = 0.041). The CV was also positively correlated with tumour stage (r = 0.537, p = 0.001) and size (r = 0.34, p = 0.037).
  
  
  CONCLUSIONS
  The Cho/water can differentiate ECa from BLs-ESm and differentiate type II from type I ECa, but cannot differentiate different stages of ECa or different grades of ECa. Cho/water increased with the increase of tumour stage and size.
  
  
  CONCLUSIONS
  • First report to attempt to assess ECa aggressiveness with magnetic resonance spectroscopy (MRS). • MRS can differentiate type I from type II ECa. • MRS can differentiate ECa from BLs-ESm. • MRS cannot differentiate different stages of ECa or different grades of ECa. • Cho/water increased with the increase of tumour stage and size.
authors.affiliation: Department of Radiology, Shandong Provincial Hospital, Shandong University, 324# Jingwu Weiqi road, Jinan, People's Republic of China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.forename: Shifeng
authors.initials: S
authors.lastname: Cai
authors.forename: Changzhong
authors.initials: C
authors.lastname: Li
authors.forename: Xichao
authors.initials: X
authors.lastname: Sun
authors.forename: Xue
authors.initials: X
authors.lastname: Han
authors.forename: Chunrun
authors.initials: C
authors.lastname: Yang
authors.forename: Caixia
authors.initials: C
authors.lastname: Fu
authors.forename: Qingwei
authors.initials: Q
authors.lastname: Liu
authors.forename: Yinghui
authors.initials: Y
authors.lastname: Xin
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Zong
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D002794:Choline / Q000032:analysis*; D003937:Diagnosis, Differential; D016889:Endometrial Neoplasms / Q000737:chemistry / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D057234:Preoperative Period; D011446:Prospective Studies; D015203:Reproducibility of Results
chemical_list: D014408:Biomarkers, Tumor; D002794:Choline