title: Proof-of-the-Concept Study on Mathematically Optimized Magnetic Resonance Spectroscopy for Breast Cancer Diagnostics.
abstract: Magnetic resonance (MR)-based modalities aid breast cancer detection without exposure to ionizing radiation. Magnetic resonance imaging is very sensitive but costly and insufficiently specific. Molecular imaging through magnetic resonance spectroscopy (MRS) can provide information about key metabolites. Here, the measured/encoded time signals cannot be interpreted directly, necessitating mathematics for mapping to the more manageable frequency domain. Conventional applications of MRS are hampered by data analysis via the fast Fourier transform (FFT) and postprocessing by fitting techniques. Most in vivo MRS studies on breast cancer rely upon estimations of total choline (tCHO). These have yielded only incremental improvements in diagnostic accuracy. In vitro studies reveal richer metabolic information for identifying breast cancer, particularly in closely overlapping components of tCHO. Among these are phosphocholine (PC), a marker of malignant transformation of the breast. The FFT cannot assess these congested spectral components. This can be done by the fast Padé transform (FPT), a high-resolution, quantification-equipped method, which we presently apply to noisy MRS time signals consistent with those encoded in breast cancer. The FPT unequivocally and robustly extracted the concentrations of all physical metabolites, including PC. In sharp contrast, the FFT produced a rough envelope spectrum with a few distorted peaks and key metabolites absent altogether. As such, the FFT has poor resolution for these typical MRS time signals from breast cancer. Hence, based on Fourier-estimated envelope spectra, tCHO estimates are unreliable. Using even truncated time signals, the FPT clearly distinguishes noise from true metabolites whose concentrations are accurately extracted. The high resolution of the FPT translates directly into shortened examination time of the patient. These capabilities strongly suggest that by applying the FPT to time signals encoded in vivo from the breast, MRS will, at last, fulfill its potential to become a clinically reliable, cost-effective method for breast cancer detection, including screening/surveillance.
authors.affiliation: Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden dzevad.belkic@ki.se.
authors.forename: Dževad
authors.initials: D
authors.lastname: Belkić
authors.affiliation: Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden School of Community and Global Health, Claremont Graduate University, Claremont, CA, USA Institute for Prevention Research, Keck School of Medicine, University of Southern California, Alhambra, CA, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Belkić
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D005583:Fourier Analysis; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D010767:Phosphorylcholine / Q000378:metabolism; D012815:Signal Processing, Computer-Assisted
chemical_list: D010767:Phosphorylcholine
keywords: breast cancer diagnostics; fast Padé transform; magnetic resonance spectroscopy; mathematical optimization