Sinead Doran

Determination of Grade and Receptor Status from the Primary Breast Lesion by Magnetic Resonance Spectroscopy

Magnetic resonance spectra (MRS) from fine needle aspiration biopsies (FNAB) from primary breast lesions were analysed using a pattern recognition method, Statistical Classification Strategy, to assess tumor grade and oestrogen receptor (ER) and progesterone receptor (PgR) status. Grade 1 and 2 breast cancers were separated from grade 3 cancers with a sensitivity and specificity of 96% and 95%, respectively. The ER status was predicted with a sensitivity of 91% and a specificity of 90%, and the PgR status with a sensitivity of 91% and a specificity of 86%. These classifiers provide rapid and reliable, computerized information and may offer an objective method for determining these prognostic indicators simultaneously with the diagnosis of primary pathology and lymph node involvement.

Two-Dimensional Proton Magnetic Resonance Spectroscopy for Tissue Characterization of Thyroid Neoplasms

Abstract. We have previously demonstrated that one dimensional (1D) proton ( 1 H) magnetic resonance spectroscopy (MRS) can distinguish normal thyroid tissue from thyroid carcinoma using a spectral ratio of peak intensity at 1.7 ppm/0.9 ppm. Two dimensional (2D) 1 H-MRS allows identification of specific molecules that have overlapping peaks in the 1D-MR spectrum. Specimens from 93 consecutive thyroid nodules were examined using 2D 1 H-MRS on a Bruker AM-360 wide-bore spectrometer. There was a progressive increase in lipid cross peaks assigned to di-/triglycerides when comparing colloid/hyperplastic nodules to follicular adenoma, and adenoma to carcinoma. A specific cross peak attributable to cholesterol/cholesteryl esters was commonly seen in carcinomas. In contrast, two unassigned cross peaks unique to the thyroid were more prevalent in benign lesions. There was an overall increase in cross peaks attributable to cell surface fucosylation in carcinoma when compared to benign lesions, although the fucose spectral pattern was not specific for cancer. On this basis, a spectral ratio of peak intensity at 2.05 ppm/0.9 ppm more clearly distinguished benign follicular adenoma from carcinoma. 2D 1 H-MRS thus identifies chemical changes that allow more specific tissue characterization of thyroid neoplasms.

Cancer pathology in the year 2000

The last one hundred and fifty years has produced the mature and sophisticated discipline of histopathology, yet still leaves the diagnosis of human cancer, by the best available technique, as more art than science. Proton magnetic resonance spectroscopy (1H MRS) ex vivo identifies the chemical markers of established pathobiological disorders within excised biopsies and fine needle aspirates, in particular, those associated with the development and progression of malignant disease. Alterations to cellular chemistry monitored by 1H MRS allows distinction between invasive and pre-invasive lesions of the uterine cervix, and separate truly benign follicular neoplasms from follicular carcinomas on analysis of fine needle aspirates containing as few as 10(6) cells. 1H chemical shift imaging (CSI) determines the spatial location of these chemical changes and provides insight into the chemistry of neoplastic transformation. It is our hypothesis that, by the year 2000, CSI will aid image guided biopsy techniques and that correlation of biopsy histology with in vivo localised 1H MRS data will: (a) lead to improved assessment of the extent of malignant disease and (b) establish the sensitivity and specificity of in vivo 1H MRS for the simultaneous determination of the size, location and neoplastic potential of a tumour mass.