MO‐SAMS‐332‐02: Introduction to Magnetic Resonance Spectroscopy of Breast and Prostrate Cancer: Current Applications

Magnetic resonance spectroscopy (MRS) and magnetic resonance spectroscopy imaging (MRSI) is increasing being utilized as adjuncts for differentiating benign from malignant lesions in the clinical setting. MRS has the ability to probe intracellular metabolites, such as, choline (Cho), Creatine (Cr), citrate (Ci) and N‐acetylaspartate (NAA). The observation of a high Choline signal appears to be the spectroscopic hallmark of cancer. This additional information can be very useful in cases of indeterminate findings in suspicious lesions, for example, in breast or prostrate cancer. Indeed, recent advances have moved the use MRS into the clinical realm for detection and classification of these tumors and more importantly, monitoring response to neoadjuvant chemotherapy treatment. This presentation will review the principles of MRS, including, pulse sequences, MRS data collection, data analysis, quantification, and quality assurance. Three major topics are considered. Introduction of relevant intracellular metabolites and their biological and medical significance in cancer, the principles underlying each quantity are given. Second, major pulse sequences used for MRS, e.g., PRESS or STEAM in breast and prostrate cancer. Finally, MRS data analysis and quantification of the results with pathological observations will be also compared with MRS‐derived quantities where appropriate. This presentation is intended as an introduction to the field of MRS for anyone who desires to use the scope of modern MRS techniques, its application and use for monitoring therapy. It will be of interest to medical physicists who are considering undertaking quantitative MRS, as well as those already in the field. Educational Objectives: 1. Identify the clinically important quantities (e.g. metabolites) that can be measured with MRS. 2. Be familiar with the methods and techniques used for MRS acquisition. 3. Basic understanding of the application of MRS to breast and prostrate cancer.