Serralde-Vázquez M, Martín-Ramos J, Redondo-Santos F, Guerrero-Avendaño G

Language: Spanish
References: 15
Page: 14-20
PDF size: 389.69 Kb.

ABSTRACT

Introduction. Magnetic resonance (MR) is a study used to evaluate the multicentricity and multifocality of carcinoma, as well as the invasive component of lesions and their post-treatment monitoring. Proton magnetic resonance spectroscopy (¹HMRS), which quantifies the concentration of choline, combined with plotting of dynamic perfusion curves, provides information on the benignancy or malignancy of lesions and raises the specificity of resonance. The Scarf Bloom Richardson (SBR) histologic scale is used as a predictive and prognostic factor of survival in patients with breast cancer because it has been associated with the risk of tumor recurrence and greater frequency of metastasis.
Material and methods. A retrospective, descriptive study, conducted in the Hospital General de Mexico Breast Imaging Area in 46 patients, between 31 and 74 years of age, with histopathological diagnosis of invasive ductal carcinoma between March 1, 2009, and July 24, 2012. For these patients, the integral of choline was quantified and dynamic perfusion curves were plotted for the tumors with a standardized ¹H-MRS method and the histologic grade of magnitude was rated on the SBR scale modified by Elston.
Results. Choline peaks above 2.38 ppm (maximum value observed: 453 ppm) were found in 42 (95.5 %) of the 44 women studied, and no trace of choline in two patients. As regards perfusion curves, type III curves were obtained in 22 patients (50%), type II in 11 (25%), and type I in 5 patients (11.3%). In the SBR tumor scores, 21 lesions were rated grade II (47.7%); 15 grade I (34.09%), and eight grade III (18.2%).
Discussion. This study shows that there was not a direct relationship between the choline value obtained and the histologic tumor grade; in other words, a high value does not precisely correlate with a higher histologic grade and vice-versa. On the other hand, perfusion curves are also not correlated with the degree of tumor differentiation. However, having found mostly type III curves and positive choline peaks in the lesions studied, we can say that the combined use of these two parameters raises the sensitivity of magnetic resonance and of the established morphological criteria.
Conclusion. Although the current parameters of magnetic resonance are effective in studying breast cancer, we need to investigate new parameters that serve as prognostic image markers to establish the best treatment to follow or modify an existing treatment.

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