Polyunsaturated fatty acid (PUFA) is associated with malignant transformation of breast cancer and can be extracted from overwhelming background signals using multiple quantum coherence (MQC) MRS. Since MQC loses half of the signal, SNR enhancement through effective combination of signals acquired from multi channel coils holds significant potential. Investigations so far focused on conventional brain MRS, with drastically different metabolites and cluttered appearance compared to MQC MRS in breast. We therefore acquired PUFA spectra from 17 fresh breast tumour specimens and a patient on a clinical 3T scanner, and current algorithms of adaptively optimised combination (AOC), S/N2, S/N, Signal evaluated.
For ex vivo experiments, seventeen specimens, freshly excised from female patients with invasive ductal carcinoma undergoing mastectomy or wide local excision surgery, were scanned. For in vivo experiments, a female patient with invasive ductal carcinoma participated in the study. The study was approved by the NHS Research Ethics Committee, and written informed consent was obtained from each patient prior to the study.
Data Acquisition: Single voxel MRS data were acquired on a 3T MRI scanner (Achieva TX, Phillips Healthcare, Best, Netherlands), using body coil for uniform transmission. For ex vivo experiments, PUFA spectrum was acquired using a 32-channel receiver coil and MQC PRESS sequence with TR/TE of 1250/130 ms, 1024 data points, spectral bandwidth of 2000 Hz, spectral editing frequency at 2.8 ppm, 256 averages. Reference spectra without water suppression were acquired using single voxel PRESS sequence with TR/TE of 1250/144 ms, 1024 data points, spectral bandwidth of 2000 Hz, 16 averages. The voxel was positioned snug fit to the tumour. For in vivo experiments, spectra were collected from the tumour and contralateral healthy breast in a patient, using a 16-channel receiver coil and identical protocol. The PUFA acquisition in the healthy breast was adjusted with voxel size of 20x20x20 mm2 and 128 averages.
Data Processing: Raw data from each channel were processed using in house software written in MATLAB (MathWorks, Natick, MA, USA). The candidate channel combination algorithms were adaptively optimised combination (AOC)3,4, S/N2 weighting5, S/N weighting6,7, Signal weighting8,9 and Equal weighting. The time domain signal of each channel in PUFA data were averaged across the number of averages, and subsequently aligned in phase. Phase shift and channel sensitivity were derived from the phase and amplitude respectively, of the dominant peak in the reference spectrum. The dominant peaks were water (4.7 ppm) for voxels containing tumour and lipid (1.3 ppm) for voxels containing healthy tissue. A weighting factor was then applied to the signal from each channel, and the combined output spectrum computed as the summation of all the weighted signals. The SNR of combined spectrum was defined as the ratio between PUFA amplitude and standard deviation of the real spectrum within the range of 9-12 ppm. The SNR improvement was calculated as percentage increase of SNR normalised to the Equal weighting algorithm. PUFA concentration was quantified using AMARES algorithm in jMRUI and referenced to total lipids in reference spectrum.
Statistical Analysis: For ex vivo experiments, paired t-tests were performed to identify performance difference in the SNR and SNR improvement among the candidate approaches. Pearson’s correlation tests were carried out to examine the relationship between the SNR improvement derived from AOC algorithm against the baseline SNR of Equal weighting and against PUFA concentration.
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