Feasibility of MR metabolomics for immediate analysis of resection margins during breast cancer surgery

PLoS One. 2013 Apr 17;8(4):e61578. doi: 10.1371/journal.pone.0061578. Print 2013.

Abstract

In this study, the feasibility of high resolution magic angle spinning (HR MAS) magnetic resonance spectroscopy (MRS) of small tissue biopsies to distinguish between tumor and non-involved adjacent tissue was investigated. With the current methods, delineation of the tumor borders during breast cancer surgery is a challenging task for the surgeon, and a significant number of re-surgeries occur. We analyzed 328 tissue samples from 228 breast cancer patients using HR MAS MRS. Partial least squares discriminant analysis (PLS-DA) was applied to discriminate between tumor and non-involved adjacent tissue. Using proper double cross validation, high sensitivity and specificity of 91% and 93%, respectively was achieved. Analysis of the loading profiles from both principal component analysis (PCA) and PLS-DA showed the choline-containing metabolites as main biomarkers for tumor content, with phosphocholine being especially high in tumor tissue. Other indicative metabolites include glycine, taurine and glucose. We conclude that metabolic profiling by HR MAS MRS may be a potential method for on-line analysis of resection margins during breast cancer surgery to reduce the number of re-surgeries and risk of local recurrence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Breast Neoplasms / metabolism*
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery*
  • Choline / metabolism
  • Discriminant Analysis
  • Feasibility Studies
  • Female
  • Humans
  • Least-Squares Analysis
  • Magnetic Resonance Spectroscopy*
  • Metabolomics*
  • Middle Aged
  • Principal Component Analysis

Substances

  • Choline

Grants and funding

This study was supported by the Liaison Committee between the Central Norway Regional Health Authority (RHA) and the Norwegian University of Science and Technology (NTNU). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.