Can the Signal-to-Noise Ratio of Choline in Magnetic Resonance Spectroscopy Reflect the Aggressiveness of Endometrial Cancer?

Rationale and Objectives To differentiate endometrial cancer (ECa) from benign lesions in endometrial or in submucosa (BLs-ESm), and investigate whether the signal-to-noise ratio (SNR) of choline-containing compounds (Cho) obtained from three-dimensional1 H magnetic resonance spectroscopy (MRS) is associated with the aggressiveness of ECa. Materials and Methods Thirty-three patients with ECa and 15 patients with BLs-ESm underwent preoperative multivoxel1 H MRS at 3 T MR. The amplitude of Cho peak of each voxel was recorded, and the corresponding SNR of Cho peak (ChoSNR ) was calculated. The maximum ChoSNR (max ChoSNR ) for each lesion was identified. The max ChoSNR of ECa and BLs-ESm, as well as type I ECa and type II ECa, was compared. The relationship between max ChoSNR and pathologic characteristics of tumors, including tumor grade, stage, type, and tumor size, was analyzed. Results The mean max ChoSNR (±standard deviation [SD]) was 30.93 ± 16.89 for ECa and 10.40 ± 3.07 for BLs-ESm ( P