In vivo magnetic resonance spectroscopy (MRS) of the breast can be used to measure the level of choline-containing compounds, which is a biomarker of malignancy. The advantage of four dimensional (4D) echo-planar correlated spectroscopic imaging (EP-COSI) enables full slice coverage of the breast facilitating recording of multi-voxel based two-dimensional (2D) MRS than the single-voxel based localized correlated spectroscopy (L-COSY). Also in addition to differentiate malignant from benign, EP-COSI can differentiate the healthy fatty from glandular. Decreased ADC values derived from diffusion weighted imaging (DWI) can be correlated with increased choline and decreased lipids quantified by the EP-COSI technique.
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