Three patients with biopsy-confirmed, infiltrating ductal carcinoma were studied at 3 Tesla to monitor changes in total Choline during neoadjuvant chemotherapy in comparison with dynamic contrast enhanced MRI. A novel bilateral high-speed 3D Proton-Echo-Planar-Spectroscopic-Imaging (PEPSI) protocol with integrated water reference acquisition mapped decreases in total Choline early during treatment in 2 HER2-negative patients with partial pathologic response, but not in the third HER2-positive patient. Surgical clip related B0-inhomogeneity impacted both PEPSI and DCE-MRI measurements. To address this limitation, we developed a novel expanded k-space encoding approach for PEPSI and demonstrated signal recovery in tissue regions affected by dephasing.
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