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A new method to reduce false positive results in breast MRI by evaluation of multiple spectral regions in proton MR-spectroscopy.

Abstract：

OBJECTIVES:To investigate whether the evaluation of multiple spectral regions can increase the diagnostic performance of 1H-MRS of the breast and reduce false positive findings. METHODS:93 patients (mean age 56 years, range 23-79) undergoing breast MRI for routine clinical indications on a 1.5T scanner were eligible for this IRB-approved prospective study. Suspicious enhancing lesions ≥8mm underwent single-voxel point-resolved 1H-MRS (PRESS, TR=2000ms, TE=272ms). Histology showed 69 malignant and 24 benign lesions. The Signal-to-Noise ratio of choline, olefinic acids and the water-to-methylene ratio were measured. The area under the ROC-curve (AUC) was used to evaluate single measurements. Combined diagnostic accuracy was explored using a 10-fold cross-validated Chi-squared automatic interaction detection (CHAID) analysis. Inter-reader agreement was evaluated in a subset of patients. RESULTS:A significant AUC for differentiation between benign and malignant lesions was identified for choline (0.733, P=0.001), olefinic acids (0.769, P=0.0001) and water-to-methylene ratio (0.704, P=0.003). All three variables were included in a classification algorithm using CHAID methodology. Using this classification, 70.8% (17/24) false positive diagnoses in benign lesions would have been avoided. Inter-reader agreement was almost perfect. CONCLUSIONS:The combined evaluation of multiple spectral regions can increase the diagnostic performance of 1H-MRS and potentially reduce false positive findings.

journal_name

Eur J Radiol

journal_title

European journal of radiology

authors

Clauser P,Marcon M,Dietzel M,Baltzer PAT

doi

10.1016/j.ejrad.2017.04.014

subject

Has Abstract

pub_date

2017-07-01 00:00:00

pages

51-57

eissn

0720-048X

issn

1872-7727

pii

S0720-048X(17)30162-6

journal_volume

92

pub_type

杂志文章

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