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Proton MR spectroscopy with choline peak as malignancy marker improves positive predictive value for breast cancer diagnosis: preliminary study.

Abstract：

PURPOSE:To prospectively evaluate the diagnostic performance of magnetic resonance (MR) spectroscopy in patients with suspicious lesions or biopsy-proved cancers at MR imaging by using histologic findings as the reference standard. MATERIALS AND METHODS:After institutional review board approval and informed consent were obtained for this HIPAA-compliant study, breast MR spectroscopy was performed in patients with suspicious or biopsy-proved malignant lesions measuring 1 cm or larger at MR imaging. Single-voxel MR spectroscopy data were collected from a single rectangular volume of interest that encompassed the lesion. MR spectroscopy findings were defined as positive if the signal-to-noise ratio of the choline resonance peak was greater than or equal to 2 and as negative in all other cases. MR spectroscopy findings were then compared with histologic findings. RESULTS:A total of 56 patients (age range, 20-77 years) with 57 lesions were imaged. The median lesion size at MR imaging was 2.3 cm (range, 1-15 cm). Histologically, 31 (54%) of 57 lesions were malignant, and 26 (46%) were benign. A choline peak was present in 34 of 57 lesions (including all cancers) and in three of 26 benign lesions, giving MR spectroscopy a sensitivity of 100% and a specificity of 88%. In 40 lesions of unknown histologic type, the use of MR spectroscopy as an adjunct to MR imaging would have significantly (P<.01) increased the positive predictive value of biopsy from 35% to 82%. If biopsy had been performed only on those lesions with a choline peak at MR spectroscopy, biopsy may have been spared in 23 (58%) of 40 lesions, and none of the cancers would have been missed. CONCLUSION:Proton MR spectroscopy was successfully incorporated into breast MR imaging studies for lesions measuring 1 cm or larger. This technique may be useful in reducing the number of lesions detected at MR imaging that require biopsy.

journal_name

Radiology

journal_title

Radiology

authors

Bartella L,Morris EA,Dershaw DD,Liberman L,Thakur SB,Moskowitz C,Guido J,Huang W

doi

10.1148/radiol.2393051046

subject

Has Abstract

pub_date

2006-06-01 00:00:00

pages

686-92

issue

eissn

0033-8419

issn

1527-1315

pii

2393051046

journal_volume

239

pub_type

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Proton MR spectroscopy with choline peak as malignancy marker improves positive predictive value for breast cancer diagnosis: preliminary study.