In vivo 1H-MRS evaluation of malignant and benign breast diseases

Kim, Jongki; Park, Sung-Hwan; Lee, Hyun Mee; Lee, Young-Hwan; Sung, Nak-Kwan; Chung, Duck-Soo; Kim, Ok-Dong

doi:10.1016/s0960-9776(03)00012-2

Cited by 55 publications

(45 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The presence of choline peaks is a diagnostic metabolic marker in malignant breast tumors. Choline is observed at 3.24 ppm in the spectrum and is not seen in benign lesions (15). In MRS, we detected marked water and lipid peaks; however, choline peaks were not detected.…”

Section: Resultsmentioning

confidence: 57%

Advanced MRI findings of breast hamartoma

Erdem

Karakaş²,

Işık³

et al. 2009

Diagn Interv Radiol

View full text Add to dashboard Cite

A lthough classical textbooks state that hamartomas are rare tumors, radiologists who use both mammography and ultrasonography (US) frequently encounter hamartomas in their daily practices. These tumors present as painless and mobile masses with well-defined borders. They are composed of variable amounts of glandular tissue, fat and fibrous elements that produce a mass of disorganized but mature specialized cells or tissues (1-3). The complete resemblance of the tissues to normal breast parenchyma and an occasional admixture of other elements limit the contribution of the pathological examination to the diagnosis. The correlation between clinical and radiological findings is of paramount importance (4, 5). Although mammographic and US findings of breast hamartomas have been well defined, advanced magnetic resonance imaging (MRI) findings in such cases have not been previously described. This study provides a description of dynamic contrastenhanced MRI (DCE-MRI), diffusion-weighted imaging (DWI) and MR spectroscopy (MRS) findings in breast hamartomas. Materials and methodsThe study was executed retrospectively based on the records of our breast imaging center over a 24-month period. During that time, all examinations were performed by the same radiologist (G.E.), who is a specialist in breast imaging. Eight patients with a diagnosis of breast hamartoma were found in the center's registry. The ages of these patients ranged from 22 to 54 years (mean age, 38.6 years; SD, 14.6 years). These patients were initially examined with US and/or mammography either as part of a routine screening or as a work-up for palpable breast masses. Cases in which the masses were diagnosed as hamartomas were further examined via MRI. These patients each underwent an MRI examination to reveal advanced imaging characteristics of these rare lesions as part of an institutional research study on DCE-MRI, DWI and MRS. Informed consent was obtained from all patients. MRI scans were conducted using a 1.5 T scanner (Intera Master, Gyroscan, Philips, The Netherlands) with a gradient force of 32 mT/m. Images were obtained in the prone position using a standard breast coil.Axial and sagittal T1-weighted (TR/TE, 550/11 ms), T2-weighted (TR/ TE, 2429/120 ms), and fat-suppressed T1-weighted images were obtained for conventional MRI examinations. DCE-MRI was performed after intravenous administration of 0.1 mmol/kg gadopentetate dimeglumine (Gd-DTPA) with an automatic injector (Spectris, Medrad, USA). In this study, 12 consecutive T1-weighted fast field echo (FFE) sequences, each lasting 20 seconds, were obtained in four minutes. After subtracting the initial unenhanced images from the remaining enhanced images, the regions of interest (ROIs) PURPOSEAlthough it has been stated that breast hamartomas are rare tumors, radiologists frequently encounter them in their daily practices. Fat, glandular and fibrous tissues all produce a mass of disorganized but mature specialized cells. Because hamartomas do not have specific diagnostic histological features, ...

show abstract

Section: Resultsmentioning

confidence: 57%

Advanced MRI findings of breast hamartoma

Erdem

Karakaş²,

Işık³

et al. 2009

Diagn Interv Radiol

View full text Add to dashboard Cite

show abstract

“…Some benign cases such as FCC, as shown in 2 patients in our study, however, also show positive choline level. Kim JK et al [23] showed that Cho was not only detected in a number of benign diseases including tubular adenomas and FCC but also in normal feeding breast tissue. Our limited data showed, although choline might be detected in benign disease, the choline level is lower than that of the malignant breast cancer (our unpublished data).…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging features of fibrocystic change of the breast

Chen

Liu

Baek

et al. 2008

Magnetic Resonance Imaging

View full text Add to dashboard Cite

Purpose-Studies specifically reporting MR imaging of fibrocystic change (FCC) of the breast are very few and its MR imaging features are not clearly known. The purpose of this study was to analyze the MR imaging features of FCC of the breast.Materials and Methods-Thirty one patients of pathologically proved FCC of the breast were retrospectively reviewed. The MRI study was performed using a 1.5 T MR scanner with standard bilateral breast coil. The imaging protocol consisted of pre-contrast T1W imaging and dynamic contrast-enhanced axial T1W imaging. The MRI features were interpreted based on the morphologic and enhancement kinetic descriptors defined on ACR BIRADS-MRI lexicon.Results-FCC of the breast had a wide spectrum of morphologic and kinetic features on MRI. Two types of FCC were found, including a more diffuse type of non-mass lesion (12/31, 39%) showing benign enhancement kinetic pattern with medium wash-in in early phase (9/10, 90%) and a focal mass type lesion (11/31, 35%) with enhancement kinetic usually showing rapid up-slope mimicking a breast cancer (8/11, 73%).Conclusion-MRI is able to elaborate the diverse imaging features of fibrocystic change of the breast. Our result showed that FCC presenting as focal mass type lesion were usually over-diagnosed as malignancy. Understanding MR imaging of FCC is important to determine which cohort of patients should be followed up alone or receive aggressive management.

show abstract

“…However, several other metabolites of interest, including N-acetyl-aspartate (2.02 ppm), Cho (3.2 ppm), creatine (3.02 ppm), myo-inositol (mI) (3.57 ppm), and lactate (1.32 ppm) can also be detected. MRS has previously been shown to differentiate benign from malignant breast lesions through the detection of increased levels of composite Cho compounds (free Cho, PC, and GPC) (6,(8)(9)(10)(11)(12)(13)(14)(15)(16).…”

Section: Discussionmentioning

confidence: 99%

Single voxel in vivo proton magnetic resonance spectroscopy of breast lesions: experience in 77 cases

Başara

Örgüç²,

Coşkun³

2012

Diagn Interv Radiol

View full text Add to dashboard Cite

ORIGINAL ARTICLE PURPOSE We aimed to determine the value of in vivo single voxel proton magnetic resonance spectroscopy (MRS) in characterizing breast lesions. MATERIALS AND METHODSBreast MRS was performed in 77 patients. Choline resonance peak at 3.2 parts per million (ppm) was defined positive when it was at least two times higher than baseline. MRS findings were compared with the final diagnosis of cases for two different values (3.23 and 3.28 ppm). RESULTSThirty-one malignant and 13 benign lesions had choline peaks. Sensitivity was 84%, specificity was 64%. Positive likelihood ratio (LHR) was 2.32, negative LHR was 0.25. Twenty-two malignant and 5 benign lesions had a peak at 3.23 ppm. Nine malignant and 8 benign lesions had a peak at 3.28 ppm. When 3.23 ppm was accepted as positive; sensitivity, specificity, and positive and negative LHRs were 79%, 82%, 4.4, and 0.26, respectively. CONCLUSION MRS provides additional parameters on evaluation of breast lesions. However, MRS of breast has some false negative results, thus it is still insufficient in clinical diagnosis.T raditional approaches for the assessment of breast lesions have limited sensitivity and specificity. Since mammography, ultrasonography (US), and contrast-enhanced magnetic resonance imaging (MRI) are unable to reliably distinguish between malignant and benign tissues, the final diagnosis of cancer is most often based on histopathological analysis.Contrast-enhanced MRI can detect breast cancers with a high degree of sensitivity (ranging from 95% to 100%), but it also has an increased rate of false-positive enhancement of benign breast lesions. This results in a relatively low specificity that ranges from 37% to 97% and could contribute to increased rate of biopsy. Approximately 75% of the breast tumors detected by mammography and approximately 50% of contrast-enhanced lesions detected by MRI have benign histology (1). One method of for avoiding these deficiencies is magnetic resonance spectroscopy (MRS), which offers a noninvasive approach for differentiating malignant from benign lesions.Proton ( 1 H) MRS is a noninvasive in vivo method that can be used to study metabolic changes in several pathologic conditions of different organs. The signal primarily comes from protons in water and lipids, and it is widely used in brain and prostate imaging. Although several metabolites, such as creatine, inositol, glucose N-acetyl aspartate, alanine and lactate, can be detected by MRS, the diagnostic value of MRS in breast imaging is typically based on the detection of elevated levels of choline compounds like phosphocholine (PC) and glycerophosphocholine (GPC) (2). In support of this, recent ex vivo MRS studies of different tumors have shown elevated levels of cholines (Ch), which can serve as tumor markers (3-5). The aim of this study was to determine the value of MRS in enhancing the specificity of the noninvasive analysis of potentially malignant breast lesions. Materials and methodsThe study was approved by the institutional review board of our instit...

show abstract

In vivo 1H-MRS evaluation of malignant and benign breast diseases

Cited by 55 publications

References 10 publications

Advanced MRI findings of breast hamartoma

Advanced MRI findings of breast hamartoma

Magnetic resonance imaging features of fibrocystic change of the breast

Single voxel in vivo proton magnetic resonance spectroscopy of breast lesions: experience in 77 cases

Contact Info

Product

Resources

About