Proton MR Spectroscopy with Choline Peak as Malignancy Marker Improves Positive Predictive Value for Breast Cancer Diagnosis: Preliminary Study

Bartella, Lia; Morris, Elizabeth A.; Dershaw, D. David; Liberman, Laura; Thakur, Sunitha B.; Moskowitz, Chaya S.; Guido, Jennifer; Huang, Wei

doi:10.1148/radiol.2393051046

Cited by 191 publications

(139 citation statements)

References 23 publications

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“…Only one of 5 DCIS cases showed a Cho peak on MRS. The prior reports suggest that DCIS may not always demonstrate a Cho peak 1,8,10,11,13 , and our results supports these ndings.…”

Section: Sensitivity and Detectability Of The Choline Peak On A 30t supporting

confidence: 91%

Proton (<sup>1</sup>H) MR Spectroscopy of the Breast at 3.0T: Detectability of the Choline Peak of Breast Cancer in Comparison with a 1.5T Imager

Saiki

Hirose

Suyama

et al. 2010

Showa Univ J Med Sci

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IntroductionMagnetic resonance imaging is highly sensitive for detecting breast lesions in general.However, the speci city for malignant tissue is relatively low. The differentiation of malignant from benign breast lesion in contrast-enhanced MRI is determined by tumor morphology and kinetic analysis of dynamic studies. Breast proton magnetic resonance spectroscopy 1 H-MR spectroscopy MRS of the breast demonstrated that choline could be detected in breast cancers. The purpose of this study was to evaluate the detectability of the choline peak Tcho in breast cancer using a 3.0T imager. A total of 52 female patients who underwent MR imaging were evaluated. Localization methods included the SVS and PRESS, with acquisition times of approximately 5 minutes. Correlations among tumor size, histological type, and the presence of Tcho were evaluated. Of 52 breast lesions that were pathologically diagnosed, 50 were malignant 45 invasive ductal carcinomas IDC , ve ductal carcinomas in situ DCIS and 2 were benign. The presence of Tcho was evaluated in 50 cases. The average diameter of malignant tumors was 2.2 cm and that of benign tumors was 1.9 cm. Tcho was identified in 24 of 48 breast cancers sensitivity 50 , specificity 100 . There was a signi cant difference between the identi cation in tumors according to tumor size. Tcho was identi ed in 76.9of IDC cases with a diameter greater than the voxel size 1.5 cm , while it was identi ed in only 17.6 of tumors less than 1.5 cm in size. Tcho was identi ed in approximately 77 of breast cancer tumors overall with a diameter greater than the voxel size. The result was comparable with the detectability at 1.5T, although the acquisition times at 3.0T were much shorter than at 1.5T. The advantages at 3.0T include the ability to investigate smaller lesions within a shorter time frame.

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“…Only one of 5 DCIS cases showed a Cho peak on MRS. The prior reports suggest that DCIS may not always demonstrate a Cho peak 1,8,10,11,13 , and our results supports these ndings.…”

Section: Sensitivity and Detectability Of The Choline Peak On A 30t supporting

confidence: 91%

Proton (<sup>1</sup>H) MR Spectroscopy of the Breast at 3.0T: Detectability of the Choline Peak of Breast Cancer in Comparison with a 1.5T Imager

Saiki

Hirose

Suyama

et al. 2010

Showa Univ J Med Sci

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“…MRS is usually performed with contrast-enhanced MR imaging because correct positioning of the volume of interest in suspicious lesions is more difficult without image guidance provided by contrast-enhanced MR imaging, although gadolinium contrast agents have been reported to influence the detection of choline-containing compounds with in vivo 1H MRS (20). In addition, recent studies showed that the addition of quantitative 1H MR spectroscopy to the contrast-enhanced breast MR imaging examination may help to distinguish benign from malignant breast lesions (21)(22)(23).…”

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confidence: 99%

Enhanced mass on contrast‐enhanced breast MR imaging: Lesion characterization using combination of dynamic contrast‐enhanced and diffusion‐weighted MR images

Yabuuchi

Matsuo

Okafuji

et al. 2008

Magnetic Resonance Imaging

176

166

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Purpose:To evaluate the diagnostic accuracy of a combination of dynamic contrast-enhanced MR imaging (DCE-MRI) and diffusion-weighted MR imaging (DWI) in characterization of enhanced mass on breast MR imaging and to find the strongest discriminators between carcinoma and benignancy. Materials and Methods:We analyzed consecutive breast MR images in 270 patients; however, 13 lesions in 93 patients were excluded based on our criteria. We analyzed tumor size, shape, margin, internal mass enhancement, kinetic curve pattern, and apparent diffusion coefficient (ADC) values. We applied univariate and multivariate analyses to find the strongest indicators of malignancy and calculate a predictive probability for malignancy. We added the corresponding categories to these prediction probabilities for malignancy and calculated diagnostic accuracy when we consider category 4b, 4c, and 5 lesions as malignant and category 4a, 3, and 2 lesions as benign. In a validation study, 75 enhancing lesions in 71 patients were examined consecutively.Results: Irregular margin, heterogeneous internal enhancement, rim enhancement, plateau time-intensity curve (TIC) pattern, and washout TIC pattern were the strongest indicators of malignancy as well as past studies, and ADC values less than 1.1 ϫ 10 Ϫ3 mm 2 /s were also the strongest indicators of malignancy. In a validation study, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 92% (56/61), 86% (12/14), 97% (56/58), 71% (12/17), and 91% (68/75), respectively. Conclusion:The combination of DWI and DCE-MRI could produce high diagnostic accuracy in the characterization of enhanced mass on breast MR imaging.

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“…3,[13][14][15][16][17][18][19][20][21] The data in the 9 papers excluding our own 21 demonstrated sensitivity of 70 to 100 z and speciˆcity of 67 to 100z. Sensitivity in the 9 articles as a whole was 88z (165/187), and speciˆc-ity was 88z (126/144), and reported diagnostic performance was related to lesions one cm or greater in size.…”

Section: Possibilities For Detecting Biomarkersmentioning

confidence: 99%

Appropriate Timing of Proton MR Spectroscopy in Breast Cancer

Tozaki

2011

magn reson med sci

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Proton magnetic resonance (MR) spectroscopy (MRS) of the mammary gland region has customarily been used in basic research but is now commonly performed in clinical practice as MR techniques have improved. To debate its usefulness in a variety ofˆelds and ultimately grade the timing of its use, a symposium entitled``Clinical Application and the Latest Technology of MRS-Timing of the Addition of MRS'' was presented in 2009 at the 37th Annual Meeting of the Japanese Society for Magnetic Resonance in Medicine (JSMRM). MRS timing was classiˆed into 3 grades according to when its addition: is always better, Grade 1; will sometimes be eŠective, Grade 2; and can provide only supplemental information, Grade 3. We describe the content of the meeting session on``Timing of the Addition of MRS in the Breast Cancer Field,'' explain the reasons for the timing classiˆcations, and review previous papers.

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Proton MR Spectroscopy with Choline Peak as Malignancy Marker Improves Positive Predictive Value for Breast Cancer Diagnosis: Preliminary Study

Abstract: 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.

Cited by 191 publications

References 23 publications

Proton (<sup>1</sup>H) MR Spectroscopy of the Breast at 3.0T: Detectability of the Choline Peak of Breast Cancer in Comparison with a 1.5T Imager

Proton (<sup>1</sup>H) MR Spectroscopy of the Breast at 3.0T: Detectability of the Choline Peak of Breast Cancer in Comparison with a 1.5T Imager

Enhanced mass on contrast‐enhanced breast MR imaging: Lesion characterization using combination of dynamic contrast‐enhanced and diffusion‐weighted MR images

Appropriate Timing of Proton MR Spectroscopy in Breast Cancer

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