<sup>1</sup>H MR Spectroscopy and Diffusion-Weighted Imaging of the Breast: Are They Useful Tools for Characterizing Breast Lesions Before Biopsy?

Tozaki, Mitsuhiro; Fukuma, Eisuke

doi:10.2214/ajr.08.2128

Cited by 115 publications

(104 citation statements)

References 36 publications

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“…By contrast, our results of 32z (9/28) sensitivity 21 were very low, and speciˆcity was 75z (12/16) (Table 2). We believe one reason for this discrepancy is the diŠerences in types of cancers studied.…”

Section: Possibilities For Detecting Biomarkerscontrasting

confidence: 69%

“…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%

“…Our study 21 was unique in that we performed proton MRS before biopsy to exclude any eŠects of bleeding or in‰ammation after biopsy, and we evaluated Breast Imaging Recording and Data System (BI-RADS)-MRI 22 category 4 and 5 lesions. Although we had 171 cases, more lesions than in any other study, sensitivity was much lower (44z; 40/91) in our study than previous studies because target lesions were small and non-mass lesions were included.…”

Section: Possibilities For Detecting Biomarkersmentioning

confidence: 99%

“…Nevertheless, sensitivity improved to 82 z (28/34) when comparison was restricted to masses measuring 15 mm or more. However, false-negative cases have been reported even for relatively large invasive cancers; in addition to invasive ductal carcinoma, 2 they have been reported in medullary carcinoma, 16,17 mucinous carcinoma, 21 apocrine carcinoma, 21 and angiosarcoma. 23 These falsenegative cases support that biopsy must not be avoided based on negative proton MRSˆndings alone.…”

Section: Possibilities For Detecting Biomarkersmentioning

confidence: 99%

“…On the other hand, false-positive cases have also been reported inˆbroadenoma 14,16,[18][19][20][21] (Fig. 4), tubular adenoma, 13,15 intraductal papilloma, 21 atypical ductal hyperplasia, 19,20 in‰ammatory lesions with atypia, 19 mastopathy (including benign proliferative disease), 14,15,20,21 and normal breast parenchyma. 24 Based on the results described, adding MRS will sometimes be eŠective for diŠeren-tiating benign and malignant masses (Grade 2).…”

Section: Possibilities For Detecting Biomarkersmentioning

confidence: 99%

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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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Section: Possibilities For Detecting Biomarkerscontrasting

confidence: 69%

Section: Possibilities For Detecting Biomarkersmentioning

confidence: 99%

Section: Possibilities For Detecting Biomarkersmentioning

confidence: 99%

Section: Possibilities For Detecting Biomarkersmentioning

confidence: 99%

Section: Possibilities For Detecting Biomarkersmentioning

confidence: 99%

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Appropriate Timing of Proton MR Spectroscopy in Breast Cancer

Tozaki

2011

magn reson med sci

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Breast cancer detection among young survivors of pediatric Hodgkin lymphoma with screening magnetic resonance imaging

Tieu

Çiğşar

Ahmed

et al. 2014

Cancer

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BACKGROUNDFemale survivors of pediatric Hodgkin lymphoma (HL) who have received chest radiotherapy are at increased risk of breast cancer. Guidelines for early breast cancer screening among these survivors are based on little data regarding clinical outcomes. This study reports outcomes of breast cancer screening with MRI and mammography (MMG) after childhood HL.METHODSWe evaluated the results of breast MRI and MMG screening among 96 female survivors of childhood HL treated with chest radiotherapy. Outcomes measured included imaging sensitivity and specificity, breast cancer characteristics, and incidence of additional imaging and breast biopsy.RESULTSMedian age at first screening was 30 years, and the median number of MRI screening rounds was 3. Ten breast cancers were detected in 9 women at a median age of 39 years (range, 24-43 years). Half were invasive and half were preinvasive. The median size of invasive tumors was 8 mm (range, 3-15 mm), and none had lymph node involvement. Sensitivity and specificity of the screening modalities were as follows: for MRI alone, 80% and 93.5%, respectively; MMG alone, 70% and 95%, respectively; both modalities combined, 100% and 88.6%, respectively. All invasive tumors were detected by MRI. Additional investigations were required in 52 patients, (54%), and 26 patients (27%) required breast biopsy, with 10 patients requiring more than 1 biopsy.CONCLUSIONSScreening including breast MRI with MMG has high sensitivity and specificity in pediatric HL survivors, with breast cancers detected at an early stage, although it is associated with a substantial rate of additional investigations. Cancer 2014;120:2507–2513. © 2014 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.Screening female survivors of pediatric Hodgkin Lymphoma for breast cancer with MRI and mammography detected tumors at an earlier stage than prior studies of mammography alone, although a substantial proportion of women required additional tests for benign imaging findings. The 5-year cumulative incidence of invasive or preinvasive tumors after initiating screening was 10.8%.

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¹H‐magnetic resonance spectroscopy of the breast at 3.0‐T: Comparison of results obtained before and after administration of gadolinium‐based contrast agent

Kawai

Naganawa

Satake

et al. 2011

Magnetic Resonance Imaging

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Purpose: To assess the effects of gadolinium-based contrast agent (GBCA) on 1 H-magnetic resonance spectroscopy (MRS) of the breast at 3.0-T. Materials and Methods:Patients (n ¼ 98) with breast cancer (98 lesions) underwent MRS (point-resolved spectroscopy sequence [PRESS]; TR/TE, 2000/100 msec; voxel size, 15 Â 15 Â 15 mm) before the administration of GBCA. In 52 of those patients, MRS was also performed after the administration of GBCA. The voxel-of-interest (VOI) was placed by referring to the noncontrastenhanced MRI (diffusion-weighted images combined with fat-suppressed T2-weighted images). We reviewed and graded the appropriateness of VOI location compared to the correlating enhancement lesions. Integral values of the choline peak at a frequency of 3.2 ppm on MRS were compared before and after the administration of GBCA. Results:The VOI was placed correctly in 64 lesions (65%), although the VOI was placed outside the targeted lesion in 34 lesions (35%). The integral value of the choline peak on MRS decreased significantly after the administration of GBCA (P < 0.001).Conclusion: Accumulation of GBCA in breast cancer could affect the choline peak on MRS. MRS of breast cancer at 3.0-T can be recommended to be acquired before contrast-enhanced study; however, some problems remain in VOI placement with reference to the noncontrast-enhanced study.

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¹H MR Spectroscopy and Diffusion-Weighted Imaging of the Breast: Are They Useful Tools for Characterizing Breast Lesions Before Biopsy?

Abstract: (1)H MRS was useful for characterizing breast lesions measuring 15 mm or larger, and diffusion-weighted imaging was useful for characterizing lesions of any size. However, these two techniques still have potential pitfalls in relation to the diagnosis of nonmass breast lesions.

Cited by 115 publications

References 36 publications

Appropriate Timing of Proton MR Spectroscopy in Breast Cancer

Appropriate Timing of Proton MR Spectroscopy in Breast Cancer

Breast cancer detection among young survivors of pediatric Hodgkin lymphoma with screening magnetic resonance imaging

¹H‐magnetic resonance spectroscopy of the breast at 3.0‐T: Comparison of results obtained before and after administration of gadolinium‐based contrast agent

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1H MR Spectroscopy and Diffusion-Weighted Imaging of the Breast: Are They Useful Tools for Characterizing Breast Lesions Before Biopsy?

Abstract: (1)H MRS was useful for characterizing breast lesions measuring 15 mm or larger, and diffusion-weighted imaging was useful for characterizing lesions of any size. However, these two techniques still have potential pitfalls in relation to the diagnosis of nonmass breast lesions.

Cited by 115 publications

References 36 publications

Appropriate Timing of Proton MR Spectroscopy in Breast Cancer

Appropriate Timing of Proton MR Spectroscopy in Breast Cancer

Breast cancer detection among young survivors of pediatric Hodgkin lymphoma with screening magnetic resonance imaging

1H‐magnetic resonance spectroscopy of the breast at 3.0‐T: Comparison of results obtained before and after administration of gadolinium‐based contrast agent

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¹H MR Spectroscopy and Diffusion-Weighted Imaging of the Breast: Are They Useful Tools for Characterizing Breast Lesions Before Biopsy?

¹H‐magnetic resonance spectroscopy of the breast at 3.0‐T: Comparison of results obtained before and after administration of gadolinium‐based contrast agent