Enhancing nonmass lesions in the breast: Evaluation with proton (1H) MR spectroscopy Journal Article
| Authors: | Bartella, L.; Thakur, S. B.; Morris, E. A.; Dershaw, D. D.; Huang, W.; Chough, E.; Cruz, M. C.; Liberman, L. |
| Article Title: | Enhancing nonmass lesions in the breast: Evaluation with proton (1H) MR spectroscopy |
| Abstract: | Purpose: To prospectively evaluate the sensitivity and specificity of proton (hydrogen 1 [1H]) magnetic resonance (MR) spectroscopy for diagnosing malignant enhancing nonmass lesions identified at breast MR imaging, with histologic examination as the reference standard. Materials and Methods: In this HIPAA-compliant, institutional review board-approved study, in which all participants gave written informed consent, proton (1H) MR spectroscopy of the breast was performed in suspicious or biopsy-proved malignant lesions that were 1 cm or larger at MR imaging. Single-voxel proton (1H) MR spectroscopic data were collected. MR spectroscopic findings were defined as positive if the signal-to-noise ratio of the choline resonance peak was 2 or greater and as negative in all other cases. MR spectroscopic results were then compared with histologic findings, and statistical analysis was performed. Results: In 32 women (median age, 48.5 years [range, 20-63 years]) with enhancing nonmass lesions, the median lesion size at MR imaging was 2.8 cm (range, 1.2-9.0 cm). At histologic analysis, 12 (37%) of 32 lesions were malignant and 20 (63%) were benign. Positive choline findings were present in 15 of 32 lesions, including all 12 (100%) cancers and three (15%) of 20 benign lesions, giving proton (1H) MR spectroscopy a sensitivity of 100% (95% confidence interval [CI]: 74%, 100%) and a specificity of 85% (95% CI: 62%, 97%) for detection of enhancing nonmass lesions. For 25 lesions with unknown histologic features, proton (1H) MR spectroscopy would have significantly (P < .01) increased the positive predictive value of biopsy from 20% to 63%. If biopsy had been performed for only those lesions with positive choline findings at proton (1H) MR spectroscopy, biopsy might have been avoided for 17 (68%) of 25 lesions, and no cancers would have been missed. Conclusion: Proton (1H) MR spectroscopy had 100% sensitivity and 85% specificity for the detection of malignancy in enhancing nonmass lesions. © RSNA, 2007. |
| Keywords: | adult; clinical article; human tissue; middle aged; histopathology; nuclear magnetic resonance imaging; cancer diagnosis; diagnostic accuracy; prospective study; sensitivity and specificity; breast cancer; signal noise ratio; breast neoplasms; biopsy; standard; magnetic resonance spectroscopy; choline; malignant neoplastic disease; benign tumor; breast biopsy; proton nuclear magnetic resonance |
| Journal Title: | Radiology |
| Volume: | 245 |
| Issue: | 1 |
| ISSN: | 0033-8419 |
| Publisher: | Radiological Society of North America, Inc. |
| Date Published: | 2007-10-01 |
| Start Page: | 80 |
| End Page: | 87 |
| Language: | English |
| DOI: | 10.1148/radiol.2451061639 |
| PUBMED: | 17885182 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 36" - "Export Date: 17 November 2011" - "CODEN: RADLA" - "Source: Scopus" |
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