Proton MR spectroscopy with choline peak as malignancy marker improves positive predictive value for breast cancer diagnosis: Preliminary study Journal Article

  

Authors:	Bartella, L.; Morris, E. A.; Dershaw, D. D.; Liberman, L.; Thakur, S. B.; Moskowitz, C.; Guido, J.; Huang, W.
Article Title:	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. 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. © RSNA, 2006.
Keywords:	adult; aged; middle aged; major clinical study; histopathology; review; disease marker; nuclear magnetic resonance imaging; magnetic resonance imaging; cancer diagnosis; prospective study; sensitivity and specificity; prospective studies; breast cancer; tumor markers, biological; signal noise ratio; breast neoplasms; prediction; biopsy; statistical significance; diagnostic value; predictive value of tests; magnetic resonance spectroscopy; choline; nuclear magnetic resonance spectroscopy; protons; biopsy technique; informed consent; proton nuclear magnetic resonance
Journal Title:	Radiology
Volume:	239
Issue:	3
ISSN:	0033-8419
Publisher:	Radiological Society of North America, Inc.
Date Published:	2006-06-01
Start Page:	686
End Page:	692
Language:	English
DOI:	10.1148/radiol.2393051046
PUBMED:	16603660
PROVIDER:	scopus
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-33744782053&partnerID=40&md5=0c63c0463ab256f4698d74df83d04ced
Notes:	--- - "Cited By (since 1996): 81" - "Export Date: 4 June 2012" - "CODEN: RADLA" - "Source: Scopus"

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