Enhancing nonmass lesions in the breast: Evaluation with proton ( 1H) MR spectroscopy

Lia Bartella, Sunitha B. Thakur, Elizabeth A. Morris, D. David Dershaw, Wei Huang, Eugenia Chough, Maria C. Cruz, Laura Liberman

Research output: Contribution to journalArticle

87 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)80-87
Number of pages8
JournalRadiology
Volume245
Issue number1
DOIs
StatePublished - Oct 2007
Externally publishedYes

Fingerprint

Breast
Magnetic Resonance Spectroscopy
Choline
Biopsy
Magnetic Resonance Imaging
Protons
Confidence Intervals
Health Insurance Portability and Accountability Act
Sensitivity and Specificity
Neoplasms
Research Ethics Committees
Signal-To-Noise Ratio
Informed Consent
Hydrogen
Proton Magnetic Resonance Spectroscopy

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Bartella, L., Thakur, S. B., Morris, E. A., Dershaw, D. D., Huang, W., Chough, E., ... Liberman, L. (2007). Enhancing nonmass lesions in the breast: Evaluation with proton ( 1H) MR spectroscopy. Radiology, 245(1), 80-87. https://doi.org/10.1148/radiol.2451061639

Enhancing nonmass lesions in the breast : Evaluation with proton ( 1H) MR spectroscopy. / Bartella, Lia; Thakur, Sunitha B.; Morris, Elizabeth A.; Dershaw, D. David; Huang, Wei; Chough, Eugenia; Cruz, Maria C.; Liberman, Laura.

In: Radiology, Vol. 245, No. 1, 10.2007, p. 80-87.

Research output: Contribution to journalArticle

Bartella, L, Thakur, SB, Morris, EA, Dershaw, DD, Huang, W, Chough, E, Cruz, MC & Liberman, L 2007, 'Enhancing nonmass lesions in the breast: Evaluation with proton ( 1H) MR spectroscopy', Radiology, vol. 245, no. 1, pp. 80-87. https://doi.org/10.1148/radiol.2451061639
Bartella, Lia ; Thakur, Sunitha B. ; Morris, Elizabeth A. ; Dershaw, D. David ; Huang, Wei ; Chough, Eugenia ; Cruz, Maria C. ; Liberman, Laura. / Enhancing nonmass lesions in the breast : Evaluation with proton ( 1H) MR spectroscopy. In: Radiology. 2007 ; Vol. 245, No. 1. pp. 80-87.
@article{146d1d1870984ef38c096f2e7a6991aa,
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.",
author = "Lia Bartella and Thakur, {Sunitha B.} and Morris, {Elizabeth A.} and Dershaw, {D. David} and Wei Huang and Eugenia Chough and Cruz, {Maria C.} and Laura Liberman",
year = "2007",
month = "10",
doi = "10.1148/radiol.2451061639",
language = "English (US)",
volume = "245",
pages = "80--87",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "1",

}

TY - JOUR

T1 - Enhancing nonmass lesions in the breast

T2 - Evaluation with proton ( 1H) MR spectroscopy

AU - Bartella, Lia

AU - Thakur, Sunitha B.

AU - Morris, Elizabeth A.

AU - Dershaw, D. David

AU - Huang, Wei

AU - Chough, Eugenia

AU - Cruz, Maria C.

AU - Liberman, Laura

PY - 2007/10

Y1 - 2007/10

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=34548685654&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34548685654&partnerID=8YFLogxK

U2 - 10.1148/radiol.2451061639

DO - 10.1148/radiol.2451061639

M3 - Article

C2 - 17885182

AN - SCOPUS:34548685654

VL - 245

SP - 80

EP - 87

JO - Radiology

JF - Radiology

SN - 0033-8419

IS - 1

ER -