Proton MR spectroscopy with choline peak as malignancy marker improves positive predictive value for breast cancer diagnosis

Preliminary study

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

Research output: Contribution to journalArticle

160 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)686-692
Number of pages7
JournalRadiology
Volume239
Issue number3
DOIs
StatePublished - Jun 2006
Externally publishedYes

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

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

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; Guido, Jennifer; Huang, Wei.

In: Radiology, Vol. 239, No. 3, 06.2006, p. 686-692.

Research output: Contribution to journalArticle

Bartella, Lia ; Morris, Elizabeth A. ; Dershaw, D. David ; Liberman, Laura ; Thakur, Sunitha B. ; Moskowitz, Chaya ; Guido, Jennifer ; Huang, Wei. / Proton MR spectroscopy with choline peak as malignancy marker improves positive predictive value for breast cancer diagnosis : Preliminary study. In: Radiology. 2006 ; Vol. 239, No. 3. pp. 686-692.
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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.",
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T1 - Proton MR spectroscopy with choline peak as malignancy marker improves positive predictive value for breast cancer diagnosis

T2 - Preliminary study

AU - Bartella, Lia

AU - Morris, Elizabeth A.

AU - Dershaw, D. David

AU - Liberman, Laura

AU - Thakur, Sunitha B.

AU - Moskowitz, Chaya

AU - Guido, Jennifer

AU - Huang, Wei

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N2 - 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.

AB - 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.

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