Abstract
Objectives: To test 3T proton magnetic resonance spectroscopy (1H-MRS) for breast mass lesions. Methods: Patients with BI-RADS 4–5 lesions at mammography/ultrasound were prospectively enrolled. After contrast-enhanced breast MRI, single-voxel MRS (point-resolved volume selection, PRESS); pencil-beam shimming; volume of interest 1 cm3; TR/TE = 3000/135 ms) was performed. Spectra were considered reliable if the full width at half maximum (FWHM) of the water peak was ≤45 Hz. A signal-to-noise ratio of the total choline (tCho) peak at 3.21 ppm ≥2 was used as cutoff for malignancy. All lesions underwent needle sampling. Final pathology was available for all malignant lesions; for benign lesions the reference standard was final pathology or at least 1-year negative follow-up. Results: Reliable spectra were obtained in 115/127 lesions (91%), with a mean FWHM of 32.4 Hz (range 8–45 Hz). A tCho peak SNR ≥2 was detected in 66 malignant lesions (62 invasive cancers; 4 ductal carcinoma in situ) and in 3 benign lesions. Excluding lesions located ≤1 cm from the skin (n = 3) or pectoral muscle (n = 11), sensitivity was 65/73 [89%, 95% confidence interval (CI): 80–95%], and specificity 25/28 (89%) (95% CI: 72–98%). Considering only invasive cancers, sensitivity reached 61/68 (90%, 95% CI: 81–96%). MRS additional time was 8 min. Conclusions: When lesions close to the skin or pectoral muscle are excluded, 3T 1H-MRS of mass lesions ≥1 cm showed a high diagnostic performance, however, insufficient to avoid needle biopsy.
| Original language | English |
|---|---|
| Pages (from-to) | 1-10 |
| Number of pages | 10 |
| Journal | Radiologia Medica |
| DOIs | |
| Publication status | Accepted/In press - Dec 15 2016 |
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Keywords
- Breast
- Breast cancer
- Magnetic resonance imaging
- Proton magnetic resonance spectroscopy (H-MRS)
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
Cite this
1H-MR spectroscopy of suspicious breast mass lesions at 3T : a clinical experience. / Montemezzi, Stefania; Cavedon, Carlo; Camera, Lucia; Meliadò, Gabriele; Caumo, Francesca; Baglio, Ilaria; Sardanelli, Francesco.
In: Radiologia Medica, 15.12.2016, p. 1-10.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - 1H-MR spectroscopy of suspicious breast mass lesions at 3T
T2 - a clinical experience
AU - Montemezzi, Stefania
AU - Cavedon, Carlo
AU - Camera, Lucia
AU - Meliadò, Gabriele
AU - Caumo, Francesca
AU - Baglio, Ilaria
AU - Sardanelli, Francesco
PY - 2016/12/15
Y1 - 2016/12/15
N2 - Objectives: To test 3T proton magnetic resonance spectroscopy (1H-MRS) for breast mass lesions. Methods: Patients with BI-RADS 4–5 lesions at mammography/ultrasound were prospectively enrolled. After contrast-enhanced breast MRI, single-voxel MRS (point-resolved volume selection, PRESS); pencil-beam shimming; volume of interest 1 cm3; TR/TE = 3000/135 ms) was performed. Spectra were considered reliable if the full width at half maximum (FWHM) of the water peak was ≤45 Hz. A signal-to-noise ratio of the total choline (tCho) peak at 3.21 ppm ≥2 was used as cutoff for malignancy. All lesions underwent needle sampling. Final pathology was available for all malignant lesions; for benign lesions the reference standard was final pathology or at least 1-year negative follow-up. Results: Reliable spectra were obtained in 115/127 lesions (91%), with a mean FWHM of 32.4 Hz (range 8–45 Hz). A tCho peak SNR ≥2 was detected in 66 malignant lesions (62 invasive cancers; 4 ductal carcinoma in situ) and in 3 benign lesions. Excluding lesions located ≤1 cm from the skin (n = 3) or pectoral muscle (n = 11), sensitivity was 65/73 [89%, 95% confidence interval (CI): 80–95%], and specificity 25/28 (89%) (95% CI: 72–98%). Considering only invasive cancers, sensitivity reached 61/68 (90%, 95% CI: 81–96%). MRS additional time was 8 min. Conclusions: When lesions close to the skin or pectoral muscle are excluded, 3T 1H-MRS of mass lesions ≥1 cm showed a high diagnostic performance, however, insufficient to avoid needle biopsy.
AB - Objectives: To test 3T proton magnetic resonance spectroscopy (1H-MRS) for breast mass lesions. Methods: Patients with BI-RADS 4–5 lesions at mammography/ultrasound were prospectively enrolled. After contrast-enhanced breast MRI, single-voxel MRS (point-resolved volume selection, PRESS); pencil-beam shimming; volume of interest 1 cm3; TR/TE = 3000/135 ms) was performed. Spectra were considered reliable if the full width at half maximum (FWHM) of the water peak was ≤45 Hz. A signal-to-noise ratio of the total choline (tCho) peak at 3.21 ppm ≥2 was used as cutoff for malignancy. All lesions underwent needle sampling. Final pathology was available for all malignant lesions; for benign lesions the reference standard was final pathology or at least 1-year negative follow-up. Results: Reliable spectra were obtained in 115/127 lesions (91%), with a mean FWHM of 32.4 Hz (range 8–45 Hz). A tCho peak SNR ≥2 was detected in 66 malignant lesions (62 invasive cancers; 4 ductal carcinoma in situ) and in 3 benign lesions. Excluding lesions located ≤1 cm from the skin (n = 3) or pectoral muscle (n = 11), sensitivity was 65/73 [89%, 95% confidence interval (CI): 80–95%], and specificity 25/28 (89%) (95% CI: 72–98%). Considering only invasive cancers, sensitivity reached 61/68 (90%, 95% CI: 81–96%). MRS additional time was 8 min. Conclusions: When lesions close to the skin or pectoral muscle are excluded, 3T 1H-MRS of mass lesions ≥1 cm showed a high diagnostic performance, however, insufficient to avoid needle biopsy.
KW - Breast
KW - Breast cancer
KW - Magnetic resonance imaging
KW - Proton magnetic resonance spectroscopy (H-MRS)
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U2 - 10.1007/s11547-016-0713-7
DO - 10.1007/s11547-016-0713-7
M3 - Article
SP - 1
EP - 10
JO - Radiologia Medica
JF - Radiologia Medica
SN - 0033-8362
ER -