1H-MR spectroscopy of suspicious breast mass lesions at 3T

a clinical experience

Stefania Montemezzi, Carlo Cavedon, Lucia Camera, Gabriele Meliadò, Francesca Caumo, Ilaria Baglio, Francesco Sardanelli

Research output: Contribution to journalArticle

5 Citations (Scopus)

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 languageEnglish
Pages (from-to)1-10
Number of pages10
JournalRadiologia Medica
DOIs
Publication statusAccepted/In press - Dec 15 2016

Fingerprint

Pectoralis Muscles
Breast
Magnetic Resonance Spectroscopy
Confidence Intervals
Choline
Mammary Ultrasonography
Pathology
Neoplasms
Skin
Carcinoma, Intraductal, Noninfiltrating
Signal-To-Noise Ratio
Needle Biopsy
Needles
Water
Proton Magnetic Resonance Spectroscopy

Keywords

  • Breast
  • Breast cancer
  • Magnetic resonance imaging
  • Proton magnetic resonance spectroscopy (H-MRS)

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Montemezzi, S., Cavedon, C., Camera, L., Meliadò, G., Caumo, F., Baglio, I., & Sardanelli, F. (Accepted/In press). 1H-MR spectroscopy of suspicious breast mass lesions at 3T: a clinical experience. Radiologia Medica, 1-10. https://doi.org/10.1007/s11547-016-0713-7

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 journalArticle

Montemezzi S, Cavedon C, Camera L, Meliadò G, Caumo F, Baglio I et al. 1H-MR spectroscopy of suspicious breast mass lesions at 3T: a clinical experience. Radiologia Medica. 2016 Dec 15;1-10. https://doi.org/10.1007/s11547-016-0713-7
Montemezzi, Stefania ; Cavedon, Carlo ; Camera, Lucia ; Meliadò, Gabriele ; Caumo, Francesca ; Baglio, Ilaria ; Sardanelli, Francesco. / 1H-MR spectroscopy of suspicious breast mass lesions at 3T : a clinical experience. In: Radiologia Medica. 2016 ; pp. 1-10.
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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.",
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AU - Cavedon, Carlo

AU - Camera, Lucia

AU - Meliadò, Gabriele

AU - Caumo, Francesca

AU - Baglio, Ilaria

AU - Sardanelli, Francesco

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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.

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