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Breast Imaging |
1 From the Departments of Clinical Oncology, Medical Physics Division (D.K.W.Y.), Diagnostic Radiology and Organ Imaging (H.S.C.), and Anatomical and Cellular Pathology (G.M.K.T.), Prince of Wales Hospital, 30-32 Ngan Shing St, Shatin, Hong Kong, China. Received July 25, 2000; revision requested September 13; final revision received January 4, 2001; accepted January 11. Address correspondence to D.K.W.Y. (e-mail: dkyeung@hkstar.com).
PURPOSE: To assess the clinical usefulness of localized proton (hydrogen 1) magnetic resonance (MR) spectroscopy in the characterization of contrast material–enhanced breast lesions on the basis of choline detection.
MATERIALS AND METHODS: Examinations were performed at 1.5 T with use of a standard breast coil. Contrast-enhanced MR imaging was performed in 30 consecutive patients (mean age, 50 years; age range, 20–80 years) who had nonspecific lesions (>1.5 cm in diameter) on sonograms or mammograms. Single-voxel 1H MR spectroscopy was performed in the enhancing lesions by using a point-resolved spectroscopic sequence with echo times of 38, 135, and 270 msec. MR spectroscopic and histopathologic findings were determined in blinded fashion and compared.
RESULTS: Twenty-four patients had carcinoma of the breast (tumor size, 2.0–11.2 cm; mean, 4.7 cm), and six had benign lesions (lesion size, 1.8–3.8 cm; mean, 2.7 cm). Choline was detected in 22 patients with carcinoma. Choline was not detected in five patients with benign lesions and in two patients with carcinoma. The preliminary results indicate that this technique had a sensitivity of 92%, specificity of 83%, and accuracy of 90%.
CONCLUSION: Choline can be reliably detected in less than 45 minutes in large contrast-enhanced breast lesions by using a multiecho point-resolved spectroscopic protocol. The presence of water-soluble choline metabolites obtainable with 1H MR spectroscopy could complement MR imaging findings to improve specificity and to reduce the number of unnecessary biopsies.
Index terms: Breast neoplasms, diagnosis. 00.31, 00.32 • Magnetic resonance (MR), contrast enhancement, 00.12143 • Magnetic resonance (MR), spectroscopy, 00.121411, 00.121413, 00.121415, 00.12143, 00.12145 • Metabolism, 00.59
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