Abstract

PurposeTo assess the additional value of quantitative tCho evaluation to diagnose malignancy and lymph node metastases in suspicious lesions on multiparametric breast MRI (mpMRI, BI-RADS 4, and BI-RADS 5).MethodsOne hundred twenty-one patients that demonstrated suspicious multiparametric breast MRI lesions using DCE, T2w, and diffusion-weighted (DW) images were prospectively enrolled in this IRB-approved study. All underwent single-voxel proton MR spectroscopy (1H-MRS, point-resolved spectroscopy sequence, TR 2000 ms, TE 272 ms) with and without water suppression. The total choline (tCho) amplitude was measured and normalized to millimoles/liter according to established methodology by two independent readers (R1, R2). ROC-analysis was employed to predict malignancy and lymph node status by tCho results.ResultsOne hundred three patients with 74 malignant and 29 benign lesions had full 1H-MRS data. The area under the ROC curve (AUC) for prediction of malignancy was 0.816 (R1) and 0.809 (R2). A cutoff of 0.8 mmol/l tCho could diagnose malignancy with a sensitivity of > 95%. For prediction of lymph node metastases, tCho measurements achieved an AUC of 0.760 (R1) and 0.788 (R2). At tCho levels < 2.4 mmol/l, no metastatic lymph nodes were found.ConclusionQuantitative tCho evaluation from 1H-MRS allowed diagnose malignancy and lymph node status in breast lesions suspicious on multiparametric breast MRI. tCho therefore demonstrated the potential to downgrade suspicious mpMRI lesions and stratify the risk of lymph node metastases for improved patient management.Key Points• Quantitative tCho evaluation can distinguish benign from malignant breast lesions suspicious after multiparametric MRI assessment.• Quantitative tCho levels are associated with lymph node status in breast cancer.• Quantitative tCho levels are higher in hormonal receptor positive compared to hormonal receptor negative lesions.

Highlights

  • MethodsBreast cancer is a major burden on the female population and subsequently for the socioeconomic system

  • Quantitative total choline (tCho) levels are associated with lymph node status in breast cancer

  • Quantitative tCho levels are higher in hormonal receptor positive compared to hormonal receptor negative lesions

Read more

Summary

Introduction

MethodsBreast cancer is a major burden on the female population and subsequently for the socioeconomic system. Screening with mammography and additional evaluations with ultrasound and MRI add in cancer diagnosis and assessment of disease [2,3,4]. To select the best treatment option, breast cancer needs to be diagnosed and accurately characterized. Breast cancer type can be determined using image-guided biopsies, biopsies only provide information on the biopsied part of the lesion which is subject to selection bias, potentially leading to inaccurate diagnoses. It has been demonstrated that imaging characteristics, in particular those derived from breast MRI, can help to identify prognostically relevant information [6,7,8,9,10,11]. There is a need for more accurate and non-invasive methods to determine lymph nodes status before treatment

Objectives
Results
Discussion
Conclusion
Full Text
Paper version not known

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.