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KMID : 1114620100070010023
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Journal of the Korean Society for Breast Screening
2010 Volume.7 No. 1 p.23 ~ p.28
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Characterization of the Breast Lesions Using In Vivo Proton Magnetic Resonance Spectroscopy - Pilot Study
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Shin Hee-Jung
Kim Hak-Hee
Cha Joo-Hee
Kim Hyun-Ji
Mun Han-Song
Oh Ha-Yeun
Ha Eun-Ju
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Abstract
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Purpose: To determine whether peak integral and signal-to-noise ratio (SNR) of total choline-containing compounds(tCho) on in vivo proton MR spectroscopy could distinguish benign from malignant lesions of the breast and to find the optimal threshold of peak integral and SNR for differentiating benign from malignant lesions.
Materials and Methods: From April to July 2008, we included patients who underwent diagnostic MRI showing contrast-enhancing mass measuring larger than 1 cm in the largest diameter and MR spectroscopy in our institution. All patients had biopsy-proven benign or malignant lesions. Single-voxel proton MR spectroscopy was performed using GRACE (GeneRAlized breast spectroscopy Exam) technique. Peak integral and SNR of tCho on MR spectroscopy were obtained by three methods; without reference (Integral0, SNR0), using internal water within tumor (Integralint, SNRint), and using external reference (saline bottle) (Integralext, SNRext). Statistical analysis was performed by student t-test and receiver operating characteristics (ROC) curve.
Results: A total of 16 patients (range, 34~68 years; mean, 49 years) underwent MRI and single-voxel proton MR spectroscopy. On surgical pathology 11 patients had malignancy and the remaining 5 patients had benign lesions. The difference of integral values (integral0, integralint, and integralext) using three methods between benign and malignant lesions was not statistically significant (p=0.163, 0.498, 0.105). The SNR (SNR0, SNRint, and SNRext) of tCho using three methods showed significant difference between benign and malignant lesions (p=0.036, 0.030, <0.001). On ROC analysis, the optimal threshold for the SNR was 2.3. Thus, considering all lesions with a SNR equal to or larger than 2.3 to be malignant, we obtained sensitivity of 100% for all three methods and specificity of 80%, 70% and 100%, respectively.
Conclusion: The addition of proton MR spectroscopy to the breast MRI may help to differentiate benign from malignant lesions of the breasts.
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KEYWORD
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Breast neoplasm, Magnetic resonance imaging (MRI), Spectroscopy
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