Improved diagnostic accuracy in differentiating malignant and benign lesions using single-voxel proton MRS of the breast at 3 T MRI

AIM: To investigate the diagnostic accuracy of single-voxel proton magnetic resonance spectroscopy (SV (1)H MRS) by quantifying total choline-containing compounds (tCho) in differentiating malignant from benign lesions, and subsequently, to analyse the relationship of tCho levels in malignant breast...

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Main Authors: Suppiah, Subapriya, Rahmat, Kartini, Md Shah, Mohammad Nazri, Che Ahmad, Azlan, Tan, L. K., Abdul Aziz, Yang Faridah, Vijayananthan, Anushya, Wui, A. L., Yip, Cheng Har
Format: Article
Language:English
Published: Elsevier 2013
Online Access:http://psasir.upm.edu.my/id/eprint/29597/
http://psasir.upm.edu.my/id/eprint/29597/1/Improved%20diagnostic%20accuracy%20in%20differentiating%20malignant%20and%20benign%20lesions%20using%20single.pdf
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author Suppiah, Subapriya
Rahmat, Kartini
Md Shah, Mohammad Nazri
Che Ahmad, Azlan
Tan, L. K.
Abdul Aziz, Yang Faridah
Vijayananthan, Anushya
Wui, A. L.
Yip, Cheng Har
author_facet Suppiah, Subapriya
Rahmat, Kartini
Md Shah, Mohammad Nazri
Che Ahmad, Azlan
Tan, L. K.
Abdul Aziz, Yang Faridah
Vijayananthan, Anushya
Wui, A. L.
Yip, Cheng Har
author_sort Suppiah, Subapriya
building UPM Institutional Repository
collection Online Access
description AIM: To investigate the diagnostic accuracy of single-voxel proton magnetic resonance spectroscopy (SV (1)H MRS) by quantifying total choline-containing compounds (tCho) in differentiating malignant from benign lesions, and subsequently, to analyse the relationship of tCho levels in malignant breast lesions with their histopathological subtypes. MATERIALS AND METHODS: A prospective study of SV 1H MRS was performed following dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in 61 women using a 3 T MR system. All lesions (n = 57) were analysed for characteristics of morphology, contrast-enhancement kinetics, and tCho peak heights at SV (1)H MRS that were two-times above baseline. Subsequently, the tCho in selected lesions (n = 32) was quantified by calculating the area under the curve, and a tCho concentration equal to or greater than the cut-off value was considered to represent malignancy. The relationship between tCho in invasive ductal carcinomas (IDCs) and their Bloom & Richardson grading of malignancy was assessed. RESULTS: Fifty-two patients (57 lesions; 42 malignant and 15 benign) were analysed. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), of predicting malignancy were 100, 73.3, 91.3, and 100%, respectively, using DCE-MRI and 95.2, 93.3, 97.6, and 87.5%, respectively, using SV (1)H MRS. The tCho cut-off for receiver operating characteristic (ROC) curve was 0.33 mmol/l. The relationship between tCho levels in malignant breast lesions with their histopathological subtypes was not statistically significant (p = 0.3). CONCLUSION: Good correlation between tCho peaks and malignancy, enables SV (1)H MRS to be used as a clinically applicable, simple, yet non-invasive tool for improved specificity and diagnostic accuracy in detecting breast cancer.
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spelling upm-295972016-09-14T08:16:58Z http://psasir.upm.edu.my/id/eprint/29597/ Improved diagnostic accuracy in differentiating malignant and benign lesions using single-voxel proton MRS of the breast at 3 T MRI Suppiah, Subapriya Rahmat, Kartini Md Shah, Mohammad Nazri Che Ahmad, Azlan Tan, L. K. Abdul Aziz, Yang Faridah Vijayananthan, Anushya Wui, A. L. Yip, Cheng Har AIM: To investigate the diagnostic accuracy of single-voxel proton magnetic resonance spectroscopy (SV (1)H MRS) by quantifying total choline-containing compounds (tCho) in differentiating malignant from benign lesions, and subsequently, to analyse the relationship of tCho levels in malignant breast lesions with their histopathological subtypes. MATERIALS AND METHODS: A prospective study of SV 1H MRS was performed following dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in 61 women using a 3 T MR system. All lesions (n = 57) were analysed for characteristics of morphology, contrast-enhancement kinetics, and tCho peak heights at SV (1)H MRS that were two-times above baseline. Subsequently, the tCho in selected lesions (n = 32) was quantified by calculating the area under the curve, and a tCho concentration equal to or greater than the cut-off value was considered to represent malignancy. The relationship between tCho in invasive ductal carcinomas (IDCs) and their Bloom & Richardson grading of malignancy was assessed. RESULTS: Fifty-two patients (57 lesions; 42 malignant and 15 benign) were analysed. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), of predicting malignancy were 100, 73.3, 91.3, and 100%, respectively, using DCE-MRI and 95.2, 93.3, 97.6, and 87.5%, respectively, using SV (1)H MRS. The tCho cut-off for receiver operating characteristic (ROC) curve was 0.33 mmol/l. The relationship between tCho levels in malignant breast lesions with their histopathological subtypes was not statistically significant (p = 0.3). CONCLUSION: Good correlation between tCho peaks and malignancy, enables SV (1)H MRS to be used as a clinically applicable, simple, yet non-invasive tool for improved specificity and diagnostic accuracy in detecting breast cancer. Elsevier 2013-09 Article PeerReviewed application/pdf en http://psasir.upm.edu.my/id/eprint/29597/1/Improved%20diagnostic%20accuracy%20in%20differentiating%20malignant%20and%20benign%20lesions%20using%20single.pdf Suppiah, Subapriya and Rahmat, Kartini and Md Shah, Mohammad Nazri and Che Ahmad, Azlan and Tan, L. K. and Abdul Aziz, Yang Faridah and Vijayananthan, Anushya and Wui, A. L. and Yip, Cheng Har (2013) Improved diagnostic accuracy in differentiating malignant and benign lesions using single-voxel proton MRS of the breast at 3 T MRI. Clinical Radiology, 68 (9). e502-e510. ISSN 0009-9260; ESSN: 1365-229X 10.1016/j.crad.2013.04.002
spellingShingle Suppiah, Subapriya
Rahmat, Kartini
Md Shah, Mohammad Nazri
Che Ahmad, Azlan
Tan, L. K.
Abdul Aziz, Yang Faridah
Vijayananthan, Anushya
Wui, A. L.
Yip, Cheng Har
Improved diagnostic accuracy in differentiating malignant and benign lesions using single-voxel proton MRS of the breast at 3 T MRI
title Improved diagnostic accuracy in differentiating malignant and benign lesions using single-voxel proton MRS of the breast at 3 T MRI
title_full Improved diagnostic accuracy in differentiating malignant and benign lesions using single-voxel proton MRS of the breast at 3 T MRI
title_fullStr Improved diagnostic accuracy in differentiating malignant and benign lesions using single-voxel proton MRS of the breast at 3 T MRI
title_full_unstemmed Improved diagnostic accuracy in differentiating malignant and benign lesions using single-voxel proton MRS of the breast at 3 T MRI
title_short Improved diagnostic accuracy in differentiating malignant and benign lesions using single-voxel proton MRS of the breast at 3 T MRI
title_sort improved diagnostic accuracy in differentiating malignant and benign lesions using single-voxel proton mrs of the breast at 3 t mri
url http://psasir.upm.edu.my/id/eprint/29597/
http://psasir.upm.edu.my/id/eprint/29597/
http://psasir.upm.edu.my/id/eprint/29597/1/Improved%20diagnostic%20accuracy%20in%20differentiating%20malignant%20and%20benign%20lesions%20using%20single.pdf