Kun Sun1, Weimin Chai1, Caixia Fu2, Ying Zhan1, Kunwei Shen3, Xianfu Luo1, Fuhua Yan4. 1. Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai, 200025, China. 2. Siemens Shenzhen Magnetic Resonance Ltd, Siemens MRI Center, Gaoxin C.Ave, 2nd, Hi-Tech Industrial Park, Shenzhen, 518057, People's Republic of China. 3. Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai, 200025, China. 4. Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai, 200025, China. yanfuhua@yahoo.com.
Abstract
PURPOSE: To investigate the feasibility and effectiveness of diffusion-weighted imaging (DWI)-guided magnetic resonance spectroscopy (MRS) using readout-segmented echo-planar imaging (RS-EPI) to characterise breast lesions. MATERIALS AND METHODS: A total of 258 patients with 258 suspicious breast lesions larger than 1 cm in diameter were examined using DWI-guided, single-voxel MRS with RS-EPI. The mean total choline-containing compound (tCho) signal-to-noise ratio (SNR) and concentration were used for the interpretation of MRS data. T-tests, χ(2)-tests, receiver operating characteristic (ROC) curve analyses and Pearson correlations were conducted for statistical analysis. RESULTS: Histologically, 183 lesions were malignant, and 75 lesions were benign. Both the mean tCho SNR and concentration of malignant lesions were higher than those of benign lesions (6.23 ± 3.30 AU/mL vs. 1.26 ± 1.75 AU/mL and 3.17 ± 2.03 mmol/kg vs. 0.86 ± 0.83 mmol/kg, respectively; P < 0.0001). For a tCho SNR of 2.0 AU/mL and a concentration of 1.76 mmol/kg, the corresponding areas under the ROC curves were 0.93 and 0.90, respectively. The mean tCho SNR and concentration negatively correlated with apparent diffusion coefficients calculated from RS-EPI, with correlation coefficients of -0.54 and -0.48, respectively. CONCLUSION: DWI-guided MRS using RS-EPI is feasible and accurate for characterising breast lesions. KEY POINTS: • The mean tCho SNR and concentration negatively correlated with ADCs. • DWI-guided MRS using RS-EPI is feasible. • DWI-guided MRS using RS-EPI accurately characterises breast lesions.
PURPOSE: To investigate the feasibility and effectiveness of diffusion-weighted imaging (DWI)-guided magnetic resonance spectroscopy (MRS) using readout-segmented echo-planar imaging (RS-EPI) to characterise breast lesions. MATERIALS AND METHODS: A total of 258 patients with 258 suspicious breast lesions larger than 1 cm in diameter were examined using DWI-guided, single-voxel MRS with RS-EPI. The mean total choline-containing compound (tCho) signal-to-noise ratio (SNR) and concentration were used for the interpretation of MRS data. T-tests, χ(2)-tests, receiver operating characteristic (ROC) curve analyses and Pearson correlations were conducted for statistical analysis. RESULTS: Histologically, 183 lesions were malignant, and 75 lesions were benign. Both the mean tCho SNR and concentration of malignant lesions were higher than those of benign lesions (6.23 ± 3.30 AU/mL vs. 1.26 ± 1.75 AU/mL and 3.17 ± 2.03 mmol/kg vs. 0.86 ± 0.83 mmol/kg, respectively; P < 0.0001). For a tCho SNR of 2.0 AU/mL and a concentration of 1.76 mmol/kg, the corresponding areas under the ROC curves were 0.93 and 0.90, respectively. The mean tCho SNR and concentration negatively correlated with apparent diffusion coefficients calculated from RS-EPI, with correlation coefficients of -0.54 and -0.48, respectively. CONCLUSION: DWI-guided MRS using RS-EPI is feasible and accurate for characterising breast lesions. KEY POINTS: • The mean tCho SNR and concentration negatively correlated with ADCs. • DWI-guided MRS using RS-EPI is feasible. • DWI-guided MRS using RS-EPI accurately characterises breast lesions.
Entities:
Keywords:
Breast lesion; Choline; Diagnosis; Diffusion-weighted magnetic resonance imaging; Magnetic resonance spectroscopy
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