Sina Meisamy MD, Presenter: Nothing to Disclose

Patrick J. Bolan MS, Abstract Co-Author: Nothing to Disclose

Michael Thomas Nelson MD, Abstract Co-Author: Nothing to Disclose

Lenore I. Everson MD, Abstract Co-Author: Nothing to Disclose

Frederick Kelcz MD, PhD, Abstract Co-Author: Nothing to Disclose

Michael G. Garwood PhD, Abstract Co-Author: Nothing to Disclose

Tim Harrison Emory MD, Abstract Co-Author: Nothing to Disclose

Kathy R. Brandt MD, Abstract Co-Author: Nothing to Disclose

Kimberly Katz Amrami MD, Abstract Co-Author: Nothing to Disclose

Mary Carol L. Lechner MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To determine whether the addition of in vivo quantitative proton MR spectroscopy (1H MRS) can improve the radiologist’s accuracy in interpreting breast MRI.

Fifty-five breast MR cases with pathologic findings confirmed by biopsy were retrospectively evaluated by 4 radiologists. Patients were examined with contrast-enhanced, fat-suppressed, T1-weighted MRI using a 4T MRI/MRS scanner. The concentration of choline-containing compounds [tCho] was quantified using single-voxel 1H MRS. For each case, the radiologists were asked to state the probability of malignancy and to provide a recommendation on patient management. Two interpretations were performed for each case. The initial interpretation was based on lesion morphology and time intensity curve; the second interpretation was based on lesion morphology, time intensity curve, and [tCho].

All lesions evaluated in this study enhanced with Gd-DTPA. Of the 55 cases evaluated in this study, 35 were invasive carcinoma and 20 were benign. The addition of 1H MRS resulted in higher sensitivity, specificity, and accuracy (AZ) for all 4 radiologists. More specifically, two of the 4 radiologists showed a significant improvement in sensitivity (p=0.03, p=0.03), and all 4 radiologists showed a significant improvement in AZ (p=0.01, p=0.05, p=0.009, p=0.0008).

These results suggest that the addition of quantitative 1H MRS to breast MRI may improve the radiologist’s ability to distinguish benign from malignant breast lesions. The additional information provided by 1H MRS is particularly valuable in cases where the lesion morphology or time-intensity curve is indeterminate.

Meisamy, S, Bolan, P, Nelson, M, Everson, L, Kelcz, F, Garwood, M, Emory, T, Brandt, K, Amrami, K, Lechner, M, et al, , The Value of Adding Quantitative ¹H MRS for Improving Diagnostic Accuracy of Breast MRI: Results from an Observer Performance Study at High Field.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4404908.html