Jill Ellen Saunders MD, Presenter: Nothing to Disclose

Eva Csilla Gombos MD, Abstract Co-Author: Research support, General Electric Company Medical Advisory Board, Bayer AG

Tuan Luu, Abstract Co-Author: Research grant, Siemens AG

Sughra Raza MD, Abstract Co-Author: Research grant, Hitachi, Ltd

Robyn L. Birdwell MD, Abstract Co-Author: Nothing to Disclose

Further characterization of suspicious masses at the time of initial breast MRI by MRS may support decisions regarding the need for a biopsy and may decrease the number of unnecessary biopsies. The goal of this study is to show the feasibility of performing magnetic resonance spectroscopy (MRS) in a clinical setting at the time of routine breast magnetic resonance imaging (MRI) examination. 

In this prospective HIPPA compliant and IRB approved study, 24 MRS exams were performed in 23 women (ages 29-83) using a 7-channel breast coil on a 3 Tesla MR scanner. All of the 24 lesions underwent pathological evaluation. An initial 3D VIBE sequence was obtained, then a shimming protocol was run and the voxel positioned for spectroscopy. A minimum voxel size of 13x13x13mm was used. Single voxel echo planar imaging sequences (TE 135) for spectroscopy and water reference sequences were run on each patient.

Of the 24 MRS exams, the time between the 3D VIBE sequence and the end of spectral acquisition ranged from 12 to 27 minutes. Once MRS imaging began, the two sequences were set to run for specific times. The mean combined shimming and image acquisition time for MRS was 18 minutes. MRS was regarded successful and concordant in 19/24 cases (79.2%).

Further characterization of suspicious masses at the time of initial breast MRI by MRS may support decisions regarding the need for a biopsy and may decrease the number of unnecessary biopsies. In this study, the actual time to perform MRS approaches 20 minutes, which is longer than the previously reported time of 10 minutes and longer than our expectation at the initial setup of our MRS program. While the technical success rate is high, our study shows the current limitations of routine clinical applicability of MRS mainly secondary to time required for shimming.

Due to patient comfort and scheduling limitations, performing routine breast MR spectroscopy will depend on the feasibility of acquiring high quality sequences within an efficient time frame.

Saunders, J, Gombos, E, Luu, T, Raza, S, Birdwell, R, Clinical Feasibility of Performing Magnetic Resonance (MR) Spectroscopy at the Time of Routine Breast MR Imaging.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8015403.html