Magnetic resonance spectroscopy of the breast at 3T: pre- and post-contrast evaluation for breast lesion characterization.
OBJECTIVE
To determine whether in vivo proton magnetic resonance spectroscopy at 3T can provide accurate breast lesion characterization, and to determine the effect of gadolinium on the resonance of tCho.


METHODS
Twenty-four positive-mammogram patients were examined on a 3T MR scanner. 1H-MRS was performed before and after gadolinium administration. tCho peak was qualitatively evaluated before and after contrast injection.


RESULTS
Fourteen out of 27 lesions proved to be malignant after histopathological diagnosis. Using 1H-MRS, before contrast injection, 6/14 confirmed malignancies and 11/13 benign lesions were correctly classified; while, after contrast injection, 11/14 confirmed malignancies and 12/13 benign processes were correctly classified. Post gadolinium 1H-MRS proved useful in picking up tCho signal, improving the overall accuracy, sensitivity, and specificity by 35%, 83%, and 9%, respectively.


CONCLUSIONS
1H-MRS overall accuracy, sensitivity, and specificity in detecting breast lesion's malignancy were increased after gadolinium administration. It is prudent to perform 1H-MRS before contrast injection in large breast lesions to avoid choline underestimation. In cases of small or non-mass lesions, it is recommended to perform 1H-MRS after contrast injection for better voxel prescription to enable a reliable preoperative diagnosis.
Medical Physics Department, University of Thessaly, Biopolis, 41110 Larissa, Greece.
E
E
Kousi
I
I
Tsougos
K
K
Vasiou
K
K
Theodorou
A
A
Poultsidi
I
I
Fezoulidis
C
C
Kappas
D000328:Adult; D000368:Aged; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D002794:Choline / Q000378:metabolism; D003287:Contrast Media / Q000494:pharmacology; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D005682:Gadolinium / Q000494:pharmacology*; D006801:Humans; D007700:Kinetics; D008279:Magnetic Resonance Imaging / Q000379:methods; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D003287:Contrast Media; D005682:Gadolinium; D002794:Choline