title: Application value of 3T ¹H-magnetic resonance spectroscopy in diagnosing breast tumors.
abstract: BACKGROUND
  Assessment of breast lesions with magnetic resonance imaging (MRI) provides a means for lesion detection and diagnosis. Proton (hydrogen-1) magnetic resonance spectroscopy ((1)H-MRS) has been proposed as a useful diagnostic technique in providing metabolic information of suspicious breast lesions.
  
  
  OBJECTIVE
  To determine the clinical significance of in-vivo single voxel (1)H-MRS at 3T in the assessment of benign and malignant breast lesions in combination with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).
  
  
  METHODS
  Twenty-four women with known breast abnormalities from conventional imaging (mammography, ultrasonography) underwent DCE-MRI at a 3T MR scanner and 26 breast lesions were detected. Breast lesions were assessed according BI-RADS classification. Single voxel (1)H-MRS was performed after gadolinium administration and choline peak was qualitatively evaluated. All lesions were confirmed histologically from the surgically excised specimens. Sensitivity, specificity, and accuracy of the (1)H-MRS, of the BI-RADS classification and of their combination (DCE-MRI + (1)H-MRS) were calculated.
  
  
  RESULTS
  Fifteen out of 26 lesions proved to be malignant and 11 proved to be benign. In our study (1)H-MRS showed sensitivity 80%, specificity 81.8%, and accuracy 80.7%. DCE-MRI showed sensitivity 100%, specificity 63.6%, and accuracy 84.6%. The combination of DCE-MRI and (1)H-MRS provided higher accuracy (96.4%), as well as higher specificity 81.8% compared to BI-RADS classification.
  
  
  CONCLUSIONS
  The combined use of (1)H-MRS and DCE-MRI found to have improved diagnostic performance in the assessment of equivocal breast lesions. (1)H-MRS can be used as a useful adjunct during lesion characterization in clinical routine in cases classified as BI-RADS 3 and 4.
authors: Department of Radiology avassiou@gmail.com.
authors: Katerina
authors: K
authors: Vassiou
authors: Department of Medical Physics.
authors: Ioannis
authors: I
authors: Tsougos
authors: Department of Medical Physics.
authors: Evanthia
authors: E
authors: Kousi
authors: Department of Radiology.
authors: Marianna
authors: M
authors: Vlychou
authors: Department of Surgery.
authors: Evaggelos
authors: E
authors: Athanasiou
authors: Department of Medical Physics.
authors: Kiriaki
authors: K
authors: Theodorou
authors: Department of Anatomy, University of Thessaly, Larissa, Greece.
authors: Dimitrios L
authors: DL
authors: Arvanitis
authors: Department of Radiology.
authors: Ioannis V
authors: IV
authors: Fezoulidis
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000378:metabolism* / Q000473:pathology; D002794:Choline / Q000378:metabolism; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D002794:Choline
keywords: Breast; MR imaging; MR spectroscopy