title: Improved Diagnostic Accuracy in Characterization of Adnexal Masses by Detection of Choline Peak Using 1H MR Spectroscopy in Comparison to Internal Reference at 3 Tesla.
abstract: BACKGROUND
  The aim of this study was to assess the role of the presence of a choline peak in 3 Tesla 1H magnetic resonance spectroscopy (MRS) for differentiating benign from malignant adnexal masses.
  
  
  METHODS
  A total of 46 adnexal masses (23 malignant and 23 benign) underwent 1H MRS study prior to surgery to assess the presence of choline peak.
  
  
  RESULTS
  A choline peak was detected in 16 malignant masses (69.5%) and was absent in the other 7 (30.5%). A choline peak was only detected in 6 (26%) of the benign adnexal masses. The presence of an MRS choline peak had a sensitivity of 69.5%, a specificity of 74%, a positive predictive value (PPV) of 72.7%, and a negative predictive value (NPV) of 71% for diagnosing malignant adnexal masses. A significant difference between the frequency of mean choline peaks in benign and malignant adnexal masses was observed (P value<0.01).
  
  
  CONCLUSIONS
  A 1H MRS choline peak is seen in malignant adnexal masses more frequently than the benign masses, and may be helpful for diagnosing malignant adnexal masses.
authors.affiliation: Department of Radiology, Medical Imaging Center, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran, Iran E-mail : Pourashraf_m@yahoo.com.
authors.forename: Mahrooz
authors.initials: M
authors.lastname: Malek
authors.forename: Maryam
authors.initials: M
authors.lastname: Pourashraf
authors.forename: Mitra Modares
authors.initials: MM
authors.lastname: Gilani
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Gity
mesh_terms: D000291:Adnexal Diseases / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002794:Choline / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D000292:Pelvic Inflammatory Disease / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D011379:Prognosis; D066244:Proton Magnetic Resonance Spectroscopy / Q000379:methods*; D012015:Reference Standards; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D002794:Choline