title: Diffusion-Weighted Imaging-guided MR Spectroscopy in Breast Lesions using Readout-Segmented Echo-Planar Imaging.
abstract: OBJECTIVE
  To investigate the feasibility and effectiveness of diffusion-weighted imaging (DWI)-guided magnetic resonance spectroscopy (MRS) using readout-segmented echo-planar imaging (RS-EPI) to characterise breast lesions.
  
  
  METHODS
  A total of 258 patients with 258 suspicious breast lesions larger than 1 cm in diameter were examined using DWI-guided, single-voxel MRS with RS-EPI. The mean total choline-containing compound (tCho) signal-to-noise ratio (SNR) and concentration were used for the interpretation of MRS data. T-tests, χ(2)-tests, receiver operating characteristic (ROC) curve analyses and Pearson correlations were conducted for statistical analysis.
  
  
  RESULTS
  Histologically, 183 lesions were malignant, and 75 lesions were benign. Both the mean tCho SNR and concentration of malignant lesions were higher than those of benign lesions (6.23 ± 3.30 AU/mL vs. 1.26 ± 1.75 AU/mL and 3.17 ± 2.03 mmol/kg vs. 0.86 ± 0.83 mmol/kg, respectively; P < 0.0001). For a tCho SNR of 2.0 AU/mL and a concentration of 1.76 mmol/kg, the corresponding areas under the ROC curves were 0.93 and 0.90, respectively. The mean tCho SNR and concentration negatively correlated with apparent diffusion coefficients calculated from RS-EPI, with correlation coefficients of -0.54 and -0.48, respectively.
  
  
  CONCLUSIONS
  DWI-guided MRS using RS-EPI is feasible and accurate for characterising breast lesions.
  
  
  CONCLUSIONS
  • The mean tCho SNR and concentration negatively correlated with ADCs. • DWI-guided MRS using RS-EPI is feasible. • DWI-guided MRS using RS-EPI accurately characterises breast lesions.
authors.affiliation: Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai, 200025, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Sun
authors.affiliation: Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai, 200025, China.
authors.forename: Weimin
authors.initials: W
authors.lastname: Chai
authors.affiliation: Siemens Shenzhen Magnetic Resonance Ltd, Siemens MRI Center, Gaoxin C.Ave, 2nd, Hi-Tech Industrial Park, Shenzhen, 518057, People's Republic of China.
authors.forename: Caixia
authors.initials: C
authors.lastname: Fu
authors.affiliation: Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai, 200025, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhan
authors.affiliation: Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai, 200025, China.
authors.forename: Kunwei
authors.initials: K
authors.lastname: Shen
authors.affiliation: Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai, 200025, China.
authors.forename: Xianfu
authors.initials: X
authors.lastname: Luo
authors.affiliation: Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai, 200025, China. yanfuhua@yahoo.com.
authors.forename: Fuhua
authors.initials: F
authors.lastname: Yan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000000981:diagnostic imaging; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging*; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging*; D002794:Choline; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D017352:Echo-Planar Imaging / Q000379:methods; D005260:Female; D018226:Fibroadenoma / Q000000981:diagnostic imaging*; D005348:Fibrocystic Breast Disease / Q000000981:diagnostic imaging*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008875:Middle Aged; D003557:Phyllodes Tumor / Q000000981:diagnostic imaging*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D059629:Signal-To-Noise Ratio; D055815:Young Adult
chemical_list: D002794:Choline
keywords: Breast lesion; Choline; Diagnosis; Diffusion-weighted magnetic resonance imaging; Magnetic resonance spectroscopy