title: Qualitative 3-T Proton MR Spectroscopy for the Characterization of Musculoskeletal Neoplasms: Update on Diagnostic Performance and Indications.
abstract: OBJECTIVE
  The objective of our study was to evaluate the diagnostic performance of qualitative 3-T proton MR spectroscopy (1H-MRS) for the characterization of musculoskeletal neoplasms.
  
  
  METHODS
  Proton MRS studies of 74 patients (76 lesions) with a histologically confirmed musculoskeletal neoplasm or neoplasms were prospectively included in this study. All studies were performed using a 3-T MRI scanner. Spectra were analyzed with conventional MRI software provided by the fabricant and with dedicated independent MRS software. Spectra were evaluated visually for the presence or absence of a choline peak at 3.2 ppm. The presence of a choline peak was considered indicative of malignancy. The influences of tumor origin and spectral quality on diagnostic performance were considered.
  
  
  RESULTS
  Diagnostic performance was similar with both software used (κ = 0.97). Qualitative1H-MRS failed to differentiate benign from malignant bone tumors regardless of the application of quality criteria (best sensitivity and specificity, 50.0% and 61.5%, respectively). Diagnostic performance was better with soft-tissue lesions, but the specificity remained low (best sensitivity and specificity, 82.4% and 64.3%, respectively). The application of spectral quality criteria for the evaluation of soft-tissue tumors led to the exclusion of 35.4% of the evaluated spectra.
  
  
  CONCLUSIONS
  Qualitative 3-T1H-MRS cannot be used to characterize bone tumors. This technique has good sensitivity but poor specificity for the characterization of soft-tissue lesions.
authors.affiliation: 1 Service d'Imagerie Guilloz, Hôpital Central, Centre Hospitalier Universitaire de Nancy, 29 Ave du Maréchal de Lattre de Tassigny, Nancy 54035, France.
authors.forename: Pedro Augusto
authors.initials: PA
authors.lastname: Gondim Teixeira
authors.affiliation: 2 Laboratoire Imagerie Adaptive Diagnostique et Interventionnelle, Université de Lorraine, Nancy, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Ledrich
authors.affiliation: 3 Laboratoire de Mathématiques Nicolas Oresmes, Université de Caen, Caen, France.
authors.forename: François
authors.initials: F
authors.lastname: Kauffmann
authors.affiliation: 1 Service d'Imagerie Guilloz, Hôpital Central, Centre Hospitalier Universitaire de Nancy, 29 Ave du Maréchal de Lattre de Tassigny, Nancy 54035, France.
authors.forename: John Mbapte
authors.initials: JM
authors.lastname: Wamba
authors.affiliation: 2 Laboratoire Imagerie Adaptive Diagnostique et Interventionnelle, Université de Lorraine, Nancy, France.|4 Nancy Clinical Investigation Centre-Innovative Technology, Nancy, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Felblinger
authors.affiliation: 1 Service d'Imagerie Guilloz, Hôpital Central, Centre Hospitalier Universitaire de Nancy, 29 Ave du Maréchal de Lattre de Tassigny, Nancy 54035, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Blum
authors.affiliation: 2 Laboratoire Imagerie Adaptive Diagnostique et Interventionnelle, Université de Lorraine, Nancy, France.|4 Nancy Clinical Investigation Centre-Innovative Technology, Nancy, France.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Hossu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001859:Bone Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D057054:Molecular Imaging / Q000379:methods*; D019042:Muscle Neoplasms / Q000175:diagnosis*; D015588:Observer Variation; D066244:Proton Magnetic Resonance Spectroscopy; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: characterization; musculoskeletal system; neoplasms; proton MR spectroscopy; qualitative analysis