Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 6/2016

01-06-2016 | Breast

Diffusion-Weighted Imaging-guided MR Spectroscopy in Breast Lesions using Readout-Segmented Echo-Planar Imaging

Authors: Kun Sun, Weimin Chai, Caixia Fu, Ying Zhan, Kunwei Shen, Xianfu Luo, Fuhua Yan

Published in: European Radiology | Issue 6/2016

Login to get access

Abstract

Purpose

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.

Materials and 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, χ2-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.

Conclusion

DWI-guided MRS using RS-EPI is feasible and accurate for characterising breast lesions.

Key Points

• 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.
Literature
1.
Gruber S, Debski BK, Pinker K et al (2011) Three-dimensional proton MR spectroscopic imaging at 3 T for the differentiation of benign and malignant breast lesions. Radiology 261:752–761CrossRefPubMed
2.
Dorrius MD, Pijnappel RM, van der Weide Jansen MC et al (2012) The added value of quantitative multi-voxel MR spectroscopy in breast magnetic resonance imaging. Eur Radiol 22:915–922CrossRefPubMedPubMedCentral
3.
Bartella L, Morris EA, Dershaw DD et al (2006) Proton MR spectroscopy with choline peak as malignancy marker improves positive predictive value for breast cancer diagnosis: preliminary study. Radiology 239:686–692CrossRefPubMed
4.
Stanwell P, Gluch L, Clark D et al (2005) Specificity of choline metabolites for in vivo diagnosis of breast cancer using 1H MRS at 1.5 T. Eur Radiol 15:1037–1043CrossRefPubMed
5.
Ei Khouli RH, Jacobs MA, Mezban SD et al (2010) Diffusion-weighted imaging improves the diagnostic accuracy of conventional 3.0-T breast MR imaging. Radiology 256:64–73CrossRefPubMedPubMedCentral
6.
Dorrius MD, Dijkstra H, Oudkerk M, Sijens PE (2014) Effect of b value and pre-admission of contrast on diagnostic accuracy of 1.5-T breast DWI: a systematic review and meta-analysis. Eur Radiol 24:2835–2847CrossRefPubMed
7.
Marini C, Iacconi C, Giannelli M, Cilotti A, Moretti M, Bartolozzi C (2007) Quantitative diffusion-weighted MR imaging in the differential diagnosis of breast lesion. Eur Radiol 17:2646–2655CrossRefPubMed
8.
Murtz P, Tsesarskiy M, Kowal A et al (2014) Diffusion-weighted magnetic resonance imaging of breast lesions: the influence of different fat-suppression techniques on quantitative measurements and their reproducibility. Eur Radiol 24:2540–2551CrossRefPubMed
9.
Baltzer PA, Dietzel M (2013) Breast lesions: diagnosis by using proton MR spectroscopy at 1.5 and 3.0 T--systematic review and meta-analysis. Radiology 267:735–746CrossRefPubMed
10.
Mizukoshi W, Kozawa E, Inoue K et al (2013) (1)H MR spectroscopy with external reference solution at 1.5 T for differentiating malignant and benign breast lesions: comparison using qualitative and quantitative approaches. Eur Radiol 23:75–83CrossRefPubMed
11.
Jacobs MA, Barker PB, Bottomley PA, Bhujwalla Z, Bluemke DA (2004) Proton magnetic resonance spectroscopic imaging of human breast cancer: a preliminary study. J Magn Reson Imaging 19:68–75CrossRefPubMed
12.
Bartella L, Thakur SB, Morris EA et al (2007) Enhancing nonmass lesions in the breast: evaluation with proton (1H) MR spectroscopy. Radiology 245:80–87CrossRefPubMed
13.
Kousi E, Tsougos I, Vasiou K et al (2012) Magnetic resonance spectroscopy of the breast at 3T: pre- and post-contrast evaluation for breast lesion characterization. ScientificWorldJournal 2012:754380PubMedPubMedCentral
14.
Lenkinski RE, Wang X, Elian M, Goldberg SN (2009) Interaction of gadolinium-based MR contrast agents with choline: implications for MR spectroscopy (MRS) of the breast. Magn Reson Med 61:1286–1292CrossRefPubMed
15.
Sijens PE, Oudkerk M, van Dijk P, Levendag PC, Vecht CJ (1998) 1H MR spectroscopy monitoring of changes in choline peak area and line shape after Gd-contrast administration. Magn Reson Imaging 16:1273–1280CrossRefPubMed
16.
Sijens PE, van den Bent MJ, Nowak PJ, van Dijk P, Oudkerk M (1997) 1H chemical shift imaging reveals loss of brain tumor choline signal after administration of Gd-contrast. Magn Reson Med 37:222–225CrossRefPubMed
17.
Baltzer PA, Gussew A, Dietzel M et al (2012) Effect of contrast agent on the results of in vivo (1)H MRS of breast tumors - is it clinically significant? NMR Biomed 25:67–74CrossRefPubMed
18.
Bogner W, Pinker-Domenig K, Bickel H et al (2012) Readout-segmented echo-planar imaging improves the diagnostic performance of diffusion-weighted MR breast examinations at 3.0 T. Radiology 263:64–76CrossRefPubMed
19.
Kim YJ, Kim SH, Kang BJ et al (2014) Readout-segmented echo-planar imaging in diffusion-weighted mr imaging in breast cancer: comparison with single-shot echo-planar imaging in image quality. Korean J Radiol 15:403–410CrossRefPubMedPubMedCentral
20.
21.
22.
Choi SY, Chang YW, Park HJ, Kim HJ, Hong SS, Seo DY (2012) Correlation of the apparent diffusion coefficiency values on diffusion-weighted imaging with prognostic factors for breast cancer. Br J Radiol 85:e474–e479CrossRefPubMedPubMedCentral
23.
Kul S, Cansu A, Alhan E, Dinc H, Gunes G, Reis A (2011) Contribution of diffusion-weighted imaging to dynamic contrast-enhanced MRI in the characterization of breast tumors. AJR Am J Roentgenol 196:210–217CrossRefPubMed
24.
Kelley DA, Wald LL, Star-Lack JM (1999) Lactate detection at 3T: compensating J coupling effects with BASING. J Magn Reson Imaging 9:732–737CrossRefPubMed
25.
Mescher M, Merkle H, Kirsch J, Garwood M, Gruetter R (1998) Simultaneous in vivo spectral editing and water suppression. NMR Biomed 11:266–272CrossRefPubMed
26.
Baik HM, Su MY, Yu H, Mehta R, Nalcioglu O (2006) Quantification of choline-containing compounds in malignant breast tumors by 1H MR spectroscopy using water as an internal reference at 1.5 T. Magma 19:96–104CrossRefPubMed
27.
Look DC, Locker DR (1970) Time saving in measurement of NMR and EPR relaxation times. Rev Sci Instrum 41:250–251CrossRef
28.
DeLong ER, DeLong DM, Clarke-Pearson DL (1988) Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 44:837–845CrossRefPubMed
29.
Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174CrossRefPubMed
30.
Heo SH, Jeong YY, Shin SS et al (2010) Apparent diffusion coefficient value of diffusion-weighted imaging for hepatocellular carcinoma: correlation with the histologic differentiation and the expression of vascular endothelial growth factor. Korean J Radiol 11:295–303CrossRefPubMedPubMedCentral
31.
Bakken IJ, Gribbestad IS, Singstad TE, Kvistad KA (2001) External standard method for the in vivo quantification of choline-containing compounds in breast tumors by proton MR spectroscopy at 1.5 Tesla. Magn Reson Med 46:189–192CrossRefPubMed
32.
Jansen JF, Backes WH, Nicolay K, Kooi ME (2006) 1H MR spectroscopy of the brain: absolute quantification of metabolites. Radiology 240:318–332CrossRefPubMed
Metadata
Title
Diffusion-Weighted Imaging-guided MR Spectroscopy in Breast Lesions using Readout-Segmented Echo-Planar Imaging
Authors
Kun Sun
Weimin Chai
Caixia Fu
Ying Zhan
Kunwei Shen
Xianfu Luo
Fuhua Yan
Publication date
01-06-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 6/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-4000-0

Other articles of this Issue 6/2016

European Radiology 6/2016 Go to the issue

Vascular-Interventional

Endovascular treatment of complex aortic aneurysms: prevalence of acute kidney injury and effect on long-term renal function

Musculoskeletal

T1rho mapping of entire femoral cartilage using depth- and angle-dependent analysis

Paediatric

Intravoxel incoherent motion magnetic resonance imaging to predict vesicoureteral reflux in children with urinary tract infection

Interventional

Predictive factors for complete response of chemoembolization with drug-eluting beads (DEB-TACE) for hepatocellular carcinoma

Computed Tomography

Impact of an advanced image-based monoenergetic reconstruction algorithm on coronary stent visualization using third generation dual-source dual-energy CT: a phantom study

Chest

Persistent pulmonary subsolid nodules with solid portions of 5 mm or smaller: Their natural course and predictors of interval growth