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Differential diagnosis between malignant and benign breast lesions using single-voxel proton MRS: a meta-analysis

  • Original Article - Clinical Oncology
  • Published:
Journal of Cancer Research and Clinical Oncology Aims and scope Submit manuscript

Abstract

Objectives

We aim to investigate the diagnostic capability of single-voxel proton MR spectroscopy (MRS) for benign/malignant discrimination of focal breast lesions with a meta-analysis.

Materials and methods

The meta-analysis included a total of 750 malignant breast lesions and 419 benign breast lesions from eighteen studies.

Results

The pooled sensitivity and specificity of MRS were 0.71 (95 % CI 0.68–0.74) and 0.85 (95 % CI 0.81–0.88), respectively. The positive likelihood ratio and negative LR were 4.11 (95 % CI 3.11–5.43) and 0.25 (95 % CI 0.17–0.36), respectively. The P value for χ 2 heterogeneity for all pooled estimates was <0.05. From the fitted summary receiver operating characteristics curve, AUC was 0.89 and Q* was 0.84. Asymmetrical in funnel plots indicated there may be publication bias (t = 2.85, P = 0.012). The meta-regression analysis indicated that neither threshold effect nor evaluated covariates that include strength of field, scanning technique (PRESS or STEAM), repetition time, NSA, and pre- or post-contrast agent were the sources of heterogeneity (all P value >0.05).

Conclusions

Single-voxel proton MRS was useful for differentiation between malignant and benign breast lesions. However, pooled diagnostic measures might be overestimated. The standardization of the acquisition protocol for MRS across the multicenter trials is recommended.

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Acknowledgments

This work is partly supported by The Science Foundation of Guangdong Province for Dr. Startup Project, No. S2012040006618; Postdoctoral Fund of Guangzhou University of Traditional Chinese Medicine, No. 20120621.

Conflict of interest

We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work; there is no professional or other personal interest of any nature or kind in any product, service, and/or company that could be construed as influencing the position presented in, or the review of, the manuscript entitled: “Differential diagnosis between malignant and benign breast lesions using single-voxel proton MRS: A meta-analysis.”

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Authors and Affiliations

  1. Department of Oncology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, Guangdong Province, People’s Republic of China

    Dongzhi Cen

  2. Department of Radiology, Guangdong Provincial Traditional Chinese Medicine Hospital and Postdoctoral Mobile Research Station of Guangzhou University of Traditional Chinese Medicine, 111 Da De Lu, Guangzhou, 510120, Guangdong Province, People’s Republic of China

    Li Xu

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  1. Dongzhi Cen
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Correspondence to Li Xu.

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Dongzhi Cen and Li Xu have contributed equally to this work.

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Cen, D., Xu, L. Differential diagnosis between malignant and benign breast lesions using single-voxel proton MRS: a meta-analysis. J Cancer Res Clin Oncol 140, 993–1001 (2014). https://doi.org/10.1007/s00432-014-1605-7

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  • DOI: https://doi.org/10.1007/s00432-014-1605-7

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