Comparative Investigation of Single Voxel Magnetic Resonance Spectroscopy and Dynamic Contrast Enhancement MR Imaging in Differentiation of Benign and Malignant Breast Lesions in a Sample of Iranian Women

Abstract

Purpose: To make a comparison of single voxel magnetic resonance spectroscopy (SV-MRS) and dynamic contrast enhancement (DCE) MRI for differentiation of benign and malignant breast lesions in a sample of Iranian women. Materials and Methods: A total of 30 women with abnormal breast lesions detected in mammography, ultrasound, or clinical breast exam were examined with DCE and SV-MRS. tCho (total choline) resonance in MRS spectra was qualitatively evaluated and detection of a visible tCho peak at 3.2 ppm was defined as a positive finding for malignancy. Different types of DCE curves were persistent (type 1), plateau (type 2), and washout (type 3). At first, lesions were classified according to choline findings and types of DCE curve, finally being compared to pathological results as the standard reference. Results: this study included 19 patients with malignant lesions and 11 patients with benign ones. While 63.6 % of benign lesions (7 of 11) showed type 1 DCE curves and 36.4% (4 of 11) showed type 2, 57.9% (11of 19) of malignant lesions were type 3 and 42.1% (8 of 19) type 2. Choline peaks were detected in 18 of 19 malignant lesions and in 3 of 11 benign counterparts. 1 malignant and 8 benign cases did not show any visible resonance at 3.2 ppm so SV-MRS featured 94.7% sensitivity, 72.7 % specificity and 86.7% accuracy.Conclusions: The present findings indicate that a combined approach using MRS and DCE MRI can improve the specificity of MRI for differentiation of benign and malignant breast lesions.

Imaging Features Derived From Dynamic Contrast-Enhanced Magnetic Resonance Imaging to Differentiate Malignant From Benign Breast Lesions: A Systematic Review and Meta-Analysis

“…Upon primary screening of the titles and abstracts, 3544 articles were excluded, and 62 articles that did not meet the inclusion criteria were excluded after full text review. Ultimately, a total of 29 studies 9–37 that evaluated the accuracy of DCE-MRI features in differentiating malignant from benign breast lesions were included in this meta-analysis, and the detailed flowchart of the literature search and study selection is presented in Figure 1.…”

“…To date and to the best of our knowledge, multiple meta-analyses have been performed to investigate the value of DCE-MRI and diffusion weighted imaging (DWI) in detecting breast lesions and evaluating the treatment response after neoadjuvant chemotherapy 6–8 . However, no well-designed meta-analysis analyzing the individual imaging features of DCE-MRI, such as lesion shape, margin, enhancement pattern, washout or plateau time intensity curve (TIC), in diagnosing and differentiating breast lesions has yet been published, leading to conflicting diagnostic reports of DCE-MRI features, mainly because different sensitivities and specificities associated with DCE-MRI features have been reported in numerous studies 9–37 …”