Diagnostic Accuracy of Magnetic Resonance Spectroscopy (MRS) in Diagnosing Malignant Breast Lesions Taking Histopathology as Gold Standard

Abstract

Background and Aims: Breast cancer is the prime cause of mortality among women of both developing and developed world. Out of 34.6% of female cancer patients, malignant breast cancer being the most common cancer found in Pakistan. The current study aims to evaluate the diagnostic accuracy of magnetic resonance spectroscopy in diagnosing malignant breast lesions taking histopathology as a gold standard. Materials and Methods: This cross-sectional study was carried out on 135 female patients with suspicious palpable lesions for malignancy referred from surgical OPD of Liaquat University of Medical and Health Sciences, Jamshoro during the period from October 2020 to March 2021. Magnetic resonance spectroscopy (MRS) dynamic enhanced images taken with contrast on 1.5 Tesla MRI machines were assessed based on kinetic and morphology. Malignancy biomarker was assessed with choline peak (Cho) allowed by MRS. The Single-voxel technique was utilized in order to evaluate the diagnostic performance of MRS in breast lesions malignancy. A comparison was made between MRS and biopsy findings. Results: Out of 135 female patients, 118 (87.40%) were malignant lesions patients assessed by MRS while histopathologically proven patients were 104 (77.33%). The calculated mean age of all the malignant patients was 48.3 ± 14.5 years with a range of 40-79 years. The diagnostic parameters of MRS such as specificity, accuracy, sensitivity, negative predictive value (NPV), and positive predictive value (PPV) was 74%, 88.2%, 93%, 77.8%, and 93.1% respectively while taking histopathology as a gold standard. Conclusion: MRS must be utilized as a primary imaging technique for the diagnosis of breast lesions malignancy due to its higher specificity, sensitivity, and accuracy in breast lumps characterization. MRS was found to be specific 74%, sensitive 88.2%, and accurate 93% in malignant breast cancer diagnosis. Keywords: MRS, Malignant breast lesions, Histopathology

The Accuracy of Magnetic Resonance Imaging in Diagnosing Malignant Breast Lesions

“…Frequency of malignant lesion by MRS was found among 92 (83.6%) cases and by histopathological results its frequency was 81 (73.6%).These results were comparable to the previous studies. [20,21] Ductal enhancement and peripheral enhancement were the most common morphology among patients of malignant lesion by MRS. [22] A study by Bartellaet al [23] compared the diagnostic performance of MRS and MRI in 56 individuals with 57 different abnormalities (level III-2 diagnostic evidence). Only 17 lesions were found to be malignant by biopsy of the 57 lesions investigated in the research; 40 of the lesions were recommended for further examination.…”

Malignant Breast Lesion Detection with MRI and its Accuracy

“…The findings were consistent with those of earlier research. [20,21] Most individuals with a malignant lesions by MRS had either a ductal or peripheral enhancement. [22] Bartellaet al [23] examined the diagnostic efficacy of MRS and MRI in a sample of 56 patients with 57 distinct anomalies (level III-2 diagnostic evidence).…”