A new method to reduce false positive results in breast MRI by evaluation of multiple spectral regions in proton MR-spectroscopy.

Objectives: To investigate whether the evaluation of multiple spectral regions can increase the diagnostic performance of 1H-MRS of the breast and reduce false positive findings.Methods: 93 patients (mean age 56 years, range 23-79) undergoing breast MRI for routine clinical indications on a 1.5T sca...

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Published in:European Journal of Radiology pp. 51 - 58
Main Authors: Clauser, Paola, Marcon, Magda, Dietzel, Matthias, Baltzer, Pascal A.T.
Format: research Journal Article
Published: Elsevier B.V. Jul2017
Online Access:View this record in EBSCOhost
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        0720048X
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      jtl: European Journal of Radiology
      issn: 0720048X
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      dt: Jul2017
      pid: 1004
      pub: Elsevier B.V.
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        123629445
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        10.1016/j.ejrad.2017.04.014
        NLM28624020
        123629445
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        atl: A new method to reduce false positive results in breast MRI by evaluation of multiple spectral regions in proton MR-spectroscopy.
      aug:
        au:
          Clauser, Paola
          Marcon, Magda
          Dietzel, Matthias
          Baltzer, Pascal A.T.
        affil: Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, Austria
      sug:
        subj:
          Breast Neoplasms
          Choline Analysis
          Magnetic Resonance Imaging Methods
          Choline
          Breast Neoplasms Pathology
          Sensitivity and Specificity
          Radiography
          Protons
          Female
          Methane
          Prospective Studies
          Algorithms
          Water
          Pharmacokinetics
          Human
          Female
      ab: Objectives: To investigate whether the evaluation of multiple spectral regions can increase the diagnostic performance of 1H-MRS of the breast and reduce false positive findings.Methods: 93 patients (mean age 56 years, range 23-79) undergoing breast MRI for routine clinical indications on a 1.5T scanner were eligible for this IRB-approved prospective study. Suspicious enhancing lesions ≥8mm underwent single-voxel point-resolved 1H-MRS (PRESS, TR=2000ms, TE=272ms). Histology showed 69 malignant and 24 benign lesions. The Signal-to-Noise ratio of choline, olefinic acids and the water-to-methylene ratio were measured. The area under the ROC-curve (AUC) was used to evaluate single measurements. Combined diagnostic accuracy was explored using a 10-fold cross-validated Chi-squared automatic interaction detection (CHAID) analysis. Inter-reader agreement was evaluated in a subset of patients.Results: A significant AUC for differentiation between benign and malignant lesions was identified for choline (0.733, P=0.001), olefinic acids (0.769, P=0.0001) and water-to-methylene ratio (0.704, P=0.003). All three variables were included in a classification algorithm using CHAID methodology. Using this classification, 70.8% (17/24) false positive diagnoses in benign lesions would have been avoided. Inter-reader agreement was almost perfect.Conclusions: The combined evaluation of multiple spectral regions can increase the diagnostic performance of 1H-MRS and potentially reduce false positive findings.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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