scholarly journals Is Elevated Choline on Magnetic Resonance Spectroscopy a Reliable Marker of Breast Lesion Malignancy?

2021 ◽  
Vol 11 ◽  
Author(s):  
Natasa Prvulovic Bunovic ◽  
Olivera Sveljo ◽  
Dusko Kozic ◽  
Jasmina Boban
Keyword(s):  
Magnetic Resonance ◽  
Sensitivity And Specificity ◽  
Cancer Detection ◽  
False Negative ◽  
Lesion Size ◽  
Test Reliability ◽  
Resonance Spectroscopy ◽  
Breast Lesions ◽  
Negative Findings ◽  
Benign Breast Lesions

BackgroundContemporary magnetic resonance imaging (MRI) of the breast represents a powerful diagnostic modality for cancer detection, with excellent sensitivity and high specificity. Magnetic resonance spectroscopy (MRS) is being explored as an additional tool for improving specificity in breast cancer detection, using multiparametric MRI. The aim of this study was to examine the possibility of 1H-MRS to discriminate malignant from benign breast lesions, using elevated choline (Cho) peak as an imaging biomarker.MethodsA total of 60 patients were included in this prospective study: 30 with malignant (average age, 55.2 years; average lesion size, 35 mm) and 30 with benign breast lesions (average age, 44.8 years; average lesion size, 20 mm), who underwent multiparametric MRI with multivoxel 3D 1H-MRS on a 1.5-T scanner in a 3-year period. Three patients with benign breast lesions were excluded from the study. All lesions were histologically verified. Peaks identified on 1H-MRS were lipid (0.9, 2.3, 2.8, and 5.2 ppm), choline (3.2 ppm), and water peaks (4.7 ppm). Sensitivity and specificity, as well as positive and negative predictive values, were defined using ROC curves. Cohen’s Kappa test of inter-test reliability was performed [testing the agreement between 1H-MRS and histologic finding, and 1H-MRS and MR mammography (MRM)].ResultsCholine peak was elevated in 24/30 malignant lesions and in 20/27 benign breast lesions. The sensitivity of 1H-MRS was 0.8, specificity was 0.741, positive predictive value was 0.774, and negative predictive value was 0.769. Area under ROC was 0.77 (CI 0.640–0.871). Inter-test reliability between 1H-MRS and histologic finding was 0.543 (moderate agreement) and that between 1H-MRS and MRM was 0.573 (moderate agreement). False-negative findings were most frequently observed in invasive lobular cancers, while false-positive findings were most frequently observed in adenoid fibroadenomas.ConclusionAlthough elevation of the choline peak has a good sensitivity and specificity in breast cancer detection, both are significantly lower than those of multiparametric MRM. Inclusion of spectra located on tumor margins as well as analysis of lipid peaks could aid both sensitivity and specificity. An important ratio of false-positive and false-negative findings in specific types of breast lesions (lobular cancer and adenoid fibroadenoma) suggests interpreting these lesions with a caveat.

False-negative findings of malignant breast lesions on preoperative magnetic resonance mammography

The Breast ◽  
2001 ◽  
Vol 10 (2) ◽  
pp. 131-139 ◽  
Author(s):  
S. Wurdinger ◽  
S. Kamprath ◽  
D. Eschrich ◽  
A. Schneider ◽  
W.A. Kaiser
Keyword(s):  
Magnetic Resonance ◽  
False Negative ◽  
Breast Lesions ◽  
Magnetic Resonance Mammography ◽  
Negative Findings ◽  
Malignant Breast ◽  
Preoperative Magnetic Resonance

Multiparametric Approach with Dynamic Contrast-Enhanced Mri, Diffusion-Weighted Imaging and Mrs of The Breast in Assessment of Suspicious Breast Lesions

2020 ◽  
Vol 106 (1_suppl) ◽  
pp. 16-16
Author(s):  
SM Abd Elsalam ◽  
AH Said ◽  
MH Sarah
Keyword(s):  
Magnetic Resonance ◽  
Diffusion Weighted Imaging ◽  
Kinetic Curve ◽  
Resonance Spectroscopy ◽  
Breast Lesions ◽  
Adc Value ◽  
Dynamic Contrast Enhanced ◽  
Cancer Breast ◽  
Diffusion Weighted ◽  
Contrast Enhanced

Introduction: Breast cancer is the most invasive malignant tumour in females worldwide and is the second leading cause of cancer death in females after lung cancer. In Egypt, cancer breast is the first common site of tumours among females (32%) and the second common tumour site in both sexes. The aim of this study was to evaluate and compare the diagnostic performance of quantitative parameters derived from diffusion-weighted imaging (DWI), dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and magnetic resonance spectroscopy (MRS) with ultrasound +/- conventional mammography in differentiating suspicious breast masses (BI-RADS III and IV) and to suggest the most accurate imaging combination for early diagnosis and treatment of cancer breast. Materials and Methods: The study included 40 patients with suspicious breast lesions detected by clinical examination, ultrasound+/- mammography . Dynamic MRI study was performed using 1.5T MRI. Lesions were analyzed regarding their morphology, kinetic curve pattern, ADC value and tCho peak measurement. The results of each MRI parameter were correlated to histo-pathology. Results: In this study sensitivity of sono-mammography was 70% and its specificity was 66.6%. According to using MRI sensitivity was 90% and specificity was 80% by using morphological and curve patterns. As regarding MRS sensitivity was 50% and specificity was 86.7%. Regarding sensitivity of ADC was 90%while its specificity was 93%. The cut off ADC value was 0.95 x 10−3 mm2/s. By using MRI with additive modalities (ADC and MRS) sensitivity was 100% and specificity was 93%. Conclusion: In comparison with MRI, sonomammography alone lack both sensitivity and specificity in detection of breast lesions in suspicious cases. MRI with additive modalities (ADC and MRS) is the best imaging modality in detection of malignant cases and exclusion of benign cases.

Washout of Mass-Like Benign Breast Lesions at Dynamic Magnetic Resonance Imaging

2012 ◽  
Vol 36 (3) ◽  
pp. 301-305 ◽  
Author(s):  
Penampai Tannaphai ◽  
Rubina Manuela Trimboli ◽  
Luca Alessandro Carbonaro ◽  
Sara Viganò ◽  
Giovanni Di Leo ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Dynamic Magnetic Resonance Imaging ◽  
Breast Lesions ◽  
Resonance Imaging ◽  
Dynamic Magnetic Resonance ◽  
Benign Breast Lesions

scholarly journals Laboratory Diagnostics of Primary Hyperaldosteronism and its Peculiarities (Literature Review)

2019 ◽  
Vol 12 (3) ◽  
pp. 215-220 ◽  
Author(s):  
O Shidlovskyi Viktor ◽  
◽  
V Shidlovskyi Oleander ◽  
Mikhail Sheremet ◽  
V Zhulkevych Igor ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Adrenal Glands ◽  
False Negative ◽  
Photon Emission ◽  
Diagnostic Value ◽  
Primary Hyperaldosteronism ◽  
Laboratory Diagnostics ◽  
Resonance Spectroscopy ◽  
Morphological Studies

The final stage of the diagnostic of primary hyperaldosteronism is to identify the causes of excessive secretion of aldosterone and determination of its variants. Based on the analysis of literature data, the diagnostic value, sensitivity and specificity of the methods of radiation diagnostics for primary hyperaldosteronism were assessed: ultrasound, computed tomography, magnetic resonance imaging, photon emission tomography, magnetic resonance spectroscopy, scintigraphy with iodine radiopharmaceuticals. The causes of false-positive and false-negative evaluations of changes in adrenal glands in the application of these diagnostics have been analyzed. There are many genetic and morphological studies when searching the literature data on the principles and methods of distinguishing the nosological forms of primary hyperaldosteronism based on the results of the aldosterone level estimation in the separated blood from the central veins of both adrenal glands or segmental veins of one gland with subsequent determination of the concentration gradient. It was noted that topical diagnostics and, especially, the determination of nosological forms of primary hyperaldosteronism are complex and expensive, but their results allow choosing an appropriate treatment approach for each particular case.

scholarly journals Efficacy of FNAC in Diagnosis of Breast Lumps - A Retrospective Study

2021 ◽  
Vol 8 (9) ◽  
pp. 13-17
Author(s):  
Oankar Kumar Maurya ◽  
Richa . ◽  
Manohar Lal
Keyword(s):  
Retrospective Study ◽  
Diagnostic Accuracy ◽  
False Negative ◽  
Patient Acceptance ◽  
Breast Lesions ◽  
Main Role ◽  
Study Results ◽  
Malignant Lesions ◽  
Benign Breast Lesions ◽  
Breast Lumps

Background: FNAC is an established and highly accurate method for diagnosis of breast lesions. Its further advantage is to give rapid diagnosis, cost-effectiveness, excellent patient acceptance and minimal or no morbidity. The study aimed to diagnose various breast masses before operation by FNAC and to compare the result of FNAC with histopathological study to assess the efficacy of FNAC. Materials and Methods: The study entitled “Efficacy of FNAC in diagnosis of Breast Lumps” is a retrospective study conducted in department of surgery with collaboration of pathology department at Nalanda Medical College and Hospital, Patna during the period of July 2017 to December 2019. During this period, 150 FNAC cases were selected for study. Results: Fibroadenoma was the most commonly diagnosed entity in benign breast lesions, followed by fibrocystic disease. Among malignant lesions, infiltrating ductal carcinoma was the most common. The overall diagnostic accuracy of FNAC in benign breast lesions was 94.59%. The fibroadenomas were correctly diagnosed in 92.96% cases. There were 5.41% false negative results in our series. There was no false positive result giving specificity of 100%. Conclusion: FNAC is an inexpensive, simple, safe and readily acceptable procedure to the patient and plays main role to provide rapid and accurate diagnosis of breast lumps. FNAC enables us to differentiate benign from malignant lesions with high sensitivity, specificity and diagnostic accuracy. Keywords: Breast Lump, FNAC, HPE: Histopathological Examination.

scholarly journals Evaluation of diagnostic value of ultrasound and magnetic resonance imaging for malignant and benign breast lesions

2018 ◽  
Vol 2 (5) ◽  
Author(s):  
Yanni Zeng ◽  
Hongwei Zhang ◽  
Jiuxia Zhang ◽  
Yan Yu ◽  
Liangjin Liu
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Statistical Significance ◽  
Diagnostic Value ◽  
Breast Lesions ◽  
Resonance Imaging ◽  
Benign Lesions ◽  
Specificity And Sensitivity ◽  
Treatment Data ◽  
Benign Breast Lesions

[Abstract] Objectives: To investigate diagnostic value of ultrasound and magnetic resonance imaging (MRI) for malignant and benign breast lesions. Methods: Retrospective analysis of treatment data of 48 patients diagnosed with malignant and benign breast lesions in our hospital, collected from December 2017 to November 2018. A total number of 56 breast masses were examined by both ultrasound and MRI, and were compared with postoperative pathological biopsy results. Results: Postoperative pathological biopsy results showed that there were 26 and 30 malignant and benign lesions respectively. Comparison of MRI curve type of malignant and benign lesions showed statistical significance (P<0.05). By comparison with pathological biopsy results, specificity and sensitivity of ultrasound diagnosis were 83.33% (25/30) and 84.61% (22/26) respectively; specificity and sensitivity of MRI diagnosis were 96.66% (29/30) and 92.30% (24/26) respectively. Conclusions: Ultrasonographic examination of malignant and benign breast lesions is straight-forward, simple and inexpensive. Accuracy, specificity and sensitivity of MRI are significantly higher than ultrasound in examining malignant and benign breast lesions, this can reduce misdiagnosis.

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

2021 ◽  
Vol 15 (7) ◽  
pp. 1847-1849
Author(s):  
Adnan Ahmed ◽  
Jawad Ali Memon ◽  
Muhammad Sibtain Shah ◽  
Hafeez ur Rehman ◽  
Tahir Baig ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Gold Standard ◽  
Resonance Spectroscopy ◽  
Breast Lesions ◽  
Female Patients ◽  
Malignant Breast

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

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