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Published online before print April 7, 2006, 10.1148/radiol.2393051046
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Proton MR Spectroscopy with Choline Peak as Malignancy Marker Improves Positive Predictive Value for Breast Cancer Diagnosis: Preliminary Study1

Lia Bartella, MD, Elizabeth A. Morris, MD, D. David Dershaw, MD, Laura Liberman, MD, Sunitha B. Thakur, PhD, Chaya Moskowitz, PhD, Jennifer Guido, BA and Wei Huang, PhD

1 From the Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021. From the 2004 RSNA Annual Meeting. Received June 21, 2005; revision requested August 5; revision received November 2; final version accepted November 16. Supported by the Memorial Sloan-Kettering Sloan Kettering Research and Development Fund. Address correspondence to L.B. (e-mail: bartelll{at}mskcc.org).


Figure 1
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  		Figure 1a: Mammographically detected and biopsy-proved invasive ductal carcinoma in left breast of 52-year-old woman. (a) Sagittal T1-weighted MR image of left breast immediately after intravenous injection of gadolinium diethylenetriaminepentaacetic acid shows a 1.5-cm mass with rim enhancement. (b) Spectrum demonstrates a choline (Cho) peak at a frequency of 3.2 ppm, with a signal-to-noise ratio of greater than 2. This is a true-positive finding. Lac = lactate, Lip = lipid.

 

Figure 1
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  		Figure 1b: Mammographically detected and biopsy-proved invasive ductal carcinoma in left breast of 52-year-old woman. (a) Sagittal T1-weighted MR image of left breast immediately after intravenous injection of gadolinium diethylenetriaminepentaacetic acid shows a 1.5-cm mass with rim enhancement. (b) Spectrum demonstrates a choline (Cho) peak at a frequency of 3.2 ppm, with a signal-to-noise ratio of greater than 2. This is a true-positive finding. Lac = lactate, Lip = lipid.

 

Figure 2
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  		Figure 2a: Suspicious lesion detected at screening in 51-year-old woman with positive family history of breast cancer. (a) Postcontrast sagittal T1-weighted MR image of left breast shows ductal-clumped enhancement in retroareolar region. (b) Magnified spectrum demonstrates a choline (Cho) resonance peak with a signal-to-noise ratio of greater than 2. Excision yielded an atypical chronic inflammatory lesion. This is a false-positive finding. Lac = lactate, Lip = lipid.

 

Figure 2
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  		Figure 2b: Suspicious lesion detected at screening in 51-year-old woman with positive family history of breast cancer. (a) Postcontrast sagittal T1-weighted MR image of left breast shows ductal-clumped enhancement in retroareolar region. (b) Magnified spectrum demonstrates a choline (Cho) resonance peak with a signal-to-noise ratio of greater than 2. Excision yielded an atypical chronic inflammatory lesion. This is a false-positive finding. Lac = lactate, Lip = lipid.

 

Figure 3
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  		Figure 3a: New palpable mass in right breast of 43-year-old woman. MR imaging–guided biopsy followed by surgical excision yielded benign fibrosis and ductal hyperplasia. (a) Postcontrast sagittal T1-weighted MR image of the right breast demonstrates an irregular 4.2-cm mass. (b) Spectrum did not demonstrate a choline (Cho) resonance peak; only noise level was observed at a frequency of 3.2 ppm. This is a true-negative finding. Lac = lactate, Lip = lipid.

 

Figure 3
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  		Figure 3b: New palpable mass in right breast of 43-year-old woman. MR imaging–guided biopsy followed by surgical excision yielded benign fibrosis and ductal hyperplasia. (a) Postcontrast sagittal T1-weighted MR image of the right breast demonstrates an irregular 4.2-cm mass. (b) Spectrum did not demonstrate a choline (Cho) resonance peak; only noise level was observed at a frequency of 3.2 ppm. This is a true-negative finding. Lac = lactate, Lip = lipid.

 




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