Adding in vivo quantitative1H MR spectroscopy to improve diagnostic accuracy of breast MR imaging: Preliminary results of observer performance study at 4.0 T

Sina Meisamy, Patrick J. Bolan, Eva H. Baker, Matthew G. Pollema, Chap T. Le, Frederick Kelcz, Mary C. Lechner, Barbara A. Luikens, Richard A. Carlson, Kathleen R Brandt, Kimberly K. Amrami, Michael T. Nelson, Lenore I. Everson, Tim H. Emory, Todd M. Turtle, Douglas Yee, Michael Garwood

Research output: Contribution to journalArticle

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Abstract

PURPOSE: To determine whether the addition of in vivo quantitative hydrogen (1H) magnetic resonance (MR) spectroscopy can improve the radiologist's diagnostic accuracy in interpreting breast MR images to distinguish benign from malignant lesions. MATERIALS AND METHODS: The study was approved by the institutional review board and, where appropriate, was compliant with the Health Insurance Portability and Accountability Act. All patients provided written informed consent. Fifty-five breast MR imaging cases-one lesion each in 55 patients aged 24-66 years with biopsy-confirmed findings-were retrospectively evaluated by four radiologists. Patients were examined with contrast material-enhanced fat-suppressed T1-weighted 4.0-T MR imaging. The concentration of total choline-containing compounds (tCho) was quantified by using single-voxel 1H MR spectroscopy. For each case, the radiologists were asked to give the percentage probability of malignancy, the Breast Imaging and Reporting Data System category, and a recommendation for patient treatment. Two interpretations were performed for each case: The initial interpretation was based on the lesion's morphologic features and time-signal intensity curve, and the second interpretation was based on the lesion's morphologic features, time-signal intensity curve, and tCho concentration. Receiver operating characteristic (ROC), Wilcoxon signed rank, κ statistic, and accuracy (based on the area under the ROC curve) analyses were performed. RESULTS: Of the 55 lesions evaluated, 35 were invasive carcinomas and 20 were benign. The addition of 1H MR spectroscopy resulted in higher sensitivity, specificity, accuracy, and interobserver agreement for all four radiologists. More specifically, two of the four radiologists achieved a significant improvement in sensitivity (P = .03, P = .03), and all four radiologists achieved a significant improvement in accuracy (P = .01, P = .05, P = .009, P < .001). CONCLUSION: Current study results suggest that the addition of quantitative 1H MR spectroscopy to the breast MR imaging examination may help to improve the radiologist's ability to distinguish benign from malignant breast lesions.

Original languageEnglish (US)
Pages (from-to)465-475
Number of pages11
JournalRadiology
Volume236
Issue number2
DOIs
StatePublished - Aug 2005

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Breast
Magnetic Resonance Spectroscopy
Magnetic Resonance Imaging
Choline
ROC Curve
Research Ethics Committees
Social Responsibility
Health Insurance
Radiologists
Informed Consent
Information Systems
Contrast Media
Hydrogen
Fats
Carcinoma
Biopsy
Sensitivity and Specificity
Neoplasms

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Adding in vivo quantitative1H MR spectroscopy to improve diagnostic accuracy of breast MR imaging : Preliminary results of observer performance study at 4.0 T. / Meisamy, Sina; Bolan, Patrick J.; Baker, Eva H.; Pollema, Matthew G.; Le, Chap T.; Kelcz, Frederick; Lechner, Mary C.; Luikens, Barbara A.; Carlson, Richard A.; Brandt, Kathleen R; Amrami, Kimberly K.; Nelson, Michael T.; Everson, Lenore I.; Emory, Tim H.; Turtle, Todd M.; Yee, Douglas; Garwood, Michael.

In: Radiology, Vol. 236, No. 2, 08.2005, p. 465-475.

Research output: Contribution to journalArticle

Meisamy, S, Bolan, PJ, Baker, EH, Pollema, MG, Le, CT, Kelcz, F, Lechner, MC, Luikens, BA, Carlson, RA, Brandt, KR, Amrami, KK, Nelson, MT, Everson, LI, Emory, TH, Turtle, TM, Yee, D & Garwood, M 2005, 'Adding in vivo quantitative1H MR spectroscopy to improve diagnostic accuracy of breast MR imaging: Preliminary results of observer performance study at 4.0 T', Radiology, vol. 236, no. 2, pp. 465-475. https://doi.org/10.1148/radiol.2362040836
Meisamy, Sina ; Bolan, Patrick J. ; Baker, Eva H. ; Pollema, Matthew G. ; Le, Chap T. ; Kelcz, Frederick ; Lechner, Mary C. ; Luikens, Barbara A. ; Carlson, Richard A. ; Brandt, Kathleen R ; Amrami, Kimberly K. ; Nelson, Michael T. ; Everson, Lenore I. ; Emory, Tim H. ; Turtle, Todd M. ; Yee, Douglas ; Garwood, Michael. / Adding in vivo quantitative1H MR spectroscopy to improve diagnostic accuracy of breast MR imaging : Preliminary results of observer performance study at 4.0 T. In: Radiology. 2005 ; Vol. 236, No. 2. pp. 465-475.
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abstract = "PURPOSE: To determine whether the addition of in vivo quantitative hydrogen (1H) magnetic resonance (MR) spectroscopy can improve the radiologist's diagnostic accuracy in interpreting breast MR images to distinguish benign from malignant lesions. MATERIALS AND METHODS: The study was approved by the institutional review board and, where appropriate, was compliant with the Health Insurance Portability and Accountability Act. All patients provided written informed consent. Fifty-five breast MR imaging cases-one lesion each in 55 patients aged 24-66 years with biopsy-confirmed findings-were retrospectively evaluated by four radiologists. Patients were examined with contrast material-enhanced fat-suppressed T1-weighted 4.0-T MR imaging. The concentration of total choline-containing compounds (tCho) was quantified by using single-voxel 1H MR spectroscopy. For each case, the radiologists were asked to give the percentage probability of malignancy, the Breast Imaging and Reporting Data System category, and a recommendation for patient treatment. Two interpretations were performed for each case: The initial interpretation was based on the lesion's morphologic features and time-signal intensity curve, and the second interpretation was based on the lesion's morphologic features, time-signal intensity curve, and tCho concentration. Receiver operating characteristic (ROC), Wilcoxon signed rank, κ statistic, and accuracy (based on the area under the ROC curve) analyses were performed. RESULTS: Of the 55 lesions evaluated, 35 were invasive carcinomas and 20 were benign. The addition of 1H MR spectroscopy resulted in higher sensitivity, specificity, accuracy, and interobserver agreement for all four radiologists. More specifically, two of the four radiologists achieved a significant improvement in sensitivity (P = .03, P = .03), and all four radiologists achieved a significant improvement in accuracy (P = .01, P = .05, P = .009, P < .001). CONCLUSION: Current study results suggest that the addition of quantitative 1H MR spectroscopy to the breast MR imaging examination may help to improve the radiologist's ability to distinguish benign from malignant breast lesions.",
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T1 - Adding in vivo quantitative1H MR spectroscopy to improve diagnostic accuracy of breast MR imaging

T2 - Preliminary results of observer performance study at 4.0 T

AU - Meisamy, Sina

AU - Bolan, Patrick J.

AU - Baker, Eva H.

AU - Pollema, Matthew G.

AU - Le, Chap T.

AU - Kelcz, Frederick

AU - Lechner, Mary C.

AU - Luikens, Barbara A.

AU - Carlson, Richard A.

AU - Brandt, Kathleen R

AU - Amrami, Kimberly K.

AU - Nelson, Michael T.

AU - Everson, Lenore I.

AU - Emory, Tim H.

AU - Turtle, Todd M.

AU - Yee, Douglas

AU - Garwood, Michael

PY - 2005/8

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N2 - PURPOSE: To determine whether the addition of in vivo quantitative hydrogen (1H) magnetic resonance (MR) spectroscopy can improve the radiologist's diagnostic accuracy in interpreting breast MR images to distinguish benign from malignant lesions. MATERIALS AND METHODS: The study was approved by the institutional review board and, where appropriate, was compliant with the Health Insurance Portability and Accountability Act. All patients provided written informed consent. Fifty-five breast MR imaging cases-one lesion each in 55 patients aged 24-66 years with biopsy-confirmed findings-were retrospectively evaluated by four radiologists. Patients were examined with contrast material-enhanced fat-suppressed T1-weighted 4.0-T MR imaging. The concentration of total choline-containing compounds (tCho) was quantified by using single-voxel 1H MR spectroscopy. For each case, the radiologists were asked to give the percentage probability of malignancy, the Breast Imaging and Reporting Data System category, and a recommendation for patient treatment. Two interpretations were performed for each case: The initial interpretation was based on the lesion's morphologic features and time-signal intensity curve, and the second interpretation was based on the lesion's morphologic features, time-signal intensity curve, and tCho concentration. Receiver operating characteristic (ROC), Wilcoxon signed rank, κ statistic, and accuracy (based on the area under the ROC curve) analyses were performed. RESULTS: Of the 55 lesions evaluated, 35 were invasive carcinomas and 20 were benign. The addition of 1H MR spectroscopy resulted in higher sensitivity, specificity, accuracy, and interobserver agreement for all four radiologists. More specifically, two of the four radiologists achieved a significant improvement in sensitivity (P = .03, P = .03), and all four radiologists achieved a significant improvement in accuracy (P = .01, P = .05, P = .009, P < .001). CONCLUSION: Current study results suggest that the addition of quantitative 1H MR spectroscopy to the breast MR imaging examination may help to improve the radiologist's ability to distinguish benign from malignant breast lesions.

AB - PURPOSE: To determine whether the addition of in vivo quantitative hydrogen (1H) magnetic resonance (MR) spectroscopy can improve the radiologist's diagnostic accuracy in interpreting breast MR images to distinguish benign from malignant lesions. MATERIALS AND METHODS: The study was approved by the institutional review board and, where appropriate, was compliant with the Health Insurance Portability and Accountability Act. All patients provided written informed consent. Fifty-five breast MR imaging cases-one lesion each in 55 patients aged 24-66 years with biopsy-confirmed findings-were retrospectively evaluated by four radiologists. Patients were examined with contrast material-enhanced fat-suppressed T1-weighted 4.0-T MR imaging. The concentration of total choline-containing compounds (tCho) was quantified by using single-voxel 1H MR spectroscopy. For each case, the radiologists were asked to give the percentage probability of malignancy, the Breast Imaging and Reporting Data System category, and a recommendation for patient treatment. Two interpretations were performed for each case: The initial interpretation was based on the lesion's morphologic features and time-signal intensity curve, and the second interpretation was based on the lesion's morphologic features, time-signal intensity curve, and tCho concentration. Receiver operating characteristic (ROC), Wilcoxon signed rank, κ statistic, and accuracy (based on the area under the ROC curve) analyses were performed. RESULTS: Of the 55 lesions evaluated, 35 were invasive carcinomas and 20 were benign. The addition of 1H MR spectroscopy resulted in higher sensitivity, specificity, accuracy, and interobserver agreement for all four radiologists. More specifically, two of the four radiologists achieved a significant improvement in sensitivity (P = .03, P = .03), and all four radiologists achieved a significant improvement in accuracy (P = .01, P = .05, P = .009, P < .001). CONCLUSION: Current study results suggest that the addition of quantitative 1H MR spectroscopy to the breast MR imaging examination may help to improve the radiologist's ability to distinguish benign from malignant breast lesions.

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