In vivo post-contrast 1H-MRS evaluation of malignant and benign breast lesions: a meta-analysis
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The aim of this study is to perform a meta-analysis to evaluate the diagnostic performance of the in vivo post-contrast proton magnetic resonance spectroscopy (MRS) for benign/malignant discrimination of focal breast lesions. Sixteen studies with a total of 661 malignant breast lesions and 388 benign breast lesions were included. The pooled sensitivity and specificity of post-contrast 1H-MRS were 74 % (95 % confidence interval (CI) 70–77 %) and 78 % (95 % CI 73–82 %), respectively. The positive likelihood ratio (PLR) and the negative likelihood ratio (NLR) were 4.00 (95 % CI 2.74–5.84) and 0.25 (95 % CI 0.17–0.37), respectively. From the fitted summary receiver operating characteristics curve (SROC), the AUC and Q* index were 0.89 and 0.83. Publication bias was present (t = 2.43, P = 0.029). Meta-regression analysis suggested that neither threshold effect nor evaluated covariates including method of choline analysis, strength of field, pulse sequence, repetition time (TR), and time interval were sources of heterogeneity (all P values >0.05). In vivo post-contrast 1H-MRS was useful for differentiation between malignant and benign focal breast lesions. However, pooled diagnostic measures might be overestimated. The standardization of the acquisition protocol as well as the post-processing method for post-contrast proton MRS need to be established for the future study.
KeywordsMeta-analysis Magnetic resonance spectroscopy Breast cancer
This research was partially supported by the National Natural Science Foundation of China (No. 61172034), the Science Foundation of Guangdong Province for Dr. Startup Project (No. S2012040006618), and the Science and Technology Program of Guangzhou, China (No.2014J4100160).
Conflicts of interest
- 1.Bartella L, Huang W. Proton (1H) MR spectroscopy of the breast. Radiographics. 2007;27 Suppl 1:S241–52.Google Scholar
- 2.Cen D, Xu L. Differential diagnosis between malignant and benign breast lesions using single-voxel proton MRS: a meta-analysis. J Cancer Res Clin Oncol. 2014;140(6):993–1001. doi: 10.1007/s00432-014-1605-7.
- 3.Coleman MP, Quaresma M, Berrino F, Lutz JM, De Angelis R, Capocaccia R, Baili P, Rachet B, Gatta G, Hakulinen T, Micheli A, Sant M, Weir HK, Elwood JM, Tsukuma H, Koifman S, GA ES, Francisci S, Santaquilani M, Verdecchia A, Storm HH, Young JL, Group CW. Cancer survival in five continents: a worldwide population-based study (CONCORD). Lancet Oncol. 2008;730–56. doi: 10.1016/S1470-2045(08)70179-7.
- 4.Lacey Jr JV, Kreimer AR, Buys SS, Marcus PM, Chang SC, Leitzmann MF, et al. Ovarian Cancer Screening Trial Project T: breast cancer epidemiology according to recognized breast cancer risk factors in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial Cohort. BMC Cancer. 2009;9:84.CrossRefPubMedPubMedCentralGoogle Scholar
- 6.Vassiou K, Tsougos I, Kousi E, Vlychou M, Athanasiou E, Theodorou K, Arvanitis DL, Fezoulidis IV. Application value of 3T 1H-magnetic resonance spectroscopy in diagnosing breast tumors. Acta Radiol. 2013;54(4):380–388.Google Scholar
- 10.Baek HM. Diagnostic value of breast proton magnetic resonance spectroscopy at 1.5T in different histopathological types. ScientificWorldJournal. 2012;2012:508295.Google Scholar
- 23.Xu L, Huang Y, Liu X, Liu B. Effects of contrast agent and outer volume saturation bands on water suppression and shimming of hepatic single-volume proton MR spectroscopy at 3.0T. ScientificWorldJournal. 2012;2012:804–698.Google Scholar