Tumor Biology

, Volume 36, Issue 1, pp 345–352 | Cite as

In vivo post-contrast 1H-MRS evaluation of malignant and benign breast lesions: a meta-analysis

  • Jieying Tan
  • Li Xu
  • Wenqing Yao
  • Yun Wan
  • Shuqin Zhou
  • Sherman Xuegang Xin
Research Article


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.


Meta-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



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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2014

Authors and Affiliations

  1. 1.Department of Medical ImagingGuangzhou Nansha Central Hospital, Guangzhou First People’s Hospital, Guangzhou Medical UniversityGuangzhouPeople’s Republic of China
  2. 2.Department of RadiologyGuangdong Provincial Traditional Chinese Medicine Hospital & Postdoctoral Mobile Research Station of Guangzhou University of Traditional Chinese MedicineGuangzhouPeople’s Republic of China
  3. 3.MRI LabBiomedical Engineering School of the Southern Medical UniversityGuangzhou CityChina
  4. 4.Bernard and Irene Schwartz Center for Biomedical ImagingNew York University School of MedicineNew YorkUSA

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