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Diffusion-Weighted Imaging-guided MR Spectroscopy in Breast Lesions using Readout-Segmented Echo-Planar Imaging

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Abstract

Purpose

To investigate the feasibility and effectiveness of diffusion-weighted imaging (DWI)-guided magnetic resonance spectroscopy (MRS) using readout-segmented echo-planar imaging (RS-EPI) to characterise breast lesions.

Materials and methods

A total of 258 patients with 258 suspicious breast lesions larger than 1 cm in diameter were examined using DWI-guided, single-voxel MRS with RS-EPI. The mean total choline-containing compound (tCho) signal-to-noise ratio (SNR) and concentration were used for the interpretation of MRS data. T-tests, χ2-tests, receiver operating characteristic (ROC) curve analyses and Pearson correlations were conducted for statistical analysis.

Results

Histologically, 183 lesions were malignant, and 75 lesions were benign. Both the mean tCho SNR and concentration of malignant lesions were higher than those of benign lesions (6.23 ± 3.30 AU/mL vs. 1.26 ± 1.75 AU/mL and 3.17 ± 2.03 mmol/kg vs. 0.86 ± 0.83 mmol/kg, respectively; P < 0.0001). For a tCho SNR of 2.0 AU/mL and a concentration of 1.76 mmol/kg, the corresponding areas under the ROC curves were 0.93 and 0.90, respectively. The mean tCho SNR and concentration negatively correlated with apparent diffusion coefficients calculated from RS-EPI, with correlation coefficients of −0.54 and −0.48, respectively.

Conclusion

DWI-guided MRS using RS-EPI is feasible and accurate for characterising breast lesions.

Key Points

• The mean tCho SNR and concentration negatively correlated with ADCs.

• DWI-guided MRS using RS-EPI is feasible.

• DWI-guided MRS using RS-EPI accurately characterises breast lesions.

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Abbreviations

ADC:

Apparent diffusion coefficient

AUC:

Area under the receiver operating characteristic curve

BI-RADS:

Breast Imaging Reporting and Data System

CI:

Confidence interval

DCE:

Dynamic contrast enhancement

DWI:

Diffusion-weighted imaging

MRS:

Magnetic resonance spectroscopy

ROC:

Receiver operating characteristic

ROI:

Region of interest

RS-EPI:

Readout-segmented echo-planar imaging

SNR:

Signal-to-noise ratio

SS-EPI:

Single-shot echo-planar imaging

tCho:

Total choline-containing compounds

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Acknowledgments

The scientific guarantor of this publication is FuhuaYan. The authors of this manuscript declare relationships with Siemens Shenzhen Magnetic Resonance Ltd. No complex statistical methods were necessary for this study. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. The study subjects and cohorts have not been previously reported. Methodology: prospective, diagnostic or prognostic study, performed at one institution.

Author information

Authors and Affiliations

  1. Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai, 200025, China

    Kun Sun, Weimin Chai, Ying Zhan, Xianfu Luo & Fuhua Yan

  2. Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai, 200025, China

    Kunwei Shen

  3. Siemens Shenzhen Magnetic Resonance Ltd, Siemens MRI Center, Gaoxin C.Ave, 2nd, Hi-Tech Industrial Park, Shenzhen, 518057, People’s Republic of China

    Caixia Fu

Authors
  1. Kun Sun
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  2. Weimin Chai
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  3. Caixia Fu
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  7. Fuhua Yan
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Correspondence to Fuhua Yan.

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Sun, K., Chai, W., Fu, C. et al. Diffusion-Weighted Imaging-guided MR Spectroscopy in Breast Lesions using Readout-Segmented Echo-Planar Imaging. Eur Radiol 26, 1565–1574 (2016). https://doi.org/10.1007/s00330-015-4000-0

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  • DOI: https://doi.org/10.1007/s00330-015-4000-0

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