1H MR Spectroscopy of Fine-Needle Aspiration Biopsy Specimens for the Discrimination of Breast Cancer

PurposeTo determine whether MR spectroscopic assessment of fine-needle aspiration (FNA) biopsy specimens from suspicious breast lesions could be used to improve the diagnostic utility of FNA biopsies for the characterization of breast lesions. Materials and MethodsIn this prospective study, a previo...

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Published inRadiology. Imaging cancer Vol. 2; no. 6; p. e200033
Main Authors Komoroski, Richard A, Lee, Jing-Huei, Welge, Jeffrey A, Dudley, Jonathan A, Chu, Wen-Jang, Mahoney, Mary C
Format Journal Article
LanguageEnglish
Published Radiological Society of North America 27.11.2020
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Summary:PurposeTo determine whether MR spectroscopic assessment of fine-needle aspiration (FNA) biopsy specimens from suspicious breast lesions could be used to improve the diagnostic utility of FNA biopsies for the characterization of breast lesions. Materials and MethodsIn this prospective study, a previously reported technique using high-spatial-resolution proton MR spectroscopy was modified and used to examine the utility of FNA biopsies in the evaluation of suspicious breast lesions. Tissue samples from 115 lesions (from 102 women; average age, 54 years) were excised by using FNA and core biopsies and were collected between September 7, 2012, and April 11, 2014. Histologic results from core biopsy specimens determined the lesions to be benign (n = 55), invasive ductal carcinoma (n = 51), invasive lobular carcinoma (n = 5), or ductal carcinoma in situ (n = 4). Measures of phosphocholine (PC), glycerophosphocholine, and choline relative to each other and to total creatine (tCr) were obtained from usable spectra. Planned comparisons among lesion groups were carried out using t test contrasts, and differences of each contrast level from zero were judged significant when the two-tailed P value was less than .05. ResultsOf the 115 samples, 69 (60%) yielded no usable MR spectra. Analysis of the 46 with usable spectra found that only the difference in PC/tCr between benign and cancer lesions was statistically significant (P = .028). ConclusionGiven that 60% of FNA biopsy specimens yielded no usable spectra and that results were largely inconclusive when derived from usable spectra, the combined MR and FNA technique, as modified and implemented in this study, is of little value for detection and diagnosis of breast cancer.Keywords: Breast, MR-Spectroscopy, Neoplasms-Primary© RSNA, 2020.
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Author contributions: Guarantors of integrity of entire study, J.H.L., W.J.C., M.C.M.; study concepts/study design or data acquisition or data analysis/interpretation, all authors; manuscript drafting or manuscript revision for important intellectual content, all authors; approval of final version of submitted manuscript, all authors; agrees to ensure any questions related to the work are appropriately resolved, all authors; literature research, R.A.K., J.H.L., J.A.D., W.J.C., M.C.M.; clinical studies, R.A.K., J.H.L., J.A.D., W.J.C., M.C.M.; statistical analysis, J.H.L., J.A.W., W.J.C.; and manuscript editing, R.A.K., J.H.L., J.A.D., W.J.C., M.C.M.
ISSN:2638-616X
DOI:10.1148/rycan.2020200033