Role of proton MR spectroscopy in the high field magnet (3T) in diagnosis of indeterminate breast masses (BIRDS 3 & 4)

Background: Since 80% of abnormalities found in the breast are benign upon biopsy, New techniques must provide more precise evaluation of these indeterminate lesions.MR spectroscopy is one of the available new techniques on MRI, it refers to the measurement of biochemical compounds in the tissue using specialized sequences. Purpose: To evaluate the role of MR spectroscopy using the state of the art high field magnet (3 Tesla) as a diagnostic method in indeterminate breast lesions (BIRADS 3 and 4 lesions) aiming at decreasing the un-necessary breast intervention. Material & method: In this study 240 female patients classified as BIRADS 3 & 4 by sono-mammography (Sono-MX) were examined by MRI using the multiphase dynamic sequence and proton MR spectroscopy using a high field magnet (3 Tesla). Single voxel technique after adequate shimming was used. Results: Eighty eight cases (35%) were malignant (based on the presence of high choline peak in the spectrum) and 152 cases (65%) were benign (no choline peak). MR-spectroscopy has increased the sensitivity & specificity of Dynamic MR-Mammography for diagnosis of probable lesion from 93.6% (88/94) and 77.9% (152/195) to 96.7% (88/91) and 95.5% (152/159), False positive results were found in 4 cases and False negative results were found in 7 cases. Conclusion: MR Proton spectroscopy in the high field magnet (3T) offered additional information that increased the sensitivity and specificity of the conventional dynamic MRI in evaluating probable breast lesions and hence reduced the need for unnecessary intervention. © 2012 Egyptian Society of Radiology and Nuclear Medicine. Production and hosting by Elsevier B.V. All rights reserved.