RSNA presenters weigh pros and cons of breast MR spectroscopy

Nov 21, 2002

The latest news in breast MR spectroscopy (MRS) will be presented at the 2002 RSNA meeting in Chicago. This up-and-coming modality looks at the chemical make-up of breast lesions, which can help determine if they are benign or malignant.

Robert Lenkinski, Ph.D., will take part in a refresher course (RC518D) on December 4. His talk will focus on the metabolic profiles of malignant breast lesions, as well as the basic principles of breast MRS.

"The breast ¹H MRS method is robust, easy to interpret, and likely to provide even better diagnostic performance with the development of high-field MRS technologies," Lenkinski wrote in a review published in the Journal of the National Cancer Institute. Lenkinski is a professor at Harvard Medical School in Cambridge, MA, and the director of the 3-tesla MRI/MRS program at Beth Israel Deaconess Medical Center in Boston.

One of Lenkinski’s colleagues, Dr. Rachel Katz-Brull from Harvard, will present a paper on the clinical utility of proton MRS in the characterization of breast lesions (paper 1615) on December 6. She will discuss a pooled analysis of breast MRS studies undertaken to date to determine the factors that influence diagnostic performance.

Katz-Brull’s talk will draw on the results of the JNCI review. Their analysis found that "the addition of MRS to the MRI examination permits noninvasive detection of tissue metabolism...the ¹H MRS examination can be easily integrated into a routine MRI examination with the addition of as little as 10 minutes to the overall scan time," (JNCI, August 21, 2002, Vol. 94:16, pp. 1197-1203).

Some of the main points of this study were:

MRS has a sensitivity of 83% and a specificity of 85% for pinpointing breast lesions.

The sensitivity of MRS depends on tumor size.

MRS has a higher sensitivity (95%) for detecting lesions in women under the age of 40.

False-negative MRS results are generally due to technical glitches, such as hardware failure, degradation of the local field homogeneity because of blood products, and patient movement.

These pitfalls for breast MRS will be the topic of an RSNA education exhibit by Dr. Eva Baker and colleagues from the Center for Magnetic Resonance Research at the University of Minnesota School of Medicine in Minneapolis.

"The objective of this exhibit is to make readers aware of issues unique to breast MRS, and to discuss how to reduce the effect of common problems and pitfalls... We studied 66 women with (one-dimensional) MRS and 54 with 2-D MRS (TE averaging)," Baker wrote in the exhibit’s abstract (space 0134BR-e).

One of their findings was that 1-D MRS imaging suffered from lipid sideband contamination. A more in-depth report on this problem was published in Magnetic Resonance in Medicine (August 2002, Vol. 48:2, pp. 215-222).

By Shalmali Pal
AuntMinnie.com staff writer
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