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Clinical relevance of total choline (tCho) quantification in suspicious lesions on multiparametric breast MRI.

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Title: Clinical relevance of total choline (tCho) quantification in suspicious lesions on multiparametric breast MRI.
Authors: Sodano, Claudia1 (AUTHOR), Clauser, Paola1 (AUTHOR), Dietzel, Matthias2 (AUTHOR), Kapetas, Panagiotis1 (AUTHOR), Pinker, Katja3 (AUTHOR), Helbich, Thomas H.1 (AUTHOR), Gussew, Alexander4 (AUTHOR), Baltzer, Pascal Andreas1 (AUTHOR) pascal.baltzer@meduniwien.ac.at
Source: European Radiology. Jun2020, Vol. 30 Issue 6, p3371-3382. 12p. 4 Charts, 6 Graphs.
Subjects: Breast, Choline, Lymph nodes, Normalized measures, Nuclear magnetic resonance spectroscopy, Adenocarcinoma, Lobular carcinoma, Breast diseases, Proton magnetic resonance spectroscopy, Magnetic resonance imaging, Ductal carcinoma, Breast cancer, Research funding, Receiver operating characteristic curves, Barthel Index, Breast tumors
Abstract: Purpose: To assess the additional value of quantitative tCho evaluation to diagnose malignancy and lymph node metastases in suspicious lesions on multiparametric breast MRI (mpMRI, BI-RADS 4, and BI-RADS 5).Methods: One hundred twenty-one patients that demonstrated suspicious multiparametric breast MRI lesions using DCE, T2w, and diffusion-weighted (DW) images were prospectively enrolled in this IRB-approved study. All underwent single-voxel proton MR spectroscopy (1H-MRS, point-resolved spectroscopy sequence, TR 2000 ms, TE 272 ms) with and without water suppression. The total choline (tCho) amplitude was measured and normalized to millimoles/liter according to established methodology by two independent readers (R1, R2). ROC-analysis was employed to predict malignancy and lymph node status by tCho results.Results: One hundred three patients with 74 malignant and 29 benign lesions had full 1H-MRS data. The area under the ROC curve (AUC) for prediction of malignancy was 0.816 (R1) and 0.809 (R2). A cutoff of 0.8 mmol/l tCho could diagnose malignancy with a sensitivity of > 95%. For prediction of lymph node metastases, tCho measurements achieved an AUC of 0.760 (R1) and 0.788 (R2). At tCho levels < 2.4 mmol/l, no metastatic lymph nodes were found.Conclusion: Quantitative tCho evaluation from 1H-MRS allowed diagnose malignancy and lymph node status in breast lesions suspicious on multiparametric breast MRI. tCho therefore demonstrated the potential to downgrade suspicious mpMRI lesions and stratify the risk of lymph node metastases for improved patient management.Key Points: • Quantitative tCho evaluation can distinguish benign from malignant breast lesions suspicious after multiparametric MRI assessment. • Quantitative tCho levels are associated with lymph node status in breast cancer. • Quantitative tCho levels are higher in hormonal receptor positive compared to hormonal receptor negative lesions. [ABSTRACT FROM AUTHOR]
Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Clinical relevance of total choline (tCho) quantification in suspicious lesions on multiparametric breast MRI.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Sodano%2C+Claudia%22&quot;&gt;Sodano, Claudia&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Clauser%2C+Paola%22&quot;&gt;Clauser, Paola&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Dietzel%2C+Matthias%22&quot;&gt;Dietzel, Matthias&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Kapetas%2C+Panagiotis%22&quot;&gt;Kapetas, Panagiotis&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Pinker%2C+Katja%22&quot;&gt;Pinker, Katja&lt;/searchLink&gt;&lt;relatesTo&gt;3&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Helbich%2C+Thomas+H%2E%22&quot;&gt;Helbich, Thomas H.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Gussew%2C+Alexander%22&quot;&gt;Gussew, Alexander&lt;/searchLink&gt;&lt;relatesTo&gt;4&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Baltzer%2C+Pascal+Andreas%22&quot;&gt;Baltzer, Pascal Andreas&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;i&gt; pascal.baltzer@meduniwien.ac.at&lt;/i&gt;
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22European+Radiology%22&quot;&gt;European Radiology&lt;/searchLink&gt;. Jun2020, Vol. 30 Issue 6, p3371-3382. 12p. 4 Charts, 6 Graphs.
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  Data: &lt;bold&gt;Purpose: &lt;/bold&gt;To assess the additional value of quantitative tCho evaluation to diagnose malignancy and lymph node metastases in suspicious lesions on multiparametric breast MRI (mpMRI, BI-RADS 4, and BI-RADS 5).&lt;bold&gt;Methods: &lt;/bold&gt;One hundred twenty-one patients that demonstrated suspicious multiparametric breast MRI lesions using DCE, T2w, and diffusion-weighted (DW) images were prospectively enrolled in this IRB-approved study. All underwent single-voxel proton MR spectroscopy (1H-MRS, point-resolved spectroscopy sequence, TR 2000&#160;ms, TE 272&#160;ms) with and without water suppression. The total choline (tCho) amplitude was measured and normalized to millimoles/liter according to established methodology by two independent readers (R1, R2). ROC-analysis was employed to predict malignancy and lymph node status by tCho results.&lt;bold&gt;Results: &lt;/bold&gt;One hundred three patients with 74 malignant and 29 benign lesions had full 1H-MRS data. The area under the ROC curve (AUC) for prediction of malignancy was 0.816 (R1) and 0.809 (R2). A cutoff of 0.8&#160;mmol/l tCho could diagnose malignancy with a sensitivity of &gt; 95%. For prediction of lymph node metastases, tCho measurements achieved an AUC of 0.760 (R1) and 0.788 (R2). At tCho levels &lt; 2.4&#160;mmol/l, no metastatic lymph nodes were found.&lt;bold&gt;Conclusion: &lt;/bold&gt;Quantitative tCho evaluation from 1H-MRS allowed diagnose malignancy and lymph node status in breast lesions suspicious on multiparametric breast MRI. tCho therefore demonstrated the potential to downgrade suspicious mpMRI lesions and stratify the risk of lymph node metastases for improved patient management.&lt;bold&gt;Key Points: &lt;/bold&gt;• Quantitative tCho evaluation can distinguish benign from malignant breast lesions suspicious after multiparametric MRI assessment. • Quantitative tCho levels are associated with lymph node status in breast cancer. • Quantitative tCho levels are higher in hormonal receptor positive compared to hormonal receptor negative lesions. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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        Value: 10.1007/s00330-020-06678-z
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      – SubjectFull: Breast
        Type: general
      – SubjectFull: Choline
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      – SubjectFull: Lymph nodes
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              Text: Jun2020
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