Magnetic Resonance Spectroscopy; An Objective Modality to Identify the Pathology of Breast Neoplasms
Abstract
Proton Magnetic Resonance Spectroscopy (MRS) in conjunction with Statistical Computerised Strategies (SCS) provides an alternative modality for the pathological diagnosis and prognosis of breast fine needle aspiration (FNA) biopsies. Benign breast lesions are distinguished from invasive cancer with a sensitivity and specificity of 95% and 96%, respectively, when visual inspection methods alone are employed. These spectra all had a signal to noise ratio (SNR) > 25. Ductal carcinoma in situ (DCIS) specimens were ranked by MRS as benign or malignant. This ranking is not explained by histopathology, suggesting MRS is reporting on chemical differences which are not morphologically manifest. Analysis of MRS data using SCS distinguishes benign and malignant lesions with a sensitivity and specificity of 92% and an accuracy of 93% for all spectra. MRS combined with SCS also reports on vascular invasion and lymph node involvement for patients with invasive breast lesions with an accuracy of 92% and 95%, respectively. A multicentre trial is now underway to verify the MRS method in four international sites: the Karolinska Institute, Stockholm, Sweden; Beth Israel and Deaconess Hospital, Boston, USA; North Western University, Chicago, USA; Royal Adelaide Hospital, Adelaide, Australia. Proton MRS on FNA from axillary nodes can detect the presence of metastatic breast disease. The method is now being used to assess sentinel lymph nodes. Two dimensional (2D) COSY MRS was unable to discriminate benign and malignant pathologies in breast tissues due large lipid contribution in the spectra or in breast FNA due to inadequate signal to noise.
Document Details
- Document Type
- Technical Report
- Publication Date
- May 01, 2000
- Accession Number
- ADB262298
Entities
People
- Carolyn Mountford
Organizations
- University of Sydney