Differentiating between Benign & Malignant Breast Tumors using the Choline Concentration As Determined by Chemical Shift Imaging

Paul E. Sijens^1,2, Monique D. Dorrius¹, Ruud M. Pijnappel¹, Martine C. Jansen-van der Weide¹, Peter Kappert¹, Matthijs Oudkerk^1,2

Most of the studies published to date use single-voxel MRS methodology suffering from limitations inherent to the method used. The remainder are multivoxel studies using qualitative or semiquantitative measurements for the detection of Cho (i.e. detectability or Cho signal-to-noise ratio. Here a recently published multivoxel MRS method based on quantitative measurement was used. The significant difference between the Cho concentrations in benign and malignant breast lesions, strongly indicates that the lesion Cho concentration in mM offers a diagnostically meaningful test, i.e. a cut-off point of 1.5 mM. Quantitative multivoxel MRS may thus be applied to reliably exclude benign breast lesions such as fibroadenomas from biopsy or other invasive procedures.