Combining DCE-MRI and 1H-MRS spectroscopy by distribution free approach results in a high performance marker: Initial study in breast patients
2013
Magnetic Resonance Imaging has gained popularity in
breast cancer diagnosis since the introduction of contrast media, and recent
developments in MRI have demonstrated a new potential use in diagnosis. Indeed,
the application of in vivo spectroscopy to mammary tissue has revealed that the spectral appearance of
choline could be a marker of malignancy, but early diagnosis and unambiguous
breast cancer characterization could benefit by a standardized protocol for the
simultaneous use of Dynamic Contrast Enhancement MRI and Magnetic Resonance
Spectroscopy and combined interpretation of associated markers. A total of 29 female patients took part
in the study. The combined protocol was performed on a General Electric Signa
HDtx 1.5 Tesla, and the DCE data analysis was performed through an evaluation
of the ROI signal intensity over time. The MRS data analysis evaluated choline
concentration and the signal to noise ratio of the choline peak. Sensitivity,
specificity and accuracy were assessed by the Receiver Operating
Characteristic methodology for Dynamic Contrast Enhancement, Magnetic Resonance
Spectroscopy and their linear combination. We performed a linear combination of
Dynamic Contrast Enhancement MRI and 1H-Magnetic Resonance Spectroscopy by distribution free approach to obtain a
high level diagnostic index. Combining the results of the two diagnostic tests has
resulted in a new, very effective, diagnostic index able to discriminate between
patients with and without malignant disease.
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