Proton magnetic resonance spectroscopic imaging of human breast cancer: a preliminary study

PURPOSE: To investigate the diagnostic value of proton magnetic resonance spectroscopic imaging (MRSI) in patients with breast lesions. MATERIALS AND METHODS: Eighteen patients underwent breast MRSI and MRI at 1.5 T. Contrast-enhanced MR was used to identify the lesion, after which single-slice MRSI (TR/TE = 2000/272 msec, 10-mm slice thickness) was performed. Water, lipid, and choline (Cho) images were reconstructed from MRSI data. The area of the Cho was measured in the lesion and expressed relative to the background noise level (signal-to-noise ratio (SNR)), measured between 7.0 and 9.0 ppm. Cho SNRs were compared between benign and malignant lesions as determined by histopathology. RESULTS: Three cases were considered technical failures on MRSI. Of the remaining 15 cases, on histopathology, eight were classified as malignant carcinoma and seven were benign. The Cho SNR from malignant tissue was significantly elevated compared to benign tissue (6.2 +/- 2.1 vs. 2.4 +/- 0.7, P < 0.0008). CONCLUSIONS: MRSI measurements of Cho are feasible in the human breast, and the SNR for Cho was significantly different between benign and malignant lesions. The potential advantages of MRSI over SV spectroscopy include the ability to assess multiple lesions as well as tissue with normal MRI appearance, as well as to perhaps gauge lesion borders and infiltration into surrounding tissue.