Magnetic resonance spectroscopy in recurrent breast masses following conservative surgery and radiation therapy

Purpose

The purpose of our study was to assess the value of functional magnetic resonance spectroscopy (1H MRS) in evaluating patients with recurrent cancer breast after breast conservative therapy (BCT) and radiation therapy by the presence of the choline-containing compounds (Cho) as a marker of malignancy.

Patients and methods

Twenty-six patients were included in the study all the patients were subjected to previous BCT and associated radiation therapy. All of them were suspected to have tumor recurrence by clinical examinations, periodic mammographic examination and or ultrasonography. All the patients were submitted to dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) followed by magnetic resonance spectroscopy (MRS) at 1.5 T MRI machine.

Results

Local recurrence was confirmed by histopathology in 19 patients, MRS detected 18 patients with sensitivity of 94.7%, false positive was seen in one patient in whom histopathology revealed inflammatory mastitis (specificity 85.7%). One patient was false negative diagnosed by histopathology as ductal carcinoma in situ (DCIS) with negative predictive value of 85.7% and overall accuracy of 92.3%.

Conclusion

In our study breast MRS using choline (Cho) integral was accurate in evaluating patients with recurrent breast masses after BCT and radiation therapy. It reaches a high level of diagnostic performance.