Jury out on MR spectroscopy for breast lesions

A systematic review and meta-analysis of the diagnostic performance of breast proton MR spectroscopy showed variable sensitivity and high specificity in the diagnosis of breast lesions, according to research published online March 6 in Radiology.

Although dynamic contrast material-enhanced MR imaging is sensitive for the detection of breast cancer, false-positive findings limit its diagnostic performance. Thus, an adjunct method providing high specificity would provide diagnostic value, according to Pascal A. Baltzer, MD, from the department of radiology at Medical University Vienna, and colleagues.

The researchers conducted a comprehensive search of PubMed and identified studies on MR breast spectroscopy published through Jan. 6, 2012. They identified 19 studies, which included 1,183 patients with 773 malignant lesions and 452 benign lesions, for data pooling, and calculated pooled sensitivity of 73 percent and specificity of 88 percent.

The researchers noted that half of the studies omitted lesions smaller than 10 mm, which limits application of MR spectroscopy in the diagnosis of early breast cancer and small lesions.

A total of 18 studies acquired data on 1.5T magnets; the researchers reported no difference in performance based on field strength, spectroscopy sequence or method of spectra analysis.

Despite these findings, Baltzer and colleagues wrote, “Further study is warranted to clarify especially the role of multichannel technology, higher field strength and spectroscopic imaging in breast MR spectroscopy, as published empirical data were found to be very limited.”