Department of Psychiatry and Behavioral Neuroscience (R.A.K., J.H.L., J.A.W., W.J.C.) and Department of Radiology (M.C.M.), College of Medicine, University of Cincinnati, 234 Goodman St, ML 761, Cincinnati, OH 45267; Department of Biomedical Engineering, College of Engineering and Applied Science, University of Cincinnati, Cincinnati, Ohio (J.H.L.); and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (J.A.D.).
Radiol Imaging Cancer. 2020 Nov 27;2(6):e200033. doi: 10.1148/rycan.2020200033. eCollection 2020 Nov.
To determine whether MR spectroscopic assessment of fine-needle aspiration (FNA) biopsy specimens from suspicious breast lesions could be used to improve the diagnostic utility of FNA biopsies for the characterization of breast lesions.
In this prospective study, a previously reported technique using high-spatial-resolution proton MR spectroscopy was modified and used to examine the utility of FNA biopsies in the evaluation of suspicious breast lesions. Tissue samples from 115 lesions (from 102 women; average age, 54 years) were excised by using FNA and core biopsies and were collected between September 7, 2012, and April 11, 2014. Histologic results from core biopsy specimens determined the lesions to be benign ( = 55), invasive ductal carcinoma ( = 51), invasive lobular carcinoma ( = 5), or ductal carcinoma in situ ( = 4). Measures of phosphocholine (PC), glycerophosphocholine, and choline relative to each other and to total creatine (tCr) were obtained from usable spectra. Planned comparisons among lesion groups were carried out using test contrasts, and differences of each contrast level from zero were judged significant when the two-tailed value was less than .05.
Of the 115 samples, 69 (60%) yielded no usable MR spectra. Analysis of the 46 with usable spectra found that only the difference in PC/tCr between benign and cancer lesions was statistically significant ( = .028).
Given that 60% of FNA biopsy specimens yielded no usable spectra and that results were largely inconclusive when derived from usable spectra, the combined MR and FNA technique, as modified and implemented in this study, is of little value for detection and diagnosis of breast cancer. Breast, MR-Spectroscopy, Neoplasms-Primary© RSNA, 2020.
确定经细针抽吸活检（FNA）获得的疑似乳腺病变标本的磁共振波谱分析是否可用于提高 FNA 活检对乳腺病变特征的诊断价值。
本前瞻性研究对先前报道的一种应用高空间分辨率质子磁共振波谱技术的方法进行了改良，并用于评估 FNA 活检在评估可疑乳腺病变中的作用。115 个病灶（来自 102 例女性；平均年龄，54 岁）的组织样本通过 FNA 和核心活检切除，采集时间为 2012 年 9 月 7 日至 2014 年 4 月 11 日。核心活检标本的组织学结果确定病变为良性（=55）、浸润性导管癌（=51）、浸润性小叶癌（=5）或导管原位癌（=4）。从可利用的波谱中获得磷酸胆碱（PC）、甘油磷酸胆碱和胆碱相对于彼此以及相对于总肌酸（tCr）的指标。使用 t 检验对比进行病变组间的计划比较，当双侧 P 值小于.05 时，从零判断每个对比水平的差异有统计学意义。
在 115 个样本中，有 69 个（60%）未产生可利用的磁共振波谱。对 46 个有可利用波谱的样本进行分析发现，仅良性和癌症病变之间的 PC/tCr 差异有统计学意义（=.028）。
鉴于 60%的 FNA 活检标本未产生可利用的波谱，且从可利用的波谱中得出的结果主要无定论，因此，本研究中改良并实施的联合磁共振和 FNA 技术对乳腺癌的检测和诊断价值有限。
乳腺；磁共振波谱学；肿瘤，原发性
