Department of Medical Imaging, National Taiwan University Hospital.
Clin Nucl Med. 2021 Nov 1;46(11):896-903. doi: 10.1097/RLU.0000000000003869.
The aim of this study was to evaluate the diagnostic performance of the proton magnetic resonance spectroscopy (MRS) and 18F-fluorocholine (FCH) PET for suspicious breast findings on conventional imaging (mammography and breast ultrasound).
From September 2012 to December 2015, 37 women with 39 breast lesions on conventional imaging were enrolled and underwent proton MRS and FCH PET. The MRS parameters of choline signal-to-noise ratio (SNR), choline integral (I(cho)), and the PET parameters including SUVmax in the prone (SUV1) and supine (SUV2) positions were analyzed. Receiver operating characteristic curves with the area under the curve, sensitivity, and specificity under the optimal cutoff points for the different parameters were determined.
Twenty-three lesions (59%) were malignant, and 16 (41.0%) were benign. The malignant lesions tended to show significantly higher MRS and PET parameters than benign lesions (choline SNR, P = 0.007; I(cho), P = 0.003; SUV1 and SUV2, P < 0.0001). Fair to moderate correlations were noted between the choline SNR and PET parameters (SUV1, Spearman rank correlation coefficient, ρ = 0.477; SUV2, ρ = 0.483), as well as I(cho) and PET parameters (SUV1, ρ = 0.493; SUV2, ρ = 0.549). The SUV2 showed the highest diagnostic performance (area under the curve, 0.918). Using 2.5 as the optimal cutoff point, the SUV2 yields 89.5% sensitivity and 87.5% specificity for differentiating malignant from benign lesions.
The MRS parameters were fairly to moderately correlated with FCH PET parameters, and both could differentiate malignant from benign breast lesions with SUV2 showing best diagnostic performance.
本研究旨在评估质子磁共振波谱（MRS）和 18F-氟胆碱（FCH）PET 对常规成像（乳房 X 线摄影和乳房超声）可疑乳房发现的诊断性能。
2012 年 9 月至 2015 年 12 月，共纳入 37 名女性 39 个常规成像的乳房病变患者，并进行质子 MRS 和 FCH PET 检查。分析 MRS 参数胆碱信号与噪声比（SNR）、胆碱积分（I（cho）），以及 PET 参数，包括俯卧位（SUV1）和仰卧位（SUV2）的 SUVmax。根据不同参数的最佳截断点，确定曲线下面积、敏感性和特异性的接收者操作特征曲线。
23 个病变（59%）为恶性，16 个（41.0%）为良性。恶性病变的 MRS 和 PET 参数明显高于良性病变（胆碱 SNR，P = 0.007；I（cho），P = 0.003；SUV1 和 SUV2，P < 0.0001）。胆碱 SNR 与 PET 参数（SUV1，Spearman 秩相关系数，ρ = 0.477；SUV2，ρ = 0.483）以及 I（cho）与 PET 参数（SUV1，ρ = 0.493；SUV2，ρ = 0.549）之间存在中度至中度相关性。SUV2 显示出最高的诊断性能（曲线下面积，0.918）。使用 2.5 作为最佳截断点，SUV2 对鉴别良恶性病变的敏感性为 89.5%，特异性为 87.5%。
MRS 参数与 FCH PET 参数有中度至中度相关性，两者均能鉴别良恶性乳房病变，SUV2 具有最佳的诊断性能。
