Hassan Bukhari, Nosheen Ahmad, Irfan Shabbir, Ibrahim Nasir Idrees.
Diagnostic accuracy of magnetic resonance spectroscopy (MRS) in malignant breast lesions.
Pak J Radiol Jun ;29(3):194-201.

Objectives: A Descriptive cross-sectional study was conducted in the Department of Radiology Allied Hospital, Faisalabad from August 2014 to June 2015 to detect the diagnostic Accuracy of Magnetic Resonance Spectroscopy (MRS) In Malignant Breast Lesions using histopathology as gold standard. Materials & Methods: A total of 110 patients with breast lesions on ultrasound (US) and on mammography and age 20-60 years were included. Patients who took chemotherapy for primary or secondary breast cancer, pregnant or breast feeding females, patients with renal failure and contraindication to MRS were excluded. All the patients were then underwent MRS on 1.5 tesla whole body MR imager. Breast lesion was considered as malignant if there was choline peak on magnetic resonance spectroscopy and choline/creatine ratio was >1.5. Magnetic resonance spectroscopy findings were correlated with histopathological findings. Results: Mean age was 49.31 +- 6.76 years. MRS supported the diagnosis of malignant breast lesions in 72 (65.45%) patients. Histopathology confirmed malignancy in 75 (68.18%) cases. In 72 MRS positive patients, 68 were True Positive and 04 were False Positive. Among, 38 MRS negative patients, 07 were False Negative whereas 31 were True Negative. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of MRS in malignant breast lesions was 90.67%, 88.57%, 94.44%, 81.58% and 90.0% respectively. Conclusion: This study concluded that magnetic resonance spectroscopy is a highly sensitive and accurate modality for diagnosing malignant breast lesions, and has improved patient care by accurate and timely diagnosis for taking proper treatment options.

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