1 H MR Spectroscopy of Fine-Needle Aspiration Biopsy Specimens for the Discrimination of Breast Cancer.

Purpose: 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.
Materials and Methods: 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 ( n = 55), invasive ductal carcinoma ( n = 51), invasive lobular carcinoma ( n = 5), or ductal carcinoma in situ ( n = 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 t test contrasts, and differences of each contrast level from zero were judged significant when the two-tailed P value was less than .05.
Results: 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 ( P = .028).
Conclusion: 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. Keywords: Breast, MR-Spectroscopy, Neoplasms-Primary© RSNA, 2020.
Competing Interests: Disclosures of Conflicts of Interest: R.A.K. disclosed no relevant relationships. J.H.L. disclosed no relevant relationships. J.A.W. disclosed no relevant relationships. J.A.D. disclosed no relevant relationships. W.J.C. Activities related to the present article: money paid to institution from an RSNA grant. Activities not related to the present article: disclosed no relevant relationships. Other relationships: disclosed no relevant relationships. M.C.M. Activities related to the present article: disclosed no relevant relationships. Activities not related to the present article: RSNA and ACR board membership, expenses reimbursed from RSNA and ACR; money paid to institution from an ACR Innovation grant; royalties from Elsevier for breast imaging textbooks. Other relationships: disclosed no relevant relationships.
(2020 by the Radiological Society of North America, Inc.)