MR Spectroscopy for Differentiating Benign From Malignant Solid Adnexal Tumors.

Abstract

OBJECTIVE:

The purpose of this article is to investigate the proton MR spectroscopy ((1)H-MRS) features of solid adnexal tumors and to evaluate the efficacy of (1)H-MRS for differentiating benign from malignant solid adnexal tumors.

MATERIALS AND METHODS:

Sixty-nine patients with surgically and histologically proven solid adnexal tumors (27 benign and 42 malignant) underwent conventional MRI and (1)H-MRS. Single-voxel spectroscopy was performed using the point-resolved spectroscopy localization technique with a voxel size of 2 × 2 × 2 cm(3). Resonance peak integrals of choline, N-acetyl aspartate (NAA), creatine, lactate, and lipid were analyzed, and the choline-tocreatine, NAA-to-creatine, lactate-to-creatine, and lipid-to-creatine ratios were recorded and compared between benign and malignant tumors.

RESULTS:

A choline peak was detected in all 69 cases (100%), NAA peak in 67 cases (97%, 25 benign and 42 malignant), lipid peak in 47 cases (17 benign and 30 malignant), and lactate peak in eight cases (four benign and four malignant). The mean (± SD) choline-tocreatine ratio was 5.13 ± 0.6 in benign tumors versus 8.90 ± 0.5 in malignant solid adnexal tumors, a statistically significant difference (p = 0.000). There were no statistically significant differences between benign and malignant tumors in the NAA-to-creatine and lipid-to-creatine ratios (p = 0.263 and 0.120, respectively). When the choline-to-creatine threshold was 7.46 for differentiating between benign and malignant tumors, the sensitivity, specificity, and accuracy were 94.1%, 97.1%, and 91.2%, respectively.

CONCLUSION:

Our preliminary study shows that the (1)H-MRS patterns of benign and malignant solid adnexal tumors differ. The choline-to-creatine ratio can help clinicians differentiate benign from malignant tumors.

• Authors: Feng Hua Ma, Jin Wei Qiang, Song Qi Cai, Shu Hui Zhao, Guo Fu Zhang, Ya Min Rao
• Journal: AJR. American journal of roentgenology (AJR Am J Roentgenol) Vol. 204 Issue 6 Pg. W724-30 (Jun 2015) ISSN: 1546-3141 [Electronic] United States
• PMID: 26001263 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers, Tumor

Topics

• Adnexal Diseases (diagnosis, metabolism)
• Adult
• Aged
• Aged, 80 and over
• Biomarkers, Tumor (analysis)
• Diagnosis, Differential
• Female
• Humans
• Middle Aged
• Ovarian Neoplasms (chemistry, diagnosis)
• Proton Magnetic Resonance Spectroscopy (methods)
• Reproducibility of Results
• Sensitivity and Specificity
• Young Adult