MR Spectroscopy for Differentiating Benign From Malignant Solid Adnexal Tumors.
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.
['Ma|Feng Hua|FH|', 'Qiang|Jin Wei|JW|', 'Cai|Song Qi|SQ|', 'Zhao|Shu Hui|SH|', 'Zhang|Guo Fu|GF|', 'Rao|Ya Min|YM|']
D000291:Adnexal Diseases D000328:Adult D000368:Aged D000369:Aged, 80 and over D014408:Biomarkers, Tumor D003937:Diagnosis, Differential D005260:Female D006801:Humans D008875:Middle Aged D010051:Ovarian Neoplasms D066244:Proton Magnetic Resonance Spectroscopy D015203:Reproducibility of Results D012680:Sensitivity and Specificity D055815:Young Adult
spectroscopy adnexal tumors MRI ovarian tumors