Sodano C, Clauser P, Dietzel M, et al. - This study was undertaken to investigate the additional value of quantitative tCho evaluation to diagnose malignancy and lymph node metastases in suspicious lesions on multiparametric breast MRI (mpMRI, BI-RADS 4, and BI-RADS 5). Researchers prospectively included a total of 121 patients that demonstrated suspicious multiparametric breast MRI lesions applying DCE, T2w, and diffusion-weighted (DW) images in this IRB-approved study. They assessed and normalized total choline (tCho) amplitude to millimoles/liter according to established methodology by two independent readers (R1, R2). They used ROC-analysis to prognosticate malignancy and lymph node status by tCho results. The outcomes of this research demonstrate that quantitative tCho assessment from ¹ H-MRS allowed diagnose malignancy and lymph node status in breast lesions suspicious on multiparametric breast MRI. tCho thus indicated the potential to downgrade suspicious mpMRI lesions and stratify the risk of lymph node metastases for improved patient management.