Limited value of multiparametric MRI with dynamic contrast-enhanced and diffusion-weighted imaging in non-mass enhancing breast tumors.
Eur J Radiol
; 156: 110523, 2022 Nov.
Article
in En
| MEDLINE
| ID: mdl-36122521
ABSTRACT
PURPOSE:
To investigate the diagnostic value of multiparametric MRI (mpMRI) including dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) in non-mass enhancing breast tumors.METHOD:
Patients who underwent mpMRI, who were diagnosed with a suspicious non-mass enhancement (NME) on DCE-MRI (BI-RADS 4/5), and who subsequently underwent image-guided biopsy were retrospectively included. Two radiologists independently evaluated all NMEs, on both DCE-MR images and high-b-value DW images. Different mpMRI reading approaches were evaluated 1) with a fixed apparent diffusion coefficient (ADC) threshold (<1.3 malignant, ≥1.3 benign) based on the recommendation by the European Society of Breast Imaging (EUSOBI); 2) with a fixed ADC threshold (<1.5 malignant, ≥1.5 benign) based on recently published trial data; 3) with an ADC threshold adapted to the assigned BI-RADS classification using a previously published reading method; and 4) with individually determined best thresholds for each reader.RESULTS:
The final study sample consisted of 66 lesions in 66 patients. DCE-MRI alone had the highest sensitivity for breast cancer detection (94.8-100 %), outperforming all mpMRI reading approaches (R1 74.4-87.1 %, R2 71.7-94.8 %) and DWI alone (R1 74.4 %, R2 79.4 %). The adapted approach achieved the best specificity for both readers (85.1 %), resulting in the best diagnostic accuracy for R1 (86.5 %) but a moderate diagnostic accuracy for R2 (77.2 %).CONCLUSION:
mpMRI has limited added diagnostic value to DCE-MRI in the assessment of NME.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Breast Neoplasms
/
Multiparametric Magnetic Resonance Imaging
Type of study:
Guideline
Limits:
Female
/
Humans
Language:
En
Journal:
Eur J Radiol
Year:
2022
Document type:
Article
Affiliation country:
Italy
Publication country:
IE
/
IRELAND
/
IRLANDA