Journal
EUROPEAN JOURNAL OF RADIOLOGY
Volume 156, Issue -, Pages -Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.ejrad.2022.110523
Keywords
Multiparametric magnetic resonance imaging; Breast neoplasms; Non-mass enhancement; Apparent diffusion coefficient; Diffusion-weighted imaging; Dynamic contrast-enhanced MRI
Funding
- Vienna Science and Technology Fund [LS19-046]
- NIH/NCI Cancer Center Support Grant [P30 CA008748]
- Austrian National Bank 'Jubilaumsfond' Project [182907]
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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 was investigated. The results showed that DCE-MRI had the highest sensitivity for breast cancer detection, while the diagnostic value of mpMRI was limited.
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.
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