期刊
AMERICAN JOURNAL OF ROENTGENOLOGY
卷 194, 期 6, 页码 1658-1663出版社
AMER ROENTGEN RAY SOC
DOI: 10.2214/AJR.09.3486
关键词
breast cancer; breast MRI; false-positive; MR mammography; sensitivity; specificity
OBJECTIVE. Breast MRI has high sensitivity in breast cancer detection, and the BI-RADS MRI lexicon was a step toward standardized description of lesions. However, false-positive findings occur and lead to unnecessary biopsy. The purpose of this investigation was to identify criteria for false-positive findings in clinical practice. MATERIALS AND METHODS. Eligible for investigation were all breast MRI examinations from a consecutive 16-month time period that had histopathologic verification and findings classified as BI-RADS category 4-6 in the initial MRI report. Accordingly, 132 patients with 120 malignant and 31 benign lesions were enrolled. Two blinded observers categorized lesions into mass or nonmass and used BI-RADS to identify descriptor distribution differences between the benign and malignant subgroups. RESULTS. The ratio of mass to nonmass lesions differed significantly (p < 0.001) between benign (1.2:1) and malignant (7: 1) findings. Seventeen mass and 14 nonmass lesions were false-positive, and 105 mass and 15 nonmass lesions were true-positive. Among mass lesions, it was possible to differentiate malignant and benign lesions on the basis of margin (smooth, irregular, or spiculated) and dynamic enhancement features (p < 0.05). Among nonmass lesions, only stippled enhancement had a significant difference between the subgroups (p < 0.05). Tumor diameter had no influence on the correct diagnosis of nonmass lesions (p = 0.301). Conversely, among mass lesions, false-positive lesions were smaller than true-positive lesions (p = 0.01). CONCLUSION. Nonmass lesions were the major cause of false-positive breast MRI findings. BI-RADS descriptors are not sufficient for differentiating benign and malignant nonmass lesions.
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