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.
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.
Authors: Tibor Vag; Pascal A T Baltzer; Matthias Dietzel; Ramy Zoubi; Mieczyslaw Gajda; Oumar Camara; Werner A Kaiser Journal: Eur Radiol Date: 2010-11-10 Impact factor: 5.315
Authors: Maria Adele Marino; Paola Clauser; Ramona Woitek; Georg J Wengert; Panagiotis Kapetas; Maria Bernathova; Katja Pinker-Domenig; Thomas H Helbich; Klaus Preidler; Pascal A T Baltzer Journal: Eur Radiol Date: 2015-10-29 Impact factor: 5.315
Authors: K Pinker; W Bogner; P Baltzer; S Trattnig; S Gruber; O Abeyakoon; M Bernathova; O Zaric; P Dubsky; Z Bago-Horvath; M Weber; D Leithner; T H Helbich Journal: Eur Radiol Date: 2013-12-05 Impact factor: 5.315