Pascal A T Baltzer1, Werner Alois Kaiser2, Matthias Dietzel3. 1. Department of Biomedical Imaging and Imge-guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. Electronic address: patbaltzer@gmail.com. 2. Department of Diagnostic and Interventional Radiology, University Hospital Jena, Erlanger Allee 101, 07740 Jena, Germany. 3. Department of Neuroradiology, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany. Electronic address: dietzelmatthias2@hotmail.com.
Abstract
PURPOSE: To evaluate the influence of lesion type (mass versus non-mass) and reader experience on the diagnostic performance of breast MRI (BMRI) in a non-screening setting. MATERIALS AND METHODS: Consecutive patients (mean age, 55 ± 12 years) with breast lesions that were verified by biopsy or surgery, and who had had BMRI as part of their diagnostic workup, were eligible for this retrospective single-center study. Cancers diagnosed by biopsy before BMRI were excluded to eliminate biological and interpretation bias due to biopsy or chemotherapy effects (n=103). Six blinded readers (experience level, high (HE, n=2); intermediate (IE, n=2); and low (LE, n=2)) evaluated all examinations and assigned independent MRI BI-RADS ratings. Lesion type (mass, non-mass, focal) was noted. Receiver operating characteristics (ROC) and logistic regression analysis was performed to compare diagnostic accuracies. RESULTS: There were 259 histologically verified lesions (123 malignant, 136 benign) investigated. There were 169 mass (103 malignant, 66 benign) and 48 non-mass lesions (19 malignant, 29 benign). Another 42 lesions that met the inclusion criteria were biopsied due to conventional findings (i.e., microcalcifications, architectural distortions), but did not enhance on MRI (41 benign, one DCIS). ROC analysis revealed a total area under the curve (AUC) between 0.834 (LE) and 0.935 (HI). Logistic regression identified a significant effect of non-mass lesions (P<0.0001) and reader experience (P=0.005) on diagnostic performance. CONCLUSIONS: Non-mass lesion type and low reader experience negatively affect the diagnostic performance of breast MRI in a non-screening setting.
PURPOSE: To evaluate the influence of lesion type (mass versus non-mass) and reader experience on the diagnostic performance of breast MRI (BMRI) in a non-screening setting. MATERIALS AND METHODS: Consecutive patients (mean age, 55 ± 12 years) with breast lesions that were verified by biopsy or surgery, and who had had BMRI as part of their diagnostic workup, were eligible for this retrospective single-center study. Cancers diagnosed by biopsy before BMRI were excluded to eliminate biological and interpretation bias due to biopsy or chemotherapy effects (n=103). Six blinded readers (experience level, high (HE, n=2); intermediate (IE, n=2); and low (LE, n=2)) evaluated all examinations and assigned independent MRI BI-RADS ratings. Lesion type (mass, non-mass, focal) was noted. Receiver operating characteristics (ROC) and logistic regression analysis was performed to compare diagnostic accuracies. RESULTS: There were 259 histologically verified lesions (123 malignant, 136 benign) investigated. There were 169 mass (103 malignant, 66 benign) and 48 non-mass lesions (19 malignant, 29 benign). Another 42 lesions that met the inclusion criteria were biopsied due to conventional findings (i.e., microcalcifications, architectural distortions), but did not enhance on MRI (41 benign, one DCIS). ROC analysis revealed a total area under the curve (AUC) between 0.834 (LE) and 0.935 (HI). Logistic regression identified a significant effect of non-mass lesions (P<0.0001) and reader experience (P=0.005) on diagnostic performance. CONCLUSIONS: Non-mass lesion type and low reader experience negatively affect the diagnostic performance of breast MRI in a non-screening setting.
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: Füsun Taşkın; Yasemin Polat; İbrahim H Erdoğdu; Figen T Türkdoğan; Veli Suha Öztürk; Serdar Özbaş Journal: Diagn Interv Radiol Date: 2018-09 Impact factor: 2.630
Authors: Paola Clauser; Barbara Krug; Hubert Bickel; Matthias Dietzel; Katja Pinker; Victor-Frederic Neuhaus; Maria Adele Marino; Marco Moschetta; Nicoletta Troiano; Thomas H Helbich; Pascal A T Baltzer Journal: Clin Cancer Res Date: 2021-01-14 Impact factor: 12.531
Authors: Claudio Spick; Dieter H M Szolar; Klaus W Preidler; Pia Reittner; Katharina Rauch; Peter Brader; Manfred Tillich; Pascal A Baltzer Journal: PLoS One Date: 2018-01-02 Impact factor: 3.240
Authors: Stephan Ellmann; Evelyn Wenkel; Matthias Dietzel; Christian Bielowski; Sulaiman Vesal; Andreas Maier; Matthias Hammon; Rolf Janka; Peter A Fasching; Matthias W Beckmann; Rüdiger Schulz Wendtland; Michael Uder; Tobias Bäuerle Journal: PLoS One Date: 2020-01-30 Impact factor: 3.240