Mariko Goto1, Koji Sakai2, Hajime Yokota3, Maki Kiba4, Mariko Yoshida2, Hiroshi Imai5, Elisabeth Weiland6, Isao Yokota7, Kei Yamada2. 1. Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi Hirokoji, Kamigyoku, Kyoto, 602-8566, Japan. gomari@koto.kpu-m.ac.jp. 2. Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi Hirokoji, Kamigyoku, Kyoto, 602-8566, Japan. 3. Department of Radiology, Chiba University Hospital, Chiba, Japan. 4. Department of Radiology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan. 5. Siemens Healthcare K.K., Tokyo, Japan. 6. Siemens Healthcare GmbH, Erlangen, Germany. 7. Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Abstract
OBJECTIVES: To assess the diagnostic value and contribution to BI-RADS categorisation of initial enhancement on ultra-fast DCE-MRI for differentiating malignant and benign breast lesions. METHODS: The institutional review board approved this study, and written informed consent was obtained from each participant. Both ultra-fast DCE-MRI for initial enhancement analysis and conventional MRI were performed on 200 subjects with a total of 215 lesions (147 malignant and 68 benign). BI-RADS categorisation of enhancing lesions was performed using the conventional MRI. Two initial enhancement measures, time to enhancement (TTE) and maximum slope (MS), were derived from the ultra-fast DCE-MRI. Diagnostic performance and the additional diagnostic value of adding TTE and MS to BI-RADS were evaluated. RESULTS: Both TTE and MS showed significant differences between malignant and benign breast lesions in masses (TTE, p <.001; MS, p = .006) and non-mass enhancement (NME) (TTE, p <.001; MS, p <.001). For masses, the AUC of TTE+MS combined with BI-RADS (0.864) was better than BI-RADS alone (0.823, p = .065). For NME, the AUC of TTE+MS combined with BI-RADS (0.923) was significantly larger than BI-RADS alone (0.865, p = .036), and diagnostic specificity improved by 40.9% (p = .005), without a significant decrease in the sensitivity (p = .083). CONCLUSION: Initial enhancement analysis using ultra-fast DCE-MRI is especially useful for increasing the diagnostic performance of NME in breast MRI. KEY POINTS: • Ultra-fast dynamic MRI effectively differentiates benign from malignant breast lesions. • Ultra-fast dynamic MRI contributes to BI-RADS categorisation in non-mass enhancement. • Management of non-mass breast lesions becomes more appropriate.
OBJECTIVES: To assess the diagnostic value and contribution to BI-RADS categorisation of initial enhancement on ultra-fast DCE-MRI for differentiating malignant and benign breast lesions. METHODS: The institutional review board approved this study, and written informed consent was obtained from each participant. Both ultra-fast DCE-MRI for initial enhancement analysis and conventional MRI were performed on 200 subjects with a total of 215 lesions (147 malignant and 68 benign). BI-RADS categorisation of enhancing lesions was performed using the conventional MRI. Two initial enhancement measures, time to enhancement (TTE) and maximum slope (MS), were derived from the ultra-fast DCE-MRI. Diagnostic performance and the additional diagnostic value of adding TTE and MS to BI-RADS were evaluated. RESULTS: Both TTE and MS showed significant differences between malignant and benign breast lesions in masses (TTE, p <.001; MS, p = .006) and non-mass enhancement (NME) (TTE, p <.001; MS, p <.001). For masses, the AUC of TTE+MS combined with BI-RADS (0.864) was better than BI-RADS alone (0.823, p = .065). For NME, the AUC of TTE+MS combined with BI-RADS (0.923) was significantly larger than BI-RADS alone (0.865, p = .036), and diagnostic specificity improved by 40.9% (p = .005), without a significant decrease in the sensitivity (p = .083). CONCLUSION: Initial enhancement analysis using ultra-fast DCE-MRI is especially useful for increasing the diagnostic performance of NME in breast MRI. KEY POINTS: • Ultra-fast dynamic MRI effectively differentiates benign from malignant breast lesions. • Ultra-fast dynamic MRI contributes to BI-RADS categorisation in non-mass enhancement. • Management of non-mass breast lesions becomes more appropriate.
Entities:
Keywords:
Breast neoplasms; Classification; Contrast media; Kinetics; Magnetic resonance imaging
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