Maya Honda1, Masako Kataoka2, Kosuke Kawaguchi3, Mami Iima1,4, Kanae Kawai Miyake1, Ayami Ohno Kishimoto1, Rie Ota1, Akane Ohashi5, Masakazu Toi3, Yuji Nakamoto1. 1. Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan. 2. Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan. makok@kuhp.kyoto-u.ac.jp. 3. Department of Breast Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan. 4. Institute for Advancement of Clinical and Translational Science (iACT), Kyoto University Hospital, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-7507, Japan. 5. Department of Radiology, National Hospital Organization Kyoto Medical Center, 1-1, Fukakushamukaihatacho, Fishimi-ku, Kyoto, 612-8555, Japan.
Abstract
PURPOSE: Category 4 in BI-RADS for magnetic resonance imaging (MRI) has a wide range of probabilities of malignancy, extending from > 2 to < 95%. We classified category 4 lesions into three subcategories and analyzed the positive predictive value (PPV) of malignancy in a tertiary hospital. MATERIALS AND METHODS: This retrospective study included 346 breast MRIs with 434 category 2-5 lesions. All enhancing lesions were classified as category 2 (0% probability of malignancy), 3 (> 0%, ≤ 2%), 4 (> 2%, < 95%) and 5 (≥ 95%); category 4 lesions were further subcategorized into 4A (> 2%, ≤ 10%), 4B (> 10%, ≤ 50%) and 4C (> 50%, < 95%) at the time of diagnosis. Radiological and pathological reports were retrospectively analyzed, and the PPVs were calculated. RESULTS: We included 149 malignant and 285 benign lesions. The PPVs of subcategories 4A, 4B and 4C were 1.8%, 11.8% and 67.5%, respectively. The PPVs were higher for lesions coexisting with category 5 or 6 lesions compared with those for isolated lesions. CONCLUSION: Category 4 lesions can be classified into three subcategories depending on the likelihood of malignancy. Lesions coexisting with category 5 or 6 lesions are more likely to be malignant.
PURPOSE: Category 4 in BI-RADS for magnetic resonance imaging (MRI) has a wide range of probabilities of malignancy, extending from > 2 to < 95%. We classified category 4 lesions into three subcategories and analyzed the positive predictive value (PPV) of malignancy in a tertiary hospital. MATERIALS AND METHODS: This retrospective study included 346 breast MRIs with 434 category 2-5 lesions. All enhancing lesions were classified as category 2 (0% probability of malignancy), 3 (> 0%, ≤ 2%), 4 (> 2%, < 95%) and 5 (≥ 95%); category 4 lesions were further subcategorized into 4A (> 2%, ≤ 10%), 4B (> 10%, ≤ 50%) and 4C (> 50%, < 95%) at the time of diagnosis. Radiological and pathological reports were retrospectively analyzed, and the PPVs were calculated. RESULTS: We included 149 malignant and 285 benign lesions. The PPVs of subcategories 4A, 4B and 4C were 1.8%, 11.8% and 67.5%, respectively. The PPVs were higher for lesions coexisting with category 5 or 6 lesions compared with those for isolated lesions. CONCLUSION: Category 4 lesions can be classified into three subcategories depending on the likelihood of malignancy. Lesions coexisting with category 5 or 6 lesions are more likely to be malignant.
Entities:
Keywords:
Breast neoplasms; Diagnosis; Magnetic resonance imaging
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