Ning Qu1, Yahong Luo1, Tao Yu1. 1. Department of Radiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China.
Abstract
INTRODUCTION: Challenges in differentiation between clinically noninflammatory granulomatous lobular mastitis (GLM) and noncalcified ductal carcinoma in situ (DCIS) remain. OBJECTIVE: To identify the dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) characteristics contributing to their differential diagnosis. METHODS: A total of 33 clinically noninflammatory GLM and 36 noncalcified DCIS were retrospectively analyzed in the study. Internal enhancement of a nonmass enhancement (NME) lesion was divided into clustered enhanced ring (absence/presence), and clustered enhanced ring (presence) was further classified as small and large ring based on the optimal cutoff value. The 5th Breast Imaging and Data System MRI descriptors were used for assessing the other DCE-MRI characteristics. Multivariate analysis including variables with significant differences in univariate analyses was conducted to identify the independent predictors. The discriminative abilities of different predictors and their combination were compared by area under the receiver-operating characteristic curves (AUCs). RESULTS: An NME lesion was seen more commonly in clinically noninflammatory GLM than in noncalcified DCIS (p = 0.003). DCE-MRI characteristics with significant differences in univariate analyses included NME size, clustered enhanced ring (absence/presence), ring size, initial increase and kinetic characteristics for the differentiation between these two entities presenting as NME lesion. Clustered enhanced ring (presence) was further classified as small (≤7 mm) or large ring (>7 mm). Multivariate analysis revealed that internal enhancement and initial increase were identified as significant independent predictors, and the AUC of their combination achieved the highest value of 0.867 (95% CI, 0.748-0.943). CONCLUSIONS: An NME lesion with a large ring is more highly suggestive of clinically noninflammatory GLM.
INTRODUCTION: Challenges in differentiation between clinically noninflammatory granulomatous lobular mastitis (GLM) and noncalcified ductal carcinoma in situ (DCIS) remain. OBJECTIVE: To identify the dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) characteristics contributing to their differential diagnosis. METHODS: A total of 33 clinically noninflammatory GLM and 36 noncalcified DCIS were retrospectively analyzed in the study. Internal enhancement of a nonmass enhancement (NME) lesion was divided into clustered enhanced ring (absence/presence), and clustered enhanced ring (presence) was further classified as small and large ring based on the optimal cutoff value. The 5th Breast Imaging and Data System MRI descriptors were used for assessing the other DCE-MRI characteristics. Multivariate analysis including variables with significant differences in univariate analyses was conducted to identify the independent predictors. The discriminative abilities of different predictors and their combination were compared by area under the receiver-operating characteristic curves (AUCs). RESULTS: An NME lesion was seen more commonly in clinically noninflammatory GLM than in noncalcified DCIS (p = 0.003). DCE-MRI characteristics with significant differences in univariate analyses included NME size, clustered enhanced ring (absence/presence), ring size, initial increase and kinetic characteristics for the differentiation between these two entities presenting as NME lesion. Clustered enhanced ring (presence) was further classified as small (≤7 mm) or large ring (>7 mm). Multivariate analysis revealed that internal enhancement and initial increase were identified as significant independent predictors, and the AUC of their combination achieved the highest value of 0.867 (95% CI, 0.748-0.943). CONCLUSIONS: An NME lesion with a large ring is more highly suggestive of clinically noninflammatory GLM.
Authors: Cedric W Pluguez-Turull; Jennifer E Nanyes; Cristina J Quintero; Hamza Alizai; Daniel D Mais; Kenneth A Kist; Nella C Dornbluth Journal: Radiographics Date: 2018 Mar-Apr Impact factor: 5.333
Authors: Murat Kocaoglu; Ibrahim Somuncu; Fatih Ors; Nail Bulakbasi; Cem Tayfun; Serkan Ilkbahar Journal: J Comput Assist Tomogr Date: 2004 Sep-Oct Impact factor: 1.826
Authors: Sanaz A Jansen; Gillian M Newstead; Hiroyuki Abe; Akiko Shimauchi; Robert A Schmidt; Gregory S Karczmar Journal: Radiology Date: 2007-12 Impact factor: 11.105