Yongyu An1, Guoqun Mao2, Weiqun Ao1, Fan Mao1, Hongxia Zhang1, Yougen Cheng1, Guangzhao Yang1. 1. Department of Radiology, Tongde Hospital of Zhejiang Province, No. 234, Gucui Road, Xihu District, Hangzhou, 310012, Zhejiang Province, China. 2. Department of Radiology, Tongde Hospital of Zhejiang Province, No. 234, Gucui Road, Xihu District, Hangzhou, 310012, Zhejiang Province, China. maoguoqun123@163.com.
Abstract
OBJECTIVES: To explore added value of diffusion-weighted imaging (DWI) as an adjunct to Kaiser score (KS) for differentiation of benign from malignant lesions on breast magnetic resonance imaging (MRI). METHODS: Two hundred forty-six patients with 273 lesions (155 malignancies) were included in this retrospective study from January 2015 to December 2019. All lesions were proved by pathology. Two radiologists blind to pathological results evaluated lesions according to KS. Lesions with score > 4 were considered malignant. Four thresholds of ADC values -1.3 × 10-3mm2/s, 1.4 × 10-3mm2/s, 1.53 × 10-3mm2/s, and 1.6 × 10-3mm2/s were used to distinguish benign from malignant lesions. For combined diagnosis, a lesion with KS > 4 and ADC values below the preset cutoffs was considered as malignant; otherwise, it was benign. Sensitivity, specificity, and area under the curve (AUC) were compared between KS, DWI, and combined diagnosis. RESULTS: The AUC of KS was significantly higher than that of DWI alone (0.941 vs 0.901, p = 0.04). The sensitivity of KS (96.8%) and DWI (97.4 - 99.4%) was comparable (p > 0.05) while the specificity of KS (83.9%) was significantly higher than that of DWI (19.5-56.8%) (p < 0.05). Adding DWI as an adjunct to KS resulted in a 0-2.5% increase of specificity and a 0.1-1.3% decrease of sensitivity; however, the difference did not reach statistical significance (p > 0.05). CONCLUSION: KS showed higher diagnostic performance than DWI alone for discrimination of breast benign and malignant lesions. DWI showed no additional value to KS for characterizing breast lesions. KEY POINTS: • KS showed higher diagnostic performance than DWI alone for differentiation of benign from breast malignant lesions. • DWI alone showed a high sensitivity but a low specificity for characterizing breast lesions. • Diagnostic performance did not improve using DWI as an adjunct to KS.
OBJECTIVES: To explore added value of diffusion-weighted imaging (DWI) as an adjunct to Kaiser score (KS) for differentiation of benign from malignant lesions on breast magnetic resonance imaging (MRI). METHODS: Two hundred forty-six patients with 273 lesions (155 malignancies) were included in this retrospective study from January 2015 to December 2019. All lesions were proved by pathology. Two radiologists blind to pathological results evaluated lesions according to KS. Lesions with score > 4 were considered malignant. Four thresholds of ADC values -1.3 × 10-3mm2/s, 1.4 × 10-3mm2/s, 1.53 × 10-3mm2/s, and 1.6 × 10-3mm2/s were used to distinguish benign from malignant lesions. For combined diagnosis, a lesion with KS > 4 and ADC values below the preset cutoffs was considered as malignant; otherwise, it was benign. Sensitivity, specificity, and area under the curve (AUC) were compared between KS, DWI, and combined diagnosis. RESULTS: The AUC of KS was significantly higher than that of DWI alone (0.941 vs 0.901, p = 0.04). The sensitivity of KS (96.8%) and DWI (97.4 - 99.4%) was comparable (p > 0.05) while the specificity of KS (83.9%) was significantly higher than that of DWI (19.5-56.8%) (p < 0.05). Adding DWI as an adjunct to KS resulted in a 0-2.5% increase of specificity and a 0.1-1.3% decrease of sensitivity; however, the difference did not reach statistical significance (p > 0.05). CONCLUSION: KS showed higher diagnostic performance than DWI alone for discrimination of breast benign and malignant lesions. DWI showed no additional value to KS for characterizing breast lesions. KEY POINTS: • KS showed higher diagnostic performance than DWI alone for differentiation of benign from breast malignant lesions. • DWI alone showed a high sensitivity but a low specificity for characterizing breast lesions. • Diagnostic performance did not improve using DWI as an adjunct to KS.
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: Lars J Grimm; Andy L Anderson; Jay A Baker; Karen S Johnson; Ruth Walsh; Sora C Yoon; Sujata V Ghate Journal: AJR Am J Roentgenol Date: 2015-05 Impact factor: 3.959
Authors: S J Kim; E A Morris; L Liberman; D J Ballon; L R La Trenta; O Hadar; A Abramson; D D Dershaw Journal: AJR Am J Roentgenol Date: 2001-09 Impact factor: 3.959
Authors: Freddie Bray; Jacques Ferlay; Isabelle Soerjomataram; Rebecca L Siegel; Lindsey A Torre; Ahmedin Jemal Journal: CA Cancer J Clin Date: 2018-09-12 Impact factor: 508.702
Authors: Ritse M Mann; Corinne Balleyguier; Pascal A Baltzer; Ulrich Bick; Catherine Colin; Eleanor Cornford; Andrew Evans; Eva Fallenberg; Gabor Forrai; Michael H Fuchsjäger; Fiona J Gilbert; Thomas H Helbich; Sylvia H Heywang-Köbrunner; Julia Camps-Herrero; Christiane K Kuhl; Laura Martincich; Federica Pediconi; Pietro Panizza; Luis J Pina; Ruud M Pijnappel; Katja Pinker-Domenig; Per Skaane; Francesco Sardanelli Journal: Eur Radiol Date: 2015-05-23 Impact factor: 5.315
Authors: Ruxandra Iulia Milos; Francesca Pipan; Anastasia Kalovidouri; Paola Clauser; Panagiotis Kapetas; Maria Bernathova; Thomas H Helbich; Pascal A T Baltzer Journal: Eur Radiol Date: 2020-06-06 Impact factor: 5.315
Authors: G J Wengert; F Pipan; J Almohanna; H Bickel; S Polanec; P Kapetas; P Clauser; K Pinker; T H Helbich; P A T Baltzer Journal: Eur Radiol Date: 2019-12-03 Impact factor: 5.315