Breast MRI: False-Negative Results and Missed                    Opportunities

Korhonen, Katrina; Zuckerman, Samantha P.; Weinstein, Susan P.; Tobey, Jennifer D.; Birnbaum, Julia; McDonald, Elizabeth S.; Conant, Emily F.

doi:10.1148/rg.2021200145

Cited by 15 publications

(13 citation statements)

References 62 publications

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“…In our cases of mucinous carcinoma, lesions were not identified using DCE MR only but were identified after correlating with T2WI. However, since the T2WI feature of mucinous carcinoma, a well-circumscribed mass with T2 high SI, also overlaps with the benign feature, attention should be paid to MR interpretation [ 6 , 16 ]. ILC had a distinctive histologic feature of an “Indian File” growth pattern that diffusely infiltrates the adjacent breast parenchyma [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…This method allows breast tissue to spread and prevents respiratory motion artifacts, ultimately facilitating lesion detection [ 18 ]. If the lesion is located on the breast periphery or chest wall, contrast media may not be sufficiently delivered due to this posture [ 6 ]. In the four cases, no lesions were found in DCE MR. On the other hand, these lesions demonstrated diffusion limitation and low-range ADC values in DWI independent of the contrast agent [ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Despite breast MR having the highest sensitivity levels, false negative cases are not found in MR, though they are found in other imaging modalities. The causes include perceptive errors, where the radiologist did not detect the case at the time of the reading; interpretation errors, where the cases are recognized but mistaken for benign lesions; and various technical errors [ 6 ]. Previous studies have reported these cases and tried to analyze the causes.…”

Section: Introductionmentioning

confidence: 99%

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The Frequency and Causes of Not-Detected Breast Malignancy in Dynamic Contrast-Enhanced MRI

et al. 2022

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Breast MR is the most sensitive imaging modality, but there are cases of malignant tumors that are not detected in MR. This study evaluated the frequency and main causes of malignant breast lesions not detected in dynamic contrast-enhanced (DCE) MR. A total of 1707 cases of preoperative breast MR performed between 2020 and 2021 were included. Three radiologists individually reviewed the DCE MRs and found not-detected malignancy cases in the MRs. The final cases were decided through consensus. For the selected cases, images other than DCE MRIs, such as mammography, ultrasounds, diffusion-weighted MRs, and, if possible, contrast-enhanced chest CTs, were analyzed. In the final sample, 12 cases were not detected in DCE MR, and the frequency was 0.7% (12/1707). Six cases were not detected due to known non-enhancing histologic features. In four cases, tumors were located in the breast periphery and showed no enhancement in MR. In the remaining two cases, malignant lesions were not identified due to underlying marked levels of BPE. The frequency of not-detected malignancy in DCE MR is rare. Knowing the causes of each case and correlating it with other imaging modalities could be helpful in the diagnosis of breast malignancy in DCE MR.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Frequency and Causes of Not-Detected Breast Malignancy in Dynamic Contrast-Enhanced MRI

et al. 2022

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“…An important morphologic feature of ILC is diffuse infiltrative growth, which poses a major challenge for early diagnosis due to its similarity to normal fibro-glandular tissue [ 10 ]. According to the literature, contrast accumulation in MR is primarily due to angiogenesis and neovascularization of malignant tumors [ 11 , 12 ]. In addition to tumor size and location, histologic type may also influence contrast accumulation in MR [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Non-enhancing malignant lesions of the breast: A case report and review of literature

Zujić

Solocki-Matic²,

Klaric

et al. 2023

Heliyon

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“…Retrospective studies have already demonstrated that breast cancer could be visualized and diagnosed as suspicious lesions, which were initially missed or misinterpreted on prior breast MRI exams. 16,17 We can speculate that serial preoperative breast MRIs could be implemented to investigate the growth rate of breast cancer in natural history.…”

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confidence: 99%

Breast Cancer Growth on Serial MRI: Volume Doubling Time Based on 3‐Dimensional Tumor Volume Assessment

Wang

Luo

Chen

et al. 2023

Magnetic Resonance Imaging

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BackgroundThe volume doubling time (VDT) of breast cancer was most frequently calculated using the two‐dimensional (2D) diameter, which is not reliable for irregular tumors. It was rarely investigated using three‐dimensional (3D) imaging with tumor volume on serial magnetic resonance imaging (MRI).PurposeTo investigate the VDT of breast cancer using 3D tumor volume assessment on serial breast MRIs.Study TypeRetrospective.SubjectsSixty women (age at diagnosis: 57 ± 10 years) with breast cancer, assessed by two or more breast MRI examinations. The median interval time was 791 days (range: 70–3654 days).Field Strength/Sequence3‐T, fast spin‐echo T2‐weighted imaging (T2WI), single‐shot echo‐planar diffusion‐weighted imaging (DWI), and gradient echo dynamic contrast‐enhanced imaging.AssessmentThree radiologists independently reviewed the morphological, DWI, and T2WI features of lesions. The whole tumor was segmented to measure the volume on contrast‐enhanced images. The exponential growth model was fitted in the 11 patients with at least three MRI examinations. The VDT of breast cancer was calculated using the modified Schwartz equation.Statistical TestsMann–Whitney U test, Kruskal–Wallis test, Chi‐squared test, intraclass correlation coefficients, and Fleiss kappa coefficients. A P‐value <0.05 was considered statistically significant. The exponential growth model was evaluated using the adjusted R2 and root mean square error (RMSE).ResultsThe median tumor diameter was 9.7 mm and 15.2 mm on the initial and final MRI, respectively. The median adjusted R2 and RMSE of the 11 exponential models were 0.97 and 15.8, respectively. The median VDT was 540 days (range: 68–2424 days). For invasive ductal carcinoma (N = 33), the median VDT of the non‐luminal type was shorter than that of the luminal type (178 days vs. 478 days). On initial MRI, breast cancer manifesting as a focus or mass lesion showed a shorter VDT than that of a non‐mass enhancement (NME) lesion (median VDT: 426 days vs. 665 days).Data ConclusionA shorter VDT was observed in breast cancer manifesting as focus or mass as compared to an NME lesion.Level of Evidence3Technical EfficacyStage 2

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Breast MRI: False-Negative Results and Missed Opportunities

Cited by 15 publications

References 62 publications

The Frequency and Causes of Not-Detected Breast Malignancy in Dynamic Contrast-Enhanced MRI

The Frequency and Causes of Not-Detected Breast Malignancy in Dynamic Contrast-Enhanced MRI

Non-enhancing malignant lesions of the breast: A case report and review of literature

Breast Cancer Growth on Serial MRI: Volume Doubling Time Based on 3‐Dimensional Tumor Volume Assessment

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