Detection of recurrent breast carcinoma using unenhanced breast MRI

Abstract

Background: Early detection of locally recurrent breast carcinoma has been shown to significantly improve longterm survival. Surgery and radiation therapy made treated breast prone to several modifications. This can complicate the interpretation of ultrasound and mammographic images, especially when local recurrence is suspected. The aim of this work is to assess the role of unenhanced MRI (T1WI, T2WI, STIR, and DWI) in differentiating recurrent breast cancer from benign post-operative lesions. Results: The presence of fat SI within the lesions had 100% sensitivity, 90.9% specificity, 94.1% PPV, 100% NPV, and 96.2% accuracy in differentiating fat necrosis from recurrent breast carcinoma. A cutoff ADC value of 1 × 10-3 mm 2 / s for observer one had 80% sensitivity, 90.9% specificity, and 88.9% accuracy in diagnosis of recurrent breast carcinoma. For observer two, a cutoff ADC value of 1.25 × 10-3 mm2/s had sensitivity of 80%, specificity of 88.6%, and diagnostic accuracy of 87.03% in differentiating recurrent breast carcinoma from benign post-operative changes. Unenhanced MRI had 81.8% sensitivity, 97.7% specificity, 90% PPV, 95.5% NPV, and 94.5% accuracy in the diagnosis of recurrent breast carcinoma. Conclusion: Unenhanced MRI including T1WI, T2WI, STIR, DWI, and ADC map had high sensitivity, specificity, and diagnostic accuracy in diagnosis of recurrent breast carcinoma and differentiating it from benign post-operative changes.

The diagnostic value of digital breast tomosynthesis with complementary ultrasound in comparison with magnetic resonance imaging in assessment of postoperative changes and locoregional recurrence of breast cancer

“…Breast MRI was conducted on a 1.5 T MR imaging system in our study Mariscotti et al, [13], Jung et al [2]. El-Adalany and El-Metwally, [8], and Rossano et al [10] conducted their studies like our study on 1.5 T MRI machines. Roganovic et.al [14] use a higher 3.0 T MRI imaging system, while Kamal et al [9] used a lower MRI operating machine than our study (1 T MR imaging system).…”

“…After breast traditionalist treatment, the rate of repetitive breast carcinoma is almost 1% per year. Early discovery of locally repetitive breast carcinoma has been appeared to altogether move forward long-term survival [8]. DCE-MRI has been appeared to be a profitable apparatus in discovery and characterization of recurrent breast carcinoma.…”

“…MRI has been appeared to be valuable in separating postoperative scar from repetitive breast carcinoma. The capacity of MRI to distinguish between re-current breast carcinoma and generous post-treatment changes depends on its capacity to survey both injury morphology and contrast uptake [8].…”

“…Rossano et al [10] conducted a study on preoperative assessment of breast cancer patients that combined DBT El-Adalany and El-Metwally [8] conducted a study to evaluate the role of MRI in the detection of breast cancer. The concluded sensitivity, specificity, NPV, PPV and accuracy (97.7%, 90%, 95.5%, 90%, 94.5%).…”

Prediction of local breast cancer recurrence after surgery: the added value of diffusion tensor imaging

“…Imaging of cases with palpable masses after mastectomy is challenging secondary to postoperative changes [1,2]. There is considerable overlap between recurrent breast cancer imaging features and benign postoperative changes in patients surgically treated for breast cancer [3,4].…”