Differentiation of benign from malignant breast disease associated with screening detected microcalcifications using dynamic contrast enhanced magnetic resonance imaging

Kneeshaw, P.J.; Lowry, Martin; Manton, David J.; Hubbard, Anne; Drew, PJ; Turnbull, LW

doi:10.1016/j.breast.2005.05.002

Cited by 86 publications

(53 citation statements)

References 14 publications

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“…The MR imaging studies of 93 women with 101 breast lesions met the following criteria for inclusion in this study: (a) MR imaging was performed by using a 3.0-T magnet, (b) both dynamic contrast-enhanced MR imaging (hereafter, dynamic imaging) and DW MR imaging sequences were performed, and (c) either the diagnosis was proved at pathologic analysis (96 lesions), or lesion stability was confi rmed at more than 2 years of follow-up (fi ve lesions). Of the 550 patients, 280 were excluded for not having a suspicious abnormality on dynamic images, 152 were excluded for having lesions without a suffi cient follow-up M agnetic resonance (MR) imaging of the breast is known for its inherently high sensitivity but only moderate specifi city for the characterization of breast lesions (1)(2)(3)(4)(5). Thus, efforts have been directed toward developing new pulse sequences and evaluation methods that improve lesion characterization.…”

Section: Patientsmentioning

confidence: 99%

“…Thus, efforts have been directed toward developing new pulse sequences and evaluation methods that improve lesion characterization. Dynamic contrast materialenhanced MR imaging ( 2,3,(5)(6)(7)(8)(9)(10)(11) is an example of these technologies: The wash-in and washout rates of gadoliniumbased contrast agents have shown potential for use in characterizing focal lesions as benign or malignant.…”

Section: Patientsmentioning

confidence: 99%

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Diffusion-weighted Imaging Improves the Diagnostic Accuracy of Conventional 3.0-T Breast MR Imaging

Jacobs²,

et al. 2010

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Purpose:To evaluate the incremental value of diffusion-weighted (DW) imaging and apparent diffusion coeffi cient (ADC) mapping in relation to conventional breast magnetic resonance (MR) imaging in the characterization of benign versus malignant breast lesions at 3.0 T. Materials and Methods:This retrospective HIPAA-compliant study was approved by the institutional review board, with the requirement for informed patient consent waived. Of 550 consecutive patients who underwent bilateral breast MR imaging over a 10-month period, 93 women with 101 lesions met the following study inclusion criteria: They had undergone three-dimensional (3D) high -spatial-resolution T1-weighted contrast material-enhanced MR imaging, dynamic contrastenhanced MR imaging, and DW imaging examinations at 3.0 T and either had received a pathologic analysis-proven diagnosis (96 lesions) or had lesion stability confi rmed at more than 2 years of follow-up (fi ve lesions). DW images were acquired with b values of 0 and 600 sec/mm 2 . Regions of interest were drawn on ADC maps of breast lesions and normal glandular tissue. Morphologic features (margin, enhancement pattern), dynamic contrastenhanced MR results (semiquantitative kinetic curve data), absolute ADCs, and glandular tissue-normalized ADCs were included in multivariate models to predict a diagnosis of benign versus malignant lesion. Results:Forty-one (44%) of the 93 patients were premenopausal, and 52 (56%) were postmenopausal. Thirty-three (32.7%) of the 101 lesions were benign, and 68 (67.3%) were malignant. Normalized ADCs were signifi cantly different between the benign (mean ADC, 1.1 3 10 2 3 mm 2 /sec 6 0.4 [standard deviation]) and malignant (mean ADC, 0.55 3 10 2 3 mm 2 /sec 6 0.16) lesions ( P , .001). Adding normalized ADCs to the 3D T1-weighted and dynamic contrast-enhanced MR data improved the diagnostic performance of MR imaging: The area under the receiver operating characteristic curve improved from 0 .89 to 0.98, and the false-positive rate decreased from 36% (nine of 25 lesions) to 24% (six of 25 lesions). Conclusion:DW imaging with glandular tissue-normalized ADC assessment improves the characterization of breast lesions beyond the characterization achieved with conventional 3D T1-weighted and dynamic contrast-enhanced MR imaging at 3.0 T.q RSNA, 2010

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Section: Patientsmentioning

confidence: 99%

Section: Patientsmentioning

confidence: 99%

Diffusion-weighted Imaging Improves the Diagnostic Accuracy of Conventional 3.0-T Breast MR Imaging

Jacobs²,

et al. 2010

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“…The last study of Japanese authors recommends BI-RADS 3 microcalcifi cations to be evaluated by MRI prior to SVAB especially in those women who does not want to undergo biopsy 22 . This is due to the high sensitivity of breast MRI for the assessment of malignant and benign microcalcifi cations 12 . In literatures, high percentage of agreement regarding the size of malignant lesion detected in breast MRI with defi nitive histology is mentioned 11 .…”

Section: Discussionmentioning

confidence: 99%

The Value of Dynamic Contrast Enhanced Breast Mri in Mammographically Detected Bi-Rads 5 Microcalcifications

Houserková¹,

Prasad²,

Svach³

et al. 2008

BIOMED PAP

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Aims:To evaluate the role of dynamic contrast-enhanced magnetic resonance imaging (MRI) in the diagnosis of BI-RADS-5 type of microcalcifi cations of the breast, to compare the size of the microcalcifi cation lesions using mammography (MG) and MRI, and to determine the value of MRI in surgery for microcalcifi cations. The study also determines the morphology of microcalcifi cation lesions, assesses kinetic curves and compare MRI features of ductal carcinoma in situ (DCIS) for diff erent histopathological grades.Methods: Our group consisted of 32 patients with mammographically detected BI-RADS 5 microcalcifi cations. The MRI was done in this group of women which was later followed by stereotactic vaccum-assisted biopsy (SVAB). Surgery was performed on all patients with a biopsy that resulted in a diagnosis of breast cancer or atypical ductal hyperplasia (ADH).Results: Of our group of 32 patients, there were 35 mammograhically detected microcalcifi cation lesions, 32 DCIS, one ADH and two benign fi ndings according to the fi nal histology.The microcalcifi cation lesions were larger using MRI than in MG in 10 women. We diagnosed DCIS multifocality in 6 women and bilateral carcinoma in one woman. As with kinetic curve assessment, we found in 67 % of DCIS a rapid rise, 27 % a moderate and in 6 % a slow initial rise. With the pattern of enhancement in the delayed phase, we found in 30 % of DCIS a washout pattern, 67 % a plateau and in 3 % a persistent pattern. Noted diff erence between high and low grade DCIS was confi rmed.Conclusions: MRI sensitivity in the detection of DCIS was 94 % in our group of patients and was the sole evidence for detection of multifocality and bilateral incidence of carcinoma. In 26 % of women the outcome of MRI was the most important for converting breast conserving surgery to mastectomy.

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“…Gadopentetate Dimeglumine FP/n FN/n TN/n Sen/% Spe% Acc% TP/n FP/n FN/n TN/n Sen/% Spe% Acc% -17 5 0 18 100 76.5 87.5 Fenlon 1997 ------------------19 2 2 21 90 91 90.9 Fischer 1999 ------------------375 50 30 93 93 65 85 ------------------18 15 3 Goerres et al 2003;Kneeshaw et al 2006;Woodhams et al 2010) on gadopentetate dimeglumine. Three trials (Knopp et al 2003;Sardanelli et al 2005;Martincich et al 2011) were multicenter studies, and four trials claimed definitely that they were sponsored by certain organizations.…”

Section: Studymentioning

confidence: 99%

“…Because the dosage unit of contrast media can't be translated, that is to say, the absolute difference on dosage among these studies is unknown, 2 articles were rejected. 17 studies (Fobben et al, 1995;Stomper et al, 1995;Fenlon et al, 1997;Helbich et al, 1997;Fischer et al, 1999;Alamo et al, 2001;Kawashima et al, 2001;Goerres et al, 2003;Knopp et al, 2003;Pediconi et al, 2005;Sardanelli et al, 2005;Kneeshaw et al, 2006;Pediconi et al, 2007;Pediconi et al, 2008;Woodhams et al, 2010;Luciani et al, 2011;Martincich et al, 2011) with 1934 patients were included based on the inclusion criteria and the data integrity.…”

Section: Literature Searchmentioning

confidence: 99%

Comparison of Gadobenate Dimeglumine and Gadopentetate Dimeglumine for Breast MRI Screening: a Meta-analysis

Yang¹,

Han²,

Ye³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Differentiation of benign from malignant breast disease associated with screening detected microcalcifications using dynamic contrast enhanced magnetic resonance imaging

Cited by 86 publications

References 14 publications

Diffusion-weighted Imaging Improves the Diagnostic Accuracy of Conventional 3.0-T Breast MR Imaging

Diffusion-weighted Imaging Improves the Diagnostic Accuracy of Conventional 3.0-T Breast MR Imaging

The Value of Dynamic Contrast Enhanced Breast Mri in Mammographically Detected Bi-Rads 5 Microcalcifications

Comparison of Gadobenate Dimeglumine and Gadopentetate Dimeglumine for Breast MRI Screening: a Meta-analysis

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