Fast and Noninvasive Characterization of Suspicious Lesions Detected at Breast Cancer X-Ray Screening: Capability of Diffusion-weighted MR Imaging with MIPs

Abstract

Unenhanced diagnostic MR imaging (DWIBS mammography), with an NPV of 0.92 and an acquisition time of less than 7 minutes, could help exclude malignancy in women with suspicious x-ray screening mammograms. The method has the potential to reduce unnecessary invasive procedures and emotional distress for breast cancer screening participants if it is used as a complement after the regular screening clarification procedure.

On a fractional order calculus model in diffusion weighted breast imaging to differentiate between malignant and benign breast lesions detected on X-ray screening mammography

“…Mathematical analysis of the FROC derived parameters β FROC , D FROC and μ FROC as evaluated in this study here have not been part of these previously published analyses and the patients described originate from a different study site. Since all patients belong to one multicenter study concept, however, data, principles and background of the methods described here may partially overlap to the previous reports [9, 26–28]. …”

“…Preliminary results of patients in one study site that received acquisition of a vendor specific DWI sequence (Diffusion Weighted Imaging With Background Suppression, DWIBS) have been published regarding the usability of different visual radiologists´ reading strategies of an abbreviated breast MRI protocol for breast cancer screening work-up and in regards to so called radiomics analyses of the DWI ()[9, 26–28]. Mathematical analysis of the FROC derived parameters β FROC , D FROC and μ FROC as evaluated in this study here have not been part of these previously published analyses and the patients described originate from a different study site.…”

“…Patients participating in the study received a MR examination prior biopsy as previously described [26]. The MR examination consisted of a full diagnostic protocol including unenhanced morphologic sequences (T1-weighted, T2-weighted), contrast enhanced sequences (0.1 mmol Gadobenate Dimeglumine (Multihance; Bracco, Mailand, Italy) per kilogram of body weight) and diffusion weighted sequences with details described in Table 1.…”

Diffusion-weighted breast MRI: Clinical applications and emerging techniques

“…More recently, Bickelhaupt et al reported that DWI may also be useful as a fast and noninvasive approach to assess the likelihood of malignancy for suspicious lesions detected on screening x‐ray mammograms and reduce unnecessary biopsies . Variations in DWI approach across studies have prevented determination of a generalizable ADC threshold value for the classification of malignant and benign lesions, in particular due to dependence of lesion ADC measures on choice and combination of b values .…”

The role of magnetic resonance imaging in the diagnosis of breast cancer

“…A prospective study by Bickelhaupt et al concluded that diffusion-weighted imaging with background suppression (DWIBS), performed without an administration of an intravenous contrast agent, is helpful in excluding cancer in women with suspecious lesions found in screening X-ray mammography (sensitivity 92%, specificity 94%, NPV 92%, PPV 93%) [27].…”