High-Spatial-Resolution MRI of Non-Masslike Breast Lesions: Interpretation Model Based on BI-RADS MRI Descriptors

Tozaki, Mitsuhiro; Fukuda, Kunihiko

doi:10.2214/ajr.05.0998

Cited by 121 publications

(114 citation statements)

References 22 publications

(39 reference statements)

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“…We also found that there was no statistical difference when considering NME internal enhancement and NME distribution in verifying malignancy. This finding is not consistent with that of a previous study by Tozaki et al (36) who found that segmental distribution, heterogeneous internal enhancement, and clustered ring enhancement were the most frequent findings in malignant NME. Some specific tumor subtypes, such as papillary carcinoma, are associated with the lowest ADC values among malignant breast tumors (37).…”

Section: Discussioncontrasting

confidence: 99%

MRI in the differential diagnosis of primary architectural distortion detected by mammography

Lifang¹,

Zhai²,

Liu³

et al. 2016

Diagn Interv Radiol

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Section: Discussioncontrasting

confidence: 99%

MRI in the differential diagnosis of primary architectural distortion detected by mammography

Lifang¹,

Zhai²,

Liu³

et al. 2016

Diagn Interv Radiol

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“…5,7,[11][12][13] Distribution was characterized as focal, linear, ductal, segmental, regional, multiple regions, and diŠuse; internal enhancement was characterized as homogeneous, heterogeneous, stippled, clumped, reticular, or clustered ring en- hancement (CRE).…”

Section: Image Interpretationmentioning

confidence: 99%

“…[6][7][8][9][10][11] In contrast, such diŠerentiation is often di‹cult with nonmass-like enhancement because there is no standardized method of interpreting non-mass-like enhancement lesions. [6][7][8]10,[12][13][14] Several studies have reported the utility of evaluating apparent diŠusion coe‹cient (ADC) values derived from diŠusion-weighted imaging (DWI) for diŠerentiating benign and malignant lesions. [15][16][17][18][19][20] DWI obtains MR signal based on the thermal diŠu-sion of water molecules (Brownian motion), and the rate of water diŠusion is expressed as the ADC value.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Performance of ADC for Non-mass-like Breast Lesions on MR Imaging

et al. 2010

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We assessed the usefulness and limitations of utilizing apparent diŠusion coe‹cient (ADC) values on diŠusion-weighted imaging (DWI) for the diŠerential diagnosis of benign and malignant non-mass-like breast lesions. We retrospectively reviewed 27 such lesions (16 malignant, 11 benign) detected on magnetic resonance (MR) imaging and analyzed the enhancing patterns of dynamic contrast-enhanced DCE-MRI (distribution and internal enhancement), kinetic curve patterns, and ADC values. All images were obtained with a 1.5-tesla MR unit, with patients supine. On DCE-MRI, malignant lesions tended to show either segmental or branching-ductal distribution, and when lesions with these patterns were considered malignant, sensitivity was 68.8z; speciˆcity, 63.6z; positive predictive value (PPV), 73.3z; negative predictive value (NPV), 58.3z; and accuracy, 66.7z. Kinetic curve analysis did not reliably diŠerentiate benign and malignant non-mass-like lesions. There was no signiˆcant diŠerence between the mean ADC value of the malignant lesions, 0.968×10 -3 mm 2 /s at b＝1000 s/mm 2 , and that of benign lesions, 1.207×10 -3 mm 2 /s (P ＝0.109). Receiver operating characteristic (ROC) analysis revealed the most eŠective threshold of ADC value for diŠerentiating tumors as 1.1×10 -3 mm 2 /s; values lower than this were observed more often in malignant than benign lesions (P＝0.054). Us of this threshold yielded sensitivity of 68.8z; speciˆcity, 72.7z; PPV, 78.6z; NPV, 61.5z; and accuracy, 70.4z. Combining the ADC value criteria with the analysis of DCE-MRI pattern increased sensitivity to 93.8z, negative predictive value (NPV) to 85.7z, and accuracy to 77.8z but decreased speciˆcity to 54.5z. Use of ADC values does not adequately improve DCE-MRI performance for diŠerential diagnosis of non-mass-like breast lesions, but adding the ADC value criteria to the DCE-MRI pattern analysis improves sensitivity, NPV, and accuracy.

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“…We reported that the presence of this sign following washout may be useful in the diŠerential diagnosis between benign and malignant lesions. 26 In this study, the frequency of this sign was signiˆcantly diŠerent between SCD I W II and SCD III NOS ductal carcinoma (P＝0.05). This may be explained by the presence of diŠuse inˆltration without the formation of large septations in ductal NOS carcinoma with a predominant scirrhous component.…”

Section: Magnetic Resonance In Medical Sciencesmentioning

confidence: 50%

Dynamic High-Spatial-Resolution MR Imaging of Invasive Ductal Carcinoma: Influence of Histological Scirrhous Component on MR Descriptors

2006

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Purpose: The purpose of this study was to assess the relationship between the amount of scirrhous component in invasive ductal carcinoma and its MR characteristics.Materials and Methods: We retrospectively reviewed 71 consecutive patients with invasive ductal carcinoma smaller than 25 mm (average, 16.6 mm) in diameter. The scirrhous component was deˆned as invasive foci in small clusters of cancer cells showing desmoplasia. Invasive ductal carcinoma was subclassiˆed into 3 groups in accordance with the amount of the scirrhous component (scirrhous component degree; SCD): SCD I (scirrhous component less than 20z), SCD II (intermediate), and SCD III (more than 80z). Dynamic magnetic resonance (MR) imaging was performed using volumetric interpolated sequence. Prior to dynamic study, T 2 *-weightedˆrst-pass perfusion images were obtained before, during, and after bolus injection of 0.1 mmol Gd-DTPA W kg.Results: Twenty-eight lesions were classiˆed as SCD I, 14 as SCD II, and 29 as SCD III. Mass margin and signal intensity loss in the perfusion study were signiˆcantly diŠerent among the 3 SCD groups (Pº0.001). The kinetic patterns were signiˆcantly diŠerent among the 3 SCD groups (P＝0.04), and between SCD I W II and SCD III (P＝0.03). The presence of enhancing internal septations was signiˆcantly diŠerent between SCD I W II and SCD III carcinomas (P＝0.05). Central enhancement was only observed in SCD I carcinoma (4z; 3W 71).Conclusion: The histological predominance of the scirrhous component in invasive ductal carcinoma may be one explanation for the diŠerences in morphologic and kinetic patterns on MR imaging.

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High-Spatial-Resolution MRI of Non-Masslike Breast Lesions: Interpretation Model Based on BI-RADS MRI Descriptors

Abstract: A combination of BI-RADS MRI descriptors and clustered ring enhancement criteria is useful for the differential diagnosis of lesions showing non-masslike enhancement.

Cited by 121 publications

References 22 publications

MRI in the differential diagnosis of primary architectural distortion detected by mammography

MRI in the differential diagnosis of primary architectural distortion detected by mammography

Diagnostic Performance of ADC for Non-mass-like Breast Lesions on MR Imaging

Dynamic High-Spatial-Resolution MR Imaging of Invasive Ductal Carcinoma: Influence of Histological Scirrhous Component on MR Descriptors

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