Morphological Distribution and Internal Enhancement Architecture of Contrast-Enhanced Magnetic Resonance Imaging in the Diagnosis of Non-Mass-Like Breast Lesions: A Meta-Analysis

Abstract

The aim of this study is to assess the diagnostic performance of contrast-enhanced magnetic resonance (MR) imaging in patients with non-mass-like breast lesions in a meta-analysis. Literature study was performed on PubMed data base on the diagnostic performance of MR imaging in patients with non-mass-like breast lesions. Details of the relevant studies were reviewed and a meta-analysis was performed to estimate the overall sensitivity and specificity of contrast-enhanced MR imaging of non-mass-like breast lesions. A summary receiver operating characteristic curve (sROC) was developed to explore the threshold effect by ROC space. Spearman correlation coefficient was calculated using Meta-Disc version 1.4 to analyze the heterogeneity between studies. A total of 858 non-mass-like lesions from 15 studies were included in the meta-analysis (sample size range: 27-131). Pooled weighted estimates of sensitivity and specificity were 50% (95% CI: 46%, 53%) and 80% (95% CI: 77%, 83%), respectively. The heterogeneity among studies was caused by other factors other than threshold effect. The findings were influenced by cancer prevalence (p = 0.0359). Subgroup analyses indicated that the sensitivity and specificity in studies with combined diagnostic criterion was higher than that in studies with single diagnostic criterion. In evaluation of non-mass-like breast lesions, contrast-enhanced MRI has high specificity and relatively lower sensitivity.

Accuracy of combined dynamic contrast-enhanced magnetic resonance imaging and diffusion-weighted imaging for breast cancer detection: a meta-analysis

“…Furthermore, the studies evaluating mass lesions had a higher SPE (0.884) than those evaluating non-mass-like breast lesions (0.70). A recent meta-analysis found higher SPE and lower SEN values for DCE-MRI of 0.80 (95% CI ¼ 0.77-0.83) and 0.50 (95% CI ¼ 0.46-0.53), respectively (37), than in the present meta-analysis. With the combination of DCE-MRI and DWI, it might be possible to avoid unnecessary surgery or biopsy procedures for benign lesions or inadequate observation of malignancy when non-mass-like lesions are encountered on breast MRI.…”

Additive Value of Texture Analysis Based on Breast MRI for Distinguishing Between Benign and Malignant Non-mass Enhancement in Premenopausal Women

“…For ROC analysis, Z.Z.S et al performed a metaanalysis of diagnostic performance based on morphological characteristics and enhanced parameters by using pooled weighted estimates, and their results indicated low sensitivity (50%) and high (80%) speci city. In contrast, the results of this study indicated high sensitivity (80.6%), while the speci city was not high (72.5%) [24].…”

Significance of Additional Non-Mass Enhancement in Patients with Breast Cancer on Preoperative 3T Dynamic Contrast Enhanced MRI of the Breast

“…The malignant potential of additional NME lesions should be elucidated because their malignant behavior can alter the course of treatment. Although several studies have characterized the MRI features of NME in differentiating malignant and benign lesions ( 6 , 7 , 11 - 17 , 19 - 25 ), standardized interpretative criteria based on the BI-RADS MRI lexicon for NME do not exist. Our study focused on additional NME lesions identified during preoperative MRI, a scenario occasionally encountered in the clinical setting.…”