Motion artifacts, lesion type, and parenchymal enhancement in breast MRI: what does really influence diagnostic accuracy?

Clauser, Paola; Dietzel, Matthias; Weber, Michael; Kaiser, Ch.; Baltzer, Pascal

doi:10.1177/0284185118770918

Cited by 17 publications

(17 citation statements)

References 31 publications

(52 reference statements)

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“…This may reflect different kind of considered motion artifacts, as Fiaschetti et al (12) reported artifacts affecting image interpretation, without any grading scale. In fact, considering only cases in which a reduction in image quality hindered image interpretation (grade 3), our rate of motion artifacts decreases to 8%, independently from breast MRI indication and similarly to the 9% rate of moderate/marked motion artifacts reported by Clauser et al (9). This relatively low rate of motion artifacts should be considered as linked to the patient prone position used in state-of-the-art breast MRI that minimizes respiratory movement (13).…”

Section: Discussionsupporting

confidence: 75%

“…Our motion artifacts rate (35%) was intermediate between the 16% reported by Fiaschetti et al (12) and the 46% reported by Clauser et al (9). This may reflect different kind of considered motion artifacts, as Fiaschetti et al (12) reported artifacts affecting image interpretation, without any grading scale.…”

Section: Discussioncontrasting

confidence: 69%

“…Frequency and grade of motion artifacts are difficult to quantify, due to technical variability between centers and protocols (8) and limited literature information. To the best of our knowledge, few studies have been performed (7-9) reporting motion artifacts in 11%-74% of T2W images (8) and in 16%-46% of subtracted T1W images (7,9).…”

Section: Introductionmentioning

confidence: 99%

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Side of contrast injection and breast size correlate with motion artifacts grade and image quality on breast MRI

et al. 2020

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Background Motion is a relevant cause of artifacts in breast magnetic resonance imaging (MRI), potentially degrading image quality, even with optimized protocols. Purpose To investigate the causes of motion artifacts (MA) impacting on image quality (IQ) of contrast-enhanced breast MRI. Material and Methods Retrospective two-center study on consecutive 1.5-T contrast-enhanced breast MRI, independently reviewed by two radiologists on first subtracted and maximum intensity projection images to define the side most affected by MA. IQ was scored as 1 (optimal), 2 (reduced, but without reduction of diagnostic power), or 3 (reduced, with reduced diagnostic power). Correlations with injection side, breast size (A/B vs. C/D cups), patient age, clinical indication, and MRI scanner/protocol were assessed using χ2 and Fisher’s exact statistics. Results In total, 237 examinations were included, with right injection performed in 124 (52%) and left in 113 (48%). MA were more frequent on the side ipsilateral to the injection (144/237, 61%, 95% confidence interval [CI] 54–67%) than on the contralateral (93/237, 95% CI 33–46%) (P < 0.001); IQ was scored 1 in 154/237 (65%), 2 in 63/237 (27%), and 3 in 20/237 (8%) examinations; patients with A/B cups showed higher IQ score than patients with C/D cups (scores 1, 2, and 3: 54% vs. 70%; 29% vs. 25%; 17% vs. 5%, respectively, P = 0.002). No significant correlations were found for MA (P≥0.106) or IQ (P ≥ 0.318) between ipsi- or contralateral injection and right/left injection, breast size, age, indication, or scanner/protocol. Conclusion MA were more frequent in breasts ipsilateral to contrast injection and showed a reduced IQ for small breasts.

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Section: Discussionsupporting

confidence: 75%

Section: Discussioncontrasting

confidence: 69%

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Side of contrast injection and breast size correlate with motion artifacts grade and image quality on breast MRI

et al. 2020

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“…However, the fast acquisition time makes DWI less susceptible to motion artifacts. The latter can be challenging in the interpretation of the DP [32]. Finally, the quantitative nature of the ADC is not without controversy, and there is ongoing research how to achieve more exact measurement using dedicated phantoms [14].…”

Section: Discussionmentioning

confidence: 99%

Breast MRI in the era of diffusion weighted imaging: do we still need signal-intensity time curves?

et al. 2019

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ObjectiveDynamic contrast-enhanced imaging of the initial (IP) and delayed phase (DP) is an integral part of any clinical breast MRI protocol. Furthermore, DWI is increasingly used as an add-on sequence by the breast-imaging community. We investigated whether DWI could be used as a substitute DP.Material and methodsOne hundred thirty-two consecutive patients with equivocal or suspicious findings at ultrasound and/or mammography received a full diagnostic breast MRI according to international recommendations. Histopathological verification served as reference standard. We evaluated three sections of the MRI protocol: IP, DP, and apparent diffusion coefficient (ADC) maps derived from DWI. Circular ROIs (regions of interest, mean size 5–10 mm2) were drawn into the enhancing parts of the lesion (first postcontrast). ROIs were transferred to the corresponding location on ADC maps and IP and DP images. Mean ROI values were investigated signal intensity (SI): (1) Initial-phase enhancement = (SI(IP) − SI(precontrast))/SI(precontrast); (2) Delayed-phase enhancement = (SI(DP) − SI(IP))/SI(IP); (3) ADC. Multiparametric combinations were computed using logistic regression analysis: (1) IP+: Initial-phase enhancement and ADC; (2) Curve: Initial-phase enhancement and delayed-phase enhancement; (3) Curve+: Curve and ADC. The diagnostic performances of these feature combinations to diagnose malignancy were compared by the area under the receiver-operating characteristics curve (AUC).ResultsOne hundred thirty-two patients (age: mean = 57.1 years, range 23–83 years) with 145 lesions were included (malignant/benign 101/44). IP+ (AUC = 0.877) outperformed Curve (AUC = 0.788, p = 0.03). Curve+ was not superior to IP+ (p = 1).ConclusionDWI could substitute DP. Because DWI is typically used as an add-on to IP and DP, our results might help to abbreviate and to simplify current practice of breast MRI.Key Points• DWI provides similar but superior diagnostic information for diagnosis of malignancy in enhancing breast lesions compared to DP. • Adding DP to DWI does not provide incremental information to distinguish benign from malignant lesions. • DWI could substitute DP. As DWI is typically used as an add-on to IP and DP, our findings might help to abbreviate and to simplify current breast MRI practice.

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“…Furthermore, we highlight that our intermediate screening setting implied an expected low cancer detection rate: researchers had to reckon also with this expectation, trying to minimize unnecessary biopsies and overdiagnosis [ 13 , 45 , 46 , 47 ]. Finally, researchers had also to be aware of the peculiar spectrum of potential false-positive and false-negative findings, for example, those engendered by motion artifacts [ 48 ] and by the influence of background parenchymal enhancement [ 49 , 50 ], which are commonly associated with MRI. As mentioned above, general countermeasures to curtail them, such as the repetition of MX or the use of targeted US, were implemented in this study and will be the object of specific analysis.…”

Section: Discussionmentioning

confidence: 99%

MRI versus Mammography plus Ultrasound in Women at Intermediate Breast Cancer Risk: Study Design and Protocol of the MRIB Multicenter, Randomized, Controlled Trial

et al. 2021

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In women at high/intermediate lifetime risk of breast cancer (BC-LTR), contrast-enhanced magnetic resonance imaging (MRI) added to mammography ± ultrasound (MX ± US) increases sensitivity but decreases specificity. Screening with MRI alone is an alternative and potentially more cost-effective strategy. Here, we describe the study protocol and the characteristics of enrolled patients for MRIB feasibility, multicenter, randomized, controlled trial, which aims to compare MRI alone versus MX+US in women at intermediate breast cancer risk (aged 40–59, with a 15–30% BC-LTR and/or extremely dense breasts). Two screening rounds per woman were planned in ten centers experienced in MRI screening, the primary endpoint being the rate of cancers detected in the 2 arms after 5 years of follow-up. From July 2013 to November 2015, 1254 women (mean age 47 years) were enrolled: 624 were assigned to MX+US and 630 to MRI. Most of them were aged below 50 (72%) and premenopausal (45%), and 52% used oral contraceptives. Among postmenopausal women, 15% had used hormone replacement therapy. Breast and/or ovarian cancer in mothers and/or sisters were reported by 37% of enrolled women, 79% had extremely dense breasts, and 41% had a 15–30% BC-LTR. The distribution of the major determinants of breast cancer risk profiles (breast density and family history of breast and ovarian cancer) of enrolled women varied across centers.

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Motion artifacts, lesion type, and parenchymal enhancement in breast MRI: what does really influence diagnostic accuracy?

Abstract: Motion artifacts can impair lesion characterization with breast MRI, but lesion type and small size have the strongest influence on diagnostic estimates.

Cited by 17 publications

References 31 publications

Side of contrast injection and breast size correlate with motion artifacts grade and image quality on breast MRI

Side of contrast injection and breast size correlate with motion artifacts grade and image quality on breast MRI

Breast MRI in the era of diffusion weighted imaging: do we still need signal-intensity time curves?

MRI versus Mammography plus Ultrasound in Women at Intermediate Breast Cancer Risk: Study Design and Protocol of the MRIB Multicenter, Randomized, Controlled Trial

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