Predictive performance of BI-RADS magnetic resonance imaging descriptors in the context of suspicious (category 4) findings

Abstract

ObjectiveTo determine the positive predictive value (PPV) and likelihood ratio for magnetic resonance imaging (MRI) characteristics of category 4 lesions, as described in the Breast Imaging Reporting and Data System (BI-RADS®) lexicon, as well as to test the predictive performance of the descriptors using multivariate analysis and the area under the curve derived from a receiver operating characteristic (ROC) curve.Materials and MethodsThis was a double-blind review study of 121 suspicious findings from 98 women examined between 2009 and 2013. The terminology was based on the 2013 edition of the BI-RADS.ResultsOf the 121 suspicious findings, 53 (43.8%) were proven to be malignant lesions, with no significant difference between mass and non-mass enhancement (p = 0.846). The PPVs were highest for masses with a spiculated margin (71%) and round shape (63%), whereas segmental distribution achieved a high PPV (80%) for non-mass enhancement. Kinetic analyses performed poorly, except for type 3 curves applied to masses (PPV of 73%). Logistic regression models were significant for both patterns, although the results were better for masses, particularly when kinetic assessments were included (p = 0.015; pseudo R2 = 0.48; area under the curve = 90%).ConclusionSome BI-RADS MRI descriptors have high PPV and good predictive performance-as demonstrated by ROC curve and multivariate analysis-when applied to BI-RADS category 4 findings. This may allow future stratification of this category.

Role of magnetic resonance imaging in the planning of breast cancer treatment strategies: comparison with conventional imaging techniques

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Breast imaging in patients with nipple discharge

“…Although MRI plays an increasingly greater role in the study of breast cancer ( 28 , 29 ) , there have been few studies on its use in cases of nipple discharge.…”

Redução do Tempo Médio de Atendimento em uma Operadora de Saúde: Otimização do Processo de Autorização de Ressonância Magnética de Coluna

“…Um dos exames mais procurados nos diversos serviços médicos por meio de agendamento é a ressonância magnética (RM), que é um método de imagem que permite a aquisição de imagens multiplanares, com alta resolução, sem exposição à radiação, em crescente uso na prática médica. Por este motivo, diversos estudos têm apontado o exame de RM cada vez mais indicado para pacientes em nosso meio (Boaventura, Rodrigues, Silva, Beltrani, Melo, et al, 2017;Ribeiro, Salata, Antunes, & Marchiori, 2015;Teixeira, Elias, Nogueira-Barbosa, Marchiori, & Santos, 2015;Guimaraes et al, 2015;Almeida, Gomes, Barros, Fahel, & Rocha, 2016). O presente estudo foi realizado em uma operadora de plano de saúde, cujo modus operandi dos operadores de atendimento era crítico, uma vez que no recebimento das ligações, principalmente aquelas com solicitação emergencial de ressonância magnética de coluna, raramente procediam o registro completo de informações essenciais para a autorização médica, tais como: hipótese diagnóstica; classificação internacional de doenças (CID); indicação clínica; área anatômica do exame solicitado, etc.…”