Sensitivity and specificity of unenhanced MR mammography (DWI combined with T2-weighted TSE imaging, ueMRM) for the differentiation of mass lesions

Baltzer, Pascal; Benndorf, Matthias; Dietzel, Matthias; Gajda, Mieczysław; Camara, O.; Kaiser, Werner A.

doi:10.1007/s00330-009-1654-5

Cited by 128 publications

(99 citation statements)

References 29 publications

(47 reference statements)

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“…Conversely, higher ADC values are usually associated with well-differentiated tumors or benign conditions. In keeping with our findings, in previous studies, lower ADC values were reported to be associated with malignant breast tumors rather than benign conditions (35,36). Constantini et al (37) reported an inverse correlation between the tumor grade and ADC values.…”

Section: Balkansupporting

confidence: 92%

Value of Apparent Diffusion Coefficient Values in Differentiating Malignant and Benign Breast Lesions

T¹,

G²,

Sezgin³

et al. 2016

Balkan Med J

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Background: Magnetic resonance imaging (MRI) has become a diagnostic and problem solving method for the breast examinations in addition to conventional breast examination methods. Diffusion-weighted imaging (DWI) adds valuable information to conventional MRI. Aims: Our aim was to show the impact of apparent diffusion coefficient (ADC) values acquired with DWI to differentiate benign and malignant breast lesions. Study Design: Diagnostic accuracy study. Methods: Forty-six women with 58 breast masses (35 malignant, 23 benign) were examined on a 1.5 T clinical MRI scanner. The morphologic characteristics of the lesions on conventional MRI sequences and contrast uptake pattern were assessed. ADC values of both lesions and normal breast parenchyma were measured. The ADC values obtained were statistically compared with the histopathologic results using Paired Samples t-Test. Results: Multiple lesions were detected in 12 (26%) of the patients, while only one lesion was detected in 34 (74%). Overall, 35 lesions out of 58 were histopathologically proven to be malignant. In the dynamic contrast-enhanced series, 5 of the malignant lesions were type 1, while 8 benign lesions revealed either type 2 or 3 time signal intensity curves (85% sensitivity, 56% spesifity Breast cancer is the most common cancer in females worldwide and the second main cause of cancer death following lung cancer. Approximately 12% of women will experience breast cancer during their lifetime (1). Therefore, breast cancer maintains its importance as a serious public health issue. The major risk factors comprise family history, genetic predisposition caused by the presence of a BRCA1 or BRCA2 gene mutation, and previously acquired breast lesions including fibrovascular papilloma, atypical ductal and lobular hyperplasia, and ductal and lobular carcinoma in situ (2,3).Imaging is crucial to diagnose and evaluate the stage and extent of breast cancer. Therefore, three types of radiologic techniques, including mammography, ultrasonography (US) and breast magnetic resonance imaging (MRI), are implemented. As a basic breast cancer scanning method, mammography is highly available, with a short scanning time.

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Section: Balkansupporting

confidence: 92%

Value of Apparent Diffusion Coefficient Values in Differentiating Malignant and Benign Breast Lesions

T¹,

G²,

Sezgin³

et al. 2016

Balkan Med J

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“…Use of DWI together with T2-weighted images created a good unenhanced imaging alternative to DCE-MRI in lesion detection and characterization. This method was previously used in some experimental clinical and reader studies and found to be useful for the diagnosis of breast cancer (24)(25)(26)(27). Lastly, Trimboli et al (28) reported 78% sensitivity and 87% specificity for breast cancer detection with unenhanced MRI of 67 women.…”

Section: Discussionmentioning

confidence: 98%

Can unenhanced breast MRI be used to decrease negative biopsy rates?

Kul

Oguz²,

Eyüboğlu³

et al. 2015

Diagn Interv Radiol

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T he Breast Imaging Reporting and Data Systems (BI-RADS) lexicon (1) of AmericanCollege of Radiology (ACR) provides an efficient and standardized assessment and management of breast lesions. It also stratifies breast cancer risk for a given lesion by classifying them into categories 1 through 5 according to the degree of suspicion.According to this system, solid masses with a circumscribed margin, oval shape (including those with two or three gentle lobulations) and parallel orientation on ultrasonography (US) exam are classified as BI-RADS 3. These types of masses are commonly seen at diagnostic and screening examinations. In this category malignancy is highly unlikely (less than 2%) and a short interval follow-up is recommended (1). However, up to one-third of such masses undergo biopsy mainly because of radiologist, referring clinician, or patient concern about the substantial risk of malignancy (2-4). Many BI-RADS 3 masses are traditionally referred for biopsy if they are palpable, large in size, patient is of advanced age or has a positive family history for breast cancer.The BI-RADS 4 assessment is reserved for findings that do not have the classic appearance of malignancy but are sufficiently suspicious to justify a recommendation for biopsy. This category is largely indeterminate and highly variable in outcome. Breast lesions in this category carry 2% to 95% risk for malignancy (1). Thus, almost all recommendations for breast biopsies come from assessments made using this category. According to BI-RADS classification; category 4 is subgrouped as 4A, 4B, and 4C to better inform the clinicians, pathologists, and patients of the degree of concern. However, the criteria for distinguishing among these subcategories have not been well delineated. BI-RADS 4A designates lesions with a low suspicion for malignancy. In this group, a benign pathologic diagnosis is expected and considered concordant (1). Studies of several institutions by the use of their internal criteria revealed positive predictive value (PPV) of 7%-9% for 4A lesions, and more than 50% of the suspicious lesions fall into this category. On the other hand, BI-RADS 4B and 4C 287From the Department of Radiology (S.K.  sibel_ozy@ yahoo.com) Karadeniz Technical University, School of Medicine, Trabzon, Turkey. BREAST IMAGING ORIGINAL ARTICLE PURPOSE We aimed to determine whether low-risk breast masses can be effectively managed with unenhanced magnetic resonance imaging (MRI) combining T2-weighted sequences with diffusion-weighted imaging (DWI) instead of immediate biopsy to decrease negative biopsy rates. METHODSAfter institutional review board and patient approvals, 141 consecutive women with 156 low-risk breast masses, who underwent unenhanced MRI and later on received a final diagnosis, were included in the study. There were 72 BI-RADS 3 masses in women with relative risk factors and 84 BI-RADS 4A masses, all referred for biopsy. Apparent diffusion coefficient (ADC) cutoff was 0.90×10-3 mm2/s. According to ADC values and T2-weighted imaging charact...

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“…Initially, this feature has invented an application area in the differantial diagnosis of the intracranial masses. Then, extended application area including head-neck (3,4,5), breast (6), vertebral column (7), musculoskletal system (8), abdomen and pelvis (9) were appeared in the subsequent years.…”

Section: Introductionmentioning

confidence: 99%

Evaluating of Parotid Gland Tumours According to Diffusion Weighted MRI

2014

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Sensitivity and specificity of unenhanced MR mammography (DWI combined with T2-weighted TSE imaging, ueMRM) for the differentiation of mass lesions

Abstract: Sensitivity and specificity of ueMRM in mass lesions equal that of ceMRM. However, a reduced lesion visibility in ueMRM may lead to more false-negative findings.

Cited by 128 publications

References 29 publications

Value of Apparent Diffusion Coefficient Values in Differentiating Malignant and Benign Breast Lesions

Value of Apparent Diffusion Coefficient Values in Differentiating Malignant and Benign Breast Lesions

Can unenhanced breast MRI be used to decrease negative biopsy rates?

Evaluating of Parotid Gland Tumours According to Diffusion Weighted MRI

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