Simple magnetic resonance imaging criteria can differentiate ductal carcinomas  in situ from invasive carcinomas

Almeida, João Ricardo Maltez de; Gomes, André Boechat; Barros, Thomas Pitangueira; Fahel, Paulo Eduardo; Rocha, Mário de Seixas

doi:10.5327/z201500030004rbm

Cited by 2 publications

(1 citation statement)

References 27 publications

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“…In the present study, the use of DWI had a greater impact on the evaluation of BI-RADS 4 lesions than on that of lesion in other categories, allowing a better, more complete assessment of these lesions and leading to tailored practices. These findings are in agreement with those of Almeida et al ( 29 ) , who demonstrated that DWI can improve the diagnostic performance of MRI and facilitate the division of BI-RADS 4 lesions into the subcategories 4A, 4B, and 4C. In addition, in comparison with MRI alone, MRI plus DWI can more accurately corroborate benign results in BI-RADS 4 lesions, as well as clarifying the analysis of lesions with a discordant histopathological result from a biopsy fragment, leading to a more accurate surgical evaluation.…”

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confidence: 94%

Can diffusion-weighted imaging add information in the evaluation of breast lesions considered suspicious on magnetic resonance imaging?

et al. 2017

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ObjectiveTo assess the role of diffusion-weighted imaging (DWI) in the evaluation of breast lesions classified as suspicious on magnetic resonance imaging (MRI), correlating the findings with the results of the histological analysis.Materials and MethodsThis was a retrospective, descriptive study based on a review of the medical records of 215 patients who were submitted to MRI with DWI before undergoing biopsy at a cancer center. Apparent diffusion coefficient (ADC) values were calculated for each lesion, and the result of the histological analysis was considered the gold standard.ResultsThe mean age was 49 years. We identified 252 lesions, 161 (63.9%) of which were found to be malignant in the histological analysis. The mean ADC value was higher for the benign lesions than for the malignant lesions (1.50 × 10–3 mm2/s vs. 0.97 × 10−3 mm2/s), the difference being statistically significant (p < 0.001). The ADC cut-off point with the greatest sensitivity and specificity on the receiver operating characteristic curve was 1.03 × 10−3 mm2/s. When the DWI and conventional MRI findings were combined, the accuracy reached 95.9%, with a sensitivity of 95.7% and a specificity of 96.4%.ConclusionThe use of DWI could facilitate the characterization of breast lesions, especially those classified as BI-RADS 4, increasing the specificity and diagnostic accuracy of MRI.

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Section: Discussionsupporting

confidence: 94%

Can diffusion-weighted imaging add information in the evaluation of breast lesions considered suspicious on magnetic resonance imaging?

et al. 2017

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Diffusion-weighted imaging of suspicious (BI-RADS 4) breast lesions: stratification based on histopathology

Almeida¹,

Gomes²,

Barros

et al. 2017

Radiol Bras

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Objective:To test the use of diffusion-weighted imaging (DWI) in stratifying suspicious breast lesions (BI-RADS 4), correlating them with histopathology. We also investigated the performance of DWI related to the main enhancement patterns (mass and non-mass) and tested its reproducibility.Materials and Methods:Seventy-six patients presented 92 lesions during the sampling period. Two independent examiners reviewed magnetic resonance imaging studies, described the lesions, and determined the apparent diffusion coefficient (ADC) values. Differences among benign, indeterminate- to high-risk, and malignant findings, in terms of the ADCs, were assessed by analysis of variance. Using receiver operating characteristic (ROC) curves, we compared the performance of ADC values in masses and non-mass lesions, and tested the reproducibility of measurements by determining the coefficient of variation and smallest real difference.Results:Among the 92 lesions evaluated, the histopathology showed that 37 were benign, 11 were indeterminate- to high-risk, and 44 were malignant. The mean ADC differed significantly among those histopathological groups, the value obtained for the malignant lesions (1.10 × 10-3 mm2/s) being significantly lower than that obtained for the other groups (p < 0.001). ROC curves demonstrated that DWI performed better when applied to masses than when applied to non-mass lesions (area under the curve, 0.88 vs. 0.67). Reproducibility was good (coefficient of variation, 7.03%; and smallest real difference, ± 0.242 × 10-3 mm2/s).Conclusion:DWI can differentiate between malignant and nonmalignant (benign or indeterminate- to high-risk) lesions, showing better performance for masses. Nevertheless, stratification based on histopathological criteria that are more refined has yet to be achieved.

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Simple magnetic resonance imaging criteria can differentiate ductal carcinomas in situ from invasive carcinomas

Cited by 2 publications

References 27 publications

Can diffusion-weighted imaging add information in the evaluation of breast lesions considered suspicious on magnetic resonance imaging?

Can diffusion-weighted imaging add information in the evaluation of breast lesions considered suspicious on magnetic resonance imaging?

Diffusion-weighted imaging of suspicious (BI-RADS 4) breast lesions: stratification based on histopathology

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