Subcategorization of Suspicious Breast Lesions (BI-RADS Category 4) According to MRI Criteria: Role of Dynamic Contrast-Enhanced and Diffusion-Weighted Imaging

Abstract

Risk stratification of suspicious lesions (BI-RADS category 4) can be satisfactorily performed with DCE-MRI and slightly improved when DWI is introduced.

Quantitative DWI implemented after DCE-MRI yields increased specificity for BI-RADS 3 and 4 breast lesions

“…15,16 The potential value of combined quantitative DWI and DCE-MRI for breast lesion differentiation has been indicated, but is generally based on the ADC, and the selection of the region of interest (ROI) usually relies on drawing a circular area and taking the average. [17][18][19] Additionally, for DWI to be implemented successfully along DCE-MRI, the sensitivity should be high (>98%) while the specificity is maximized. These opportunities were implemented in a method defined as semiautomated breast lesion analysis and is described in a previous study.…”

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

“…The subgroup of patients analyzed here was part of a larger cohort previously studied for different purposes (12-14) . The present study stems from a collaboration between an academic institution and a local private referral center for women's healthcare.…”

“…If the patient is compliant, we also obtain a single-phase late axial isotropic fat-suppressed T1-weighted sequence using VIBRANT. The detailed parameters of our protocol can be accessed in previous publications (12,14) .…”

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

“…This patient collective was already used for other purposes 15 . For the present study, we have excluded non-malignant lesions, those smaller than 0.5 cm (foci) or without available histopathologic confirmation, and studies without DWI acquisition or with imaging artifacts considered, by any of the reviewers, as prominent enough to interfere with their diagnostic performance.…”

“…DWI sequence is always the last to be acquired and we employ gradients in six directions with b=0 and 750 sec/mm 2 (TR/TE, 11.7/96; number of excitations, 8; matrix size, 256 x 224; field of view, 340x340 mm; slice thickness, 3.5 mm; intersection gap, 0.5 mm), using array spatial sensitivity parallel imaging (ASSET, GE Healthcare). Detailed protocol has been published elsewhere 15 .…”