Unenhanced breast MRI (STIR, T2-weighted TSE, DWIBS): An accurate and alternative strategy for detecting and differentiating breast lesions

Telegrafo, Michele; Rella, Leonarda; Ianora, Amato Antonio Stabile; Angelelli, Giuseppe; Moschetta, Marco

doi:10.1016/j.mri.2015.06.002

Cited by 60 publications

(50 citation statements)

References 28 publications

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“…The authors found that optimal ADC determination and DWI quality at 3T could be reached with a combination of two b‐values, 50 and 850 s/mm 2 , which resulted in a diagnostic accuracy of 96%. Recently, DWI with background body signal suppression (DWIBS) was investigated for the depiction and differentiation of benign and malignant breast tumors . It was demonstrated that DWIBS is superior to conventional DWI in the visualization of both malignant and benign lesions (Fig.…”

Section: Introductionmentioning

confidence: 99%

“…In general, there is broad consensus that DWI is a promising imaging biomarker, which provides additional functional information to CE‐MRI. DWI significantly increases the specificity (75–84%) compared to CE‐MRI alone (67–72%), and thus, obviates unnecessary breast interventions without missing cancers . In addition to the differentiation of benign and malignant breast tumors, DWI can potentially be used as a noninvasive biomarker for the differentiation of tumor subtypes, invasive vs. noninvasive disease, tumor receptor status, and tumor grading .…”

Section: Introductionmentioning

confidence: 99%

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Multiparametric MRI of the breast: A review

Marino

Helbich

Baltzer

et al. 2017

Magnetic Resonance Imaging

107

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Multiparametric MRI of the breast: A review

Marino

Helbich

Baltzer

et al. 2017

Magnetic Resonance Imaging

107

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show abstract

“…In addition to contrast enhanced protocols, abbreviated unenhanced protocols omitting contrast agent administration have been subject of different studies with promising results regarding the differentiation between malignant and benign breast lesions [8–11]. Besides shortening examination times, another aspect of unenhanced, abbreviated breast MRI protocols represent recent reports on gadolinium deposition in the human brain after repetitive intravenous application with unclear clinical relevance [12, 13].…”

Section: Introductionmentioning

confidence: 99%

On a fractional order calculus model in diffusion weighted breast imaging to differentiate between malignant and benign breast lesions detected on X-ray screening mammography

et al. 2017

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ObjectiveTo evaluate a fractional order calculus (FROC) model in diffusion weighted imaging to differentiate between malignant and benign breast lesions in breast cancer screening work-up using recently introduced parameters (βFROC, DFROC and μFROC).Materials and methodsThis retrospective analysis within a prospective IRB-approved study included 51 participants (mean 58.4 years) after written informed consent. All patients had suspicious screening mammograms and indication for biopsy. Prior to biopsy, full diagnostic contrast-enhanced MRI examination was acquired including diffusion-weighted-imaging (DWI, b = 0,100,750,1500 s/mm2). Conventional apparent diffusion coefficient Dapp and FROC parameters (βFROC, DFROC and μFROC) as suggested further indicators of diffusivity components were measured in benign and malignant lesions. Receiver operating characteristics (ROC) were calculated to evaluate the diagnostic performance of the parameters.Results29/51 patients histopathologically revealed malignant lesions. The analysis revealed an AUC for Dapp of 0.89 (95% CI 0.80–0.98). For FROC derived parameters, AUC was 0.75 (0.60–0.89) for DFROC, 0.59 (0.43–0.75) for βFROC and 0.59 (0.42–0.77) for μFROC. Comparison of the AUC curves revealed a significantly higher AUC of Dapp compared to the FROC parameters DFROC (p = 0.009), βFROC (p = 0.003) and μFROC (p = 0.001).ConclusionIn contrast to recent description in brain tumors, the apparent diffusion coefficient Dapp showed a significantly higher AUC than the recently proposed FROC parameters βFROC, DFROC and μFROC for differentiating between malignant and benign breast lesions. This might be related to the intrinsic high heterogeneity within breast tissue or to the lower maximal b-value used in our study.

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“…In terms of screening feasibility, ultrasound elastography and unenhanced abbreviated breast magnetic resonance imaging (MRI) currently appear to have potential for added benefit during noninvasive work‐up . Recently, contrast‐free breast MRI protocols with high‐quality diffusion‐weighted imaging (DWI) have shown promise in the diagnostic decision‐making of breast lesions . The combination of DWI with morphological T 2 ‐weighted imaging sequences has been reported to provide reliable characterization of breast lesions .…”

mentioning

confidence: 99%