scholarly journals BIRADS 4 breast lesions: comparison of contrast-enhanced spectral mammography and contrast-enhanced MRI

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Rabab Yasin ◽  
Enas Abd El Ghany
Keyword(s):  
Breast Cancer ◽  
Developing Countries ◽  
Statistical Significance ◽  
Breast Mri ◽  
Excision Biopsy ◽  
Breast Lesions ◽  
Common Cancer ◽  
Contrast Enhanced ◽  
Histopathological Result ◽  
Contrast Enhanced Mri

Abstract Background Breast cancer is the most common cancer in women worldwide. It is responsible for about 23% of cancer in females in both developed and developing countries [1]. We aimed to assess the accuracy of contrast-enhanced spectral mammography (CESM) versus contrast-enhanced breast MRI in the evaluation of BIRADS 4 breast lesions. Results Fifty patients were included in this study; there were 28 malignant cases and 22 benign cases; all cases were proved by histopathological result either by core biopsy or excision biopsy. CESM was found to have less sensitivity (94.1%) than MRI (100%) but CESM has higher specificity (100%) than MRI (95.5%). The accuracy of CESM was 96.4%, while the accuracy of MRI was 98.2% with no statistical significance (P value 0.827). Conclusion CESM can be used as a sensitive diagnostic tool in the detection and staging of breast cancer with higher specificity and less sensitivity as compared to contrast enhanced breast MRI.

scholarly journals Breast cancer in dense breasts: comparative diagnostic merits of contrast-enhanced mammography and diffusion-weighted breast MRI

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Reham Anwar ◽  
Mohamed Amr Farouk ◽  
Wafaa Raafat Abdel Hamid ◽  
Amal Amin Abu El Maati ◽  
Hanan Eissa
Keyword(s):  
Breast Cancer ◽  
Diagnostic Accuracy ◽  
Breast Mri ◽  
Breast Lesions ◽  
Dense Breasts ◽  
Diffusion Weighted ◽  
Contrast Enhanced ◽  
Mass Lesions ◽  
And Diffusion ◽  
Total Accuracy

Abstract Background The study was done to compare the value of contrast-enhanced mammography and diffusion-weighted breast MRI in dense breast screening and accurate detection of the breast cancer with correlation of the findings to the histopathological results. The study included 32 female patients having suspicious breast lesions and underwent digital mammography then scheduled for CESM and MRI DW imaging technique. The imaging findings were correlated to the histopathological findings. Results The study was conducted on 40 breast lesions in 32 female patients having dense breasts; they were classified by the digital mammography into ACR C (59.4%) and ACR D (40.6%). By CESM, there were twenty three lesions (57.5%) as mass lesions and thirteen lesions (32.5%) as non-mass lesions. Four lesions (10%) showed no contrast enhancement. According to the lesion characteristics in diffusion-weighted imaging, the breast lesions were classified into thirty three lesions (82.5%) with restricted diffusion and seven lesions (17.5%) with non-restricted diffusion. The study showed a cutoff ADC value to detect the malignant lesions in the dense breasts ≤ 1.1 × 10-3 s/mm2 at b value of 1000 s/mm2 with a sensitivity of 96.77%, specificity of 66.67%, PPV of 96.77%, NPV of 55.55%, and an overall total accuracy of 92.5%. On comparing the diagnostic accuracy of the CESM to that of the DW MRI, the sensitivity of DW MRI (96.77%) was higher than that of CESM (90.32%). The specificity of DW MRI (66.67%) was higher than that of CESM (33.33%). Total accuracy of DW MRI was higher than that of CESM; they were 90% and 77.5%, respectively. Also, PPV and NPV of DW MRI were 90.91 and 85.71% as compared with 82.35 and 50.00% in CESM, respectively. When comparing the sensitivity of CESM to DW MRI in the detection of multiple breast lesions, they were 88.8 and 100%, respectively. Conclusion CESM is a useful technique in identification of hidden lesions in mammographically dense breasts. DW MRI is a fast, unenhanced modality that can be used as a breast cancer screening modality. CESM and DWI demonstrated good overall diagnostic accuracy in dense breast patients; however, DW MRI has a higher diagnostic accuracy than CESM for the detection of malignant breast lesions and their multiplicity.

The Role of Combined Diffusion-Weighted Imaging and Dynamic Contrast-Enhanced MRI for Differentiating Malignant From Benign Breast Lesions Presenting Washout Curve

2020 ◽  
pp. 084653712090709
Author(s):  
Sehnaz Tezcan ◽  
Funda Ulu Ozturk ◽  
Nihal Uslu ◽  
Eda Yilmaz Akcay
Keyword(s):  
Breast Mri ◽  
Breast Lesions ◽  
Benign Lesions ◽  
Cutoff Value ◽  
Dce Mri ◽  
Dynamic Contrast Enhanced Mri ◽  
Dynamic Contrast Enhanced ◽  
Enhanced Mri ◽  
Contrast Enhanced ◽  
Contrast Enhanced Mri

Purpose: The aim of this study is to evaluate the diagnostic performance of combined breast magnetic resonance imaging (MRI) protocol including dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI) in patients with enhancing lesions that demonstrated washout curve and to determine whether applying apparent diffusion coefficient (ADC) cutoff value could improve the diagnostic value of breast MRI. Methods: The retrospective study included 116 patients with 116 suspicious breast lesions, which showed washout curve on DCE-MRI, who underwent subsequent biopsy. Morphologic characteristics on DCE-MRI and ADC values on DWI were evaluated. Apparent diffusion coefficient values and morphologic features of benign and malignant lesions were compared. Diagnostic values of DCE-MRI and combined MRI, including DCE-MRI and DWI (applying an ADC cutoff value) for distinguishing malignancy from benign lesions, were calculated. Results: Of the 116 breast lesions, 79 were malignant and 37 were benign. The ADC value of malignant tumors (median ADC, 0.72 × 10−3 mm2/s) was significantly lower than that of benign lesions (median ADC, 1.03 × 10−3 mm2/s; P < .000). The sensitivity and specificity of an ADC cutoff value of 0.89 × 10−3 mm2/s were 92% and 95%, respectively. Dynamic contrast-enhanced MRI alone presented 100% sensitivity and 59.4% specificity. Adding an ADC cutoff value of 0.89 × 10−3 mm2/s provided 100% sensitivity and 81% specificity, which would have prevented biopsy for 21.6% of benign lesions without missing any malignancies. Conclusion: Applying an ADC cutoff value to DCE-MRI provides an improvement in the diagnostic value of breast MRI for differentiating among lesions presenting washout curve.

scholarly journals Diagnostic Accuracy of Contrast-Enhanced MRI for Detecting the Malignant Breast Lesions

2021 ◽  
Vol 25 (1) ◽  
pp. 26-30
Author(s):  
Naila Parveen ◽  
Rabia Waseem Butt ◽  
Manal Niazi ◽  
Kulsoom Iqbal ◽  
Sidra Manzoor ◽  
...  
Keyword(s):  
Imaging Modality ◽  
Breast Mri ◽  
Breast Lesions ◽  
Mri Imaging ◽  
Sample Collection ◽  
Cross Sectional ◽  
Enhanced Mri ◽  
Contrast Enhanced ◽  
Malignant Breast ◽  
Contrast Enhanced Mri

Objectives: To determine the accuracy of contrast-enhanced MRI in the diagnosis and detection of breast lesions and their malignant potential by taking the gold standard of histopathology.Materials and Methods: This study was conducted at the Department of Diagnostic Radiology, Pakistan Institute of Medical Sciences (P.I.M.S.) Islamabad. It was undertaken in collaboration with the Department of General Surgery P.I.M.S, Department of Pathology P.I.M.S Islamabad, and HIT Hospital Taxila. The study design was a cross-sectional (Validation) study and the duration of the study was 6 months (from 01-Oct-2016 to 31-Mar-2017). Results: Sample size was calculated by using sensitivity and specificity calculator taking sensitivity 94%1 with a precision of 6%, specificity 85%1 with a precision of 10%, prevalence is 45.9%2, and confidence interval of 95% it comes out to be 92%. Sample collection was made by the technique of Consecutive non-probability sampling.Conclusion: Breast MRI imaging is a modern evolving modality. A gradual increase in diagnostic specificity is achieved with improved software and techniques. More such studies would help develop confidence in this advanced imaging modality for improving patient management and avoiding unnecessary biopsies.

scholarly journals Diffusion tensor imaging on 3-T MRI breast: diagnostic performance in comparison to diffusion-weighted imaging

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Dalia Abdelhady ◽  
Amany Abdelbary ◽  
Ahmed H. Afifi ◽  
Alaa-eldin Abdelhamid ◽  
Hebatallah H. M. Hassan
Keyword(s):  
Breast Cancer ◽  
Diffusion Tensor Imaging ◽  
Sensitivity And Specificity ◽  
Diffusion Weighted Imaging ◽  
Diffusion Tensor ◽  
Breast Mri ◽  
Breast Lesions ◽  
Dce Mri ◽  
Additional Tool ◽  
Diffusion Weighted

Abstract Background Breast cancer is the most prevalent cancer among females. Dynamic contrast-enhanced MRI (DCE-MRI) breast is highly sensitive (90%) in the detection of breast cancer. Despite its high sensitivity in detecting breast cancer, its specificity (72%) is moderate. Owing to 3-T breast MRI which has the advantage of a higher signal to noise ratio and shorter scanning time rather than the 1.5-T MRI, the adding of new techniques as diffusion tensor imaging (DTI) to breast MRI became more feasible. Diffusion-weighted imaging (DWI) which tracks the diffusion of the tissue water molecule as well as providing data about the integrity of the cell membrane has been used as a valuable additional tool of DCE-MRI to increase its specificity. Based on DWI, more details about the microstructure could be detected using diffusion tensor imaging. The DTI applies diffusion in many directions so apparent diffusion coefficient (ADC) will vary according to the measured direction raising its sensitivity to microstructure elements and cellular density. This study aimed to investigate the diagnostic accuracy of DTI in the assessment of breast lesions in comparison to DWI. Results By analyzing the data of the 50 cases (31 malignant cases and 19 benign cases), the sensitivity and specificity of DWI in differentiation between benign and malignant lesions were about 90% and 63% respectively with PPV 90% and NPV 62%, while the DTI showed lower sensitivity and specificity about 81% and 51.7%, respectively, with PPV 78.9% and NPV 54.8% (P-value ≤ 0.05). Conclusion While the DWI is still the most established diffusion parameter, DTI may be helpful in the further characterization of tumor microstructure and differentiation between benign and malignant breast lesions.

scholarly journals Contrast-enhanced ultrasound of breast fibromatosis: a case report

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110106
Author(s):  
Shanhong Lin ◽  
Yong Cao ◽  
Libin Chen ◽  
Mei Chen ◽  
Shengmin Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Rare Case ◽  
Common Type ◽  
Breast Lesions ◽  
Contrast Enhanced Ultrasound ◽  
High Similarity ◽  
Potential Value ◽  
Contrast Enhanced ◽  
Malignant Breast ◽  
Contrast Enhanced Ultrasonography

We herein present a rare case of breast fibromatosis, the contrast-enhanced ultrasonography (CEUS) findings of which we believe have never been described. The high similarity between the clinical and imaging manifestations of breast cancer makes its differential diagnosis difficult. In this report, we describe the CEUS findings of a less common type of fibromatosis, discuss the potential value of CEUS to differentiate it from malignant breast lesions, and briefly review the literature.

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