Diagnostic Accuracy of Mammography and Contrast-Enhanced MR Imaging in 238 Histologically Verified Breast Lesions

Purpose: To determine the sensitivity and specificity of X-ray mammography and of MR imaging in 238 consecutively operated breasts, and to correlate the findings to histopathological diagnosis. Material and Methods: Over 15 months, 220 patients scheduled for breast surgery were examined consecutively, before surgery, by means of both mammography and MR imaging. of the 220 patients, 18 underwent bilateral breast surgery. The entire breast was examined by means of T1-weighted transversal images using a 3D fast low-angle shot (FLASH) sequence. One pre— and 2 post-contrast scans were performed. Each breast was examined by means of mammography and 3 views were applied as routine. All palpable and mammographically suspect lesions were examined on additional images as microfocus magnification or spot compression. The two methods were evaluated independently of each other. Results: In total, 145 malignant and 93 benign lesions were found at histopathological examination. The sensitivity of mammography was 89% and MR imaging 92%. The specificity was 72% in both methods. When the results of the 2 methods were combined, a sensitivity of 99% and a specificity of 55% was achieved. Conclusion: Mammography and MR imaging seemed to complement each other to produce a high sensitivity. Unfortunately it is impossible at present to supplement mammography with MR imaging in each patient as a routine owing to the current technical and financial limitations.

Download Full-text

Intravoxel incoherent motion MR imaging for breast lesions: comparison and correlation with pharmacokinetic evaluation from dynamic contrast-enhanced MR imaging

European Radiology ◽

10.1007/s00330-016-4241-6 ◽

2016 ◽

Vol 26 (11) ◽

pp. 3888-3898 ◽

Cited By ~ 38

Author(s):

Chunling Liu ◽

Kun Wang ◽

Queenie Chan ◽

Zaiyi Liu ◽

Jine Zhang ◽

...

Keyword(s):

Mr Imaging ◽

Intravoxel Incoherent Motion ◽

Breast Lesions ◽

Dynamic Contrast Enhanced ◽

Contrast Enhanced ◽

Pharmacokinetic Evaluation

Download Full-text

Limited role of DWI with apparent diffusion coefficient mapping in breast lesions presenting as non-mass enhancement on dynamic contrast-enhanced MRI

Breast Cancer Research ◽

10.1186/s13058-019-1208-y ◽

2019 ◽

Vol 21 (1) ◽

Cited By ~ 7

Author(s):

Daly Avendano ◽

Maria Adele Marino ◽

Doris Leithner ◽

Sunitha Thakur ◽

Blanca Bernard-Davila ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Roc Curves ◽

Breast Cancer Diagnosis ◽

Breast Lesions ◽

Mri Findings ◽

Adc Value ◽

Dce Mri ◽

Dynamic Contrast Enhanced ◽

Contrast Enhanced ◽

Mass Enhancement

Abstract Background Available data proving the value of DWI for breast cancer diagnosis is mainly for enhancing masses; DWI may be less sensitive and specific in non-mass enhancement (NME) lesions. The objective of this study was to assess the diagnostic accuracy of DWI using different ROI measurement approaches and ADC metrics in breast lesions presenting as NME lesions on dynamic contrast-enhanced (DCE) MRI. Methods In this retrospective study, 95 patients who underwent multiparametric MRI with DCE and DWI from September 2007 to July 2013 and who were diagnosed with a suspicious NME (BI-RADS 4/5) were included. Twenty-nine patients were excluded for lesion non-visibility on DWI (n = 24: 12 benign and 12 malignant) and poor DWI quality (n = 5: 1 benign and 4 malignant). Two readers independently assessed DWI and DCE-MRI findings in two separate randomized readings using different ADC metrics and ROI approaches. NME lesions were classified as either benign (> 1.3 × 10−3 mm2/s) or malignant (≤ 1.3 × 10−3 mm2/s). Histopathology was the standard of reference. ROC curves were plotted, and AUCs were determined. Concordance correlation coefficient (CCC) was measured. Results There were 39 malignant (59%) and 27 benign (41%) lesions in 66 (65 women, 1 man) patients (mean age, 51.8 years). The mean ADC value of the darkest part of the tumor (Dptu) achieved the highest diagnostic accuracy, with AUCs of up to 0.71. Inter-reader agreement was highest with Dptu ADC max (CCC 0.42) and lowest with the point tumor (Ptu) ADC min (CCC = − 0.01). Intra-reader agreement was highest with Wtu ADC mean (CCC = 0.44 for reader 1, 0.41 for reader 2), but this was not associated with the highest diagnostic accuracy. Conclusions Diagnostic accuracy of DWI with ADC mapping is limited in NME lesions. Thirty-one percent of lesions presenting as NME on DCE-MRI could not be evaluated with DWI, and therefore, DCE-MRI remains indispensable. Best results were achieved using Dptu 2D ROI measurement and ADC mean.

Download Full-text

Contrast Enhanced Mammography: The added value in the assessment of Suspicious Breast Lesions

QJM ◽

10.1093/qjmed/hcaa068.001a ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

R Abdullah ◽

L Abdelmonem ◽

N Nasry ◽

M Ayoub

Keyword(s):

Breast Cancer ◽

Diagnostic Accuracy ◽

Predictive Value ◽

Malignant Tumors ◽

High Energy ◽

Added Value ◽

Breast Lesions ◽

Predictive Values ◽

Dense Breasts ◽

Contrast Enhanced

Abstract Background Breast cancer in women is a major public health problem throughout the world, being the second most common cancer worldwide. Sonomammography has been always recommended as the basic breast imaging modality for early detection and diagnosis of breast cancer. Some malignant tumors have been missed, specially in dense breasts, and high false-negative rate have been reported. Contrast enhanced spectral mammography is a new modality, used to depict the tumor vascularity and neoangiogenesis; a classic sign of malignant tumors. Aim of Work The purpose of this study is to determine the added value of dual energy contrast mammography to sono-mammography in the assessment of suspicious breast lesions. Patients and Methods 36 patients were included in the study, referred from outpatient clinics in private settings and from Demerdash Hospitals. Contrast enhanced spectral mammography CESM was performed by using a digital mammography unit (Seno DS; GE, Buc, France) that had been adapted to obtain two images for each view: a low-energy image (below the k edge of iodine, 33.2 keV) and a high-energy image (above the k edge of iodine) at 45 to 49 kVp. Results: CEDM versus sonomammography shows p (0.021) value less than 0.05. Also the area under the ROC curve was higher for MX+CEDM (94.4%) than that was for sonomammography (63.8%) compared to pathology analysis with 100% sensitivity, 88.2 % specificity, 90.48 %PPV and 100 % NPV in diagnosis of suspicious lesions. Conclusion The diagnostic accuracy of CEDM+ MX for the detection of breast carcinoma has proven to be superior to sonomammography alone. CEDM had a better diagnostic accuracy mainly due to improved positive and negative predictive values (Positive predictive value about 90.48, negative predictive value 100). The role of CEDM in detection of multifocal / multicentric carcinomas with particular interest for the assessment of the extent of disease specially in dense breasts is appreciated.

Download Full-text