Aims and objectives
Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is becoming an increasingly popular breast imaging tool especially for screening high-risk women,
staging local disease in newly diagnosed breast cancer,
and tumour evaluation during neoadjuvant treatment.[1]
While it has an excellent sensitivity,
breast MRI interpretation can be challenging.
The American College of Radiology (ACR) Breast Imaging Reporting and Data System.
(BI-RADS) lexicon is a widely accepted standard that provides a common language with MRI descriptors based on lesion morphology and functional contrast enhancement kinetics.[2]
While this is a...
Methods and materials
Patient population
An anonymized database of consecutively collected histologically verified breast MRI cases (n=70,
24 malignant,
46 benign) was read by two independent off-site fellowship trained readers.
Histopathological analysis was obtained either by image-guided biopsy (core / vacuum assisted biopsy under US/mammographic / MRI guidance) or surgical excision with the histopathological assessment done by board-certified breast pathologists.
Data collection and analysis
The structured reading of predefined lesions included T2w and contrast-enhanced dynamic T1w scans.
Ratings were assigned to each lesion as per the Kaiser score....
Results
A total of 70 lesions in 70 patients (24 malignant,
46 benign) were analysed.
51 lesions were classified as “mass” and 19 as “non-mass”.
Diagnostic accuracy (area under the ROC curve,
AUC) ranged between 85.4% and 91.6%.
(Fig.2)
Kaiser score reading results using the peak enhancement of either the first or second timepoint performed significantly better than the other approaches (P<0.05,
respectively).
A high sensitivity level,
corresponding to a rule-out criterion,
was achieved for all three.
reading techniques,
but with a higher specificity when initial...
Conclusion
It is well established that the time-signal intensity curve (TIC) from dynamic contrast-enhanced magnetic resonance imaging (DCE- MRI) reflects the hemodynamic features of a specific lesion.[5]
The enhancement kinetics are an important aid in characterizing breast lesions and improving delineation between benign and malignant lesions. The shape of the time-signal intensity curve is classified according to ACR BIRADS lexicon as persistent enhancing "Type 1",
plateau "Type 2",
or washout "Type 3" (Fig.
3).
Several studies have reported that time-signal intensity curves have a very high...
Personal information
Department of Diagnostic Imaging
National University Hospital,
Singapore And Yong Loo Lin School of Medicine,
National University of Singapore
References
[1]F.
Sardanelli,
C.
Boetes,
B.
Borisch,
T.
Decker,
M.
Federico,
F.J.
Gilbert,
T.
Helbich,
S.H.
Heywang-Köbrunner,
W.A.
Kaiser,
M.J.
Kerin,
R.E.
Mansel,
L.
Marotti,
L.
Martincich,
L.
Mauriac,
H.
Meijers-Heijboer,
R.
Orecchia,
P.
Panizza,
A.
Ponti,
A.D.
Purushotham,
P.
Regitnig,
M.R.
Del Turco,
F.
Thibault,
R.
Wilson,
Magnetic resonance imaging of the breast: Recommendations from the EUSOMA working group,
Eur.
J.
Cancer.
46 (2010) 1296–1316.
doi:10.1016/j.ejca.2010.02.015.
[2] [2]C.
D’Orsi,
E.
Sickles,
E.
Mendelson,
E.
Morris,
ACR BI-RADS atlas,
breast imaging reporting and data system.,
2013....