Aims and objectives
To assess whether multiparametric-MRI (mpMRI) with dynamic-contrast-enhancement- MRI (DCE-MRI) and diffusion weighted imaging (DWI) improves the diagnostic accuracy in breast non-mass enhancement (NME) lesions.
Methods and materials
In this IRB-approved study,
a prospectively populated database was searched for patients with a breast mpMRI and a suspicious NME lesion (BI-RADS 4/5).
95 patients were identified.
29 were excluded due to suboptimal quality/non-visibility of the lesion on DWI.
Two readers (r1,
r2) independently assessed the NME on DCE-MRI and DWI.
For each lesion they assigned a score for DCE-MRI according to BI-RADS lexicon.
A 2D ROI was manually drawn in the most hypointense/suspicious area of the NME and ADC values were measured.
There were 66 patients (mean ages 51.8 ±10.8 yo) with a mean size lesion of 40±25 mm: 37 malignant (56%) and 29 benign (44%) (Figure 2).
For DCE-MRI a SE of 94.9% (r1) and 100% (r2) and a SP of 66.7% (r1) and 77.8% (r2) were achieved.
For MpMRI the SE was 87.2% (r1) and 90% (r2) and the SP 85.2% for both readers (P>0.5).
The reduction of false positive was ranged between 33.3% (6 vs 2)and 55.5% (9 vs 4) (Figure 3).
MpMRI enables an improved specificity and agreement compared to DCE-MRI in non-mass enhancement lesions of the breast.
American College of Radiology BI-RADS Atlas (2013),
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