Keywords:
Image verification, Cancer, Diagnostic procedure, Decision analysis, MR, Mammography, Oncology, Breast
Authors:
D. LA FORGIA1, R. Dentamaro2, V. Didonna2, A. Fanizzi3, L. Losurdo2, M. Raffaella2, P. Tamborra2, M. Telegrafo2, M. Moschetta2; 1BARI, BA/IT, 2BARI/IT, 3Bari, Italy/IT
DOI:
10.26044/ecr2019/C-3045
Methods and materials
Patient dataset:
Between March 2017 and April 2018,
65 patient (aged between 35 and 79 years) underwent both MRI and CESM examinations at I.R.C.C.S.
Istituto Tumori "Giovanni Paolo II" of Bari (Italy).
For each patient,
the exams were performed with a temporal range of 15 days from each other.
Primary and secondary (where present) lesions were detected and 71 findings were resulted and extracted.
Then,
each case was classified according to BPE classification (ACR BIRADS),
both in MRI and CESM,
as minimal (class I: < 25% of glandular tissue enhancement),
mild (II: 25 - 50%),
moderate (III: 50 - 75%),
and marked (IV: > 75%).
The 66,7% of patients with a minimum BPE value were in menopause.
Data acquisition and analysis:
For this purpose,
a modified DM devise (Senographe Essential GE,
Healthcare) was used for CESM examinations (Fig.
1),
after a single-shot intravenous injection of 1.5 ml/kg of body mass of iodinated CM (Visipaque 320 mg I/ml) at a flow rate of 2-3 ml/s.
Breast MRI scanning process was performed in the prone position with a dedicated seven-channel breast coil on a 1.5 Tesla PHILIPS scanner (Achieva,
Philips Medical Systems,
Best,
Netherlands),
shown in Figure 2.
As contrast medium,
a dose of 0.2 ml/kg of gadoteridol (ProHance 279.3 mg/ml) was injected at a flow rate of 1.5 ml/s followed by 20 ml of saline solution.
The MRI tests were performed between the 7th and the 20th day of the menstrual cycle.
All findings were evaluated by the radiologist according to the score of the Breast Imaging Reporting And Data System (BIRADS) [11].
Table 1 summerizes the categories given by the International BIRADS scoring system for the breast lesion diagnosis.
For each case,
semiological features of the lesions,
number of lesions,
BPE degree,
and BIRADS score were taken into account for both methods.
Then,
the results were compared with histological examinations for each technique.