Problem Solving MRI to Reduce False‐Positive Biopsy Related to Breast US: Conductivity vs. DWI vs. Abbreviated Contrast‐Enhanced MRI

医学 活检 乳房磁振造影 有效扩散系数 接收机工作特性 乳房成像 乳腺活检 放射科 磁共振弥散成像 双雷达 乳腺癌 曲线下面积 磁共振成像 核医学 乳腺摄影术 癌症 内科学
作者
Jun Hyeong Kim,Soo‐Yeon Kim,Chuanjiang Cui,Hye Min Ji,Heera Yoen,Nariya Cho,Dong‐Hyun Kim
出处
期刊:Journal of Magnetic Resonance Imaging [Wiley]
卷期号:59 (4): 1218-1228 被引量:2
标识
DOI:10.1002/jmri.28884
摘要

While breast ultrasound (US) is a useful tool for diagnosing breast masses, it can entail false-positive biopsy results because of some overlapping features between benign and malignant breast masses and subjective interpretation.To evaluate the performance of conductivity imaging for reducing false-positive biopsy results related to breast US, as compared to diffusion-weighted imaging (DWI) and abbreviated MRI consisting of one pre- and one post-contrast T1-weighted imaging.Prospective.Seventy-nine women (median age, 44 years) with 86 Breast Imaging Reporting and Data System (BI-RADS) category 4 masses as detected by breast US.3-T, T2-weighted turbo spin echo sequence, DWI, and abbreviated contrast-enhanced MRI (T1-weighted gradient echo sequence).US-guided biopsy (reference standard) was obtained on the same day as MRI. The maximum and mean conductivity parameters from whole and single regions of interest (ROIs) were measured. Apparent diffusion coefficient (ADC) values were obtained from an area with the lowest signal within a lesion on the ADC map. The performance of conductivity, ADC, and abbreviated MRI for reducing false-positive biopsies was evaluated using the following criteria: lowest conductivity and highest ADC values among malignant breast lesions and BI-RADS categories 2 or 3 on abbreviated MRI.One conductivity parameter with the maximum area under the curve (AUC) from receiver operating characteristics was selected. A P-value <0.05 was considered statistically significant.US-guided biopsy revealed 65 benign lesions and 21 malignant lesions. The mean conductivity parameter of the single ROI method was selected (AUC = 0.74). Considering conductivity (≤0.10 S/m), ADC (≥1.60 × 10-3 mm2 /sec), and BI-RADS categories 2 or 3 reduced false-positive biopsies by 23% (15 of 65), 38% (25 of 65), and 43% (28 of 65), respectively, without missing malignant lesions.Conductivity imaging may show lower performance than DWI and abbreviated MRI in reducing unnecessary biopsies.2 TECHNICAL EFFICACY: Stage 2.
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