Erschienen in:
01.07.2013 | Breast
Combined contrast-enhanced magnetic resonance and diffusion-weighted imaging reading adapted to the “Breast Imaging Reporting and Data System” for multiparametric 3-T imaging of breast lesions
verfasst von:
K. Pinker, H. Bickel, T. H. Helbich, S. Gruber, P. Dubsky, U. Pluschnig, M. Rudas, Z. Bago-Horvath, M. Weber, S. Trattnig, W. Bogner
Erschienen in:
European Radiology
|
Ausgabe 7/2013
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Abstract
Objective
To develop and assess a combined reading for contrast-enhanced magnetic resonance (CE-MRI) and diffusion weighted imaging (DWI) adapted to the BI-RADS for multiparametric MRI of the breast at 3 T.
Methods
A total of 247 patients with histopathologically verified breast lesions were included in this IRB-approved prospective study. All patients underwent CE-MR and DWI at 3 T. MRIs were classified according to BI-RADS and assessed for apparent diffusion coefficient (ADC) values. A reading method that adapted ADC thresholds to the assigned BI-RADS classification was developed. Sensitivity, specificity, diagnostic accuracy and the area under the curve were calculated. BI-RADS-adapted reading was compared with previously published reading methods in the same population. Inter- and intra-reader variability was assessed.
Results
Sensitivity of BI-RADS-adapted reading was not different from the high sensitivity of CE-MRI (P = 0.4). BI-RADS-adapted reading maximised specificity (89.4 %), which was significantly higher compared with CE-MRI (P < 0.001). Previous reading methods did not perform as well as the BI-RADS method except for a logistic regression model. BI-RADS-adapted reading was more sensitive in non-mass-like enhancements (NMLE) and was more robust to inter- and intra-reader variability.
Conclusion
Multiparametric 3-T MRI of the breast using a BI-RADS-adapted reading is fast, simple to use and significantly improves the diagnostic accuracy of breast MRI.
Keypoints
• Multiparametric breast 3-T MRI with BI-RADS-adapted reading improves diagnostic accuracy.
• BI-RADS-adapted reading of CE-MRI and DWI is based on established reporting guidelines.
• BI-RADS-adapted reading is fast and easy to use in routine clinical practice.
• BI-RADS-adapted reading is robust to intra- and inter-reader variability.