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25.04.2016 | Breast

Incidentally detected enhancing lesions found in breast MRI: analysis of apparent diffusion coefficient and T2 signal intensity significantly improves specificity

verfasst von: Otso Arponen, Amro Masarwah, Anna Sutela, Mikko Taina, Mervi Könönen, Reijo Sironen, Juhana Hakumäki, Ritva Vanninen, Mazen Sudah

Erschienen in: European Radiology | Ausgabe 12/2016

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Abstract

Objectives

To evaluate the value of adding T2- and diffusion-weighted imaging (DWI) to the BI-RADS® classification in MRI-detected lesions.

Methods

This retrospective study included 112 consecutive patients who underwent 3.0T structural breast MRI with T2- and DWI on the basis of EUSOMA recommendations. Morphological and kinetic features, T2 signal intensity (T2 SI) and apparent diffusion coefficient (ADC) findings were assessed.

Results

Thirty-three (29.5 %) patients (mean age 57.0 ± 12.7 years) had 36 primarily MRI-detected incidental lesions of which 16 (44.4 %) proved to be malignant. No single morphological or kinetic feature was associated with malignancy. Both low T2 SI (P = 0.009) and low ADC values (≤0.87 × 10⁻³ mm²s⁻¹, P < 0.001) yielded high specificity (80.0 %/80.0 %). The BI-RADS classification supplemented with information from DWI and T2-WI improved the diagnostic performance of the BI-RADS classification as sensitivity remained 100 % and specificity improved from 30 % to 65.0 %. The numbers of false positive lesions declined from 39 % (N = 14) to 19 % (N = 7).

Conclusion

MRI-detected incidental lesions may be challenging to characterize as they have few specific malignancy indicating features. The specificity of MRI can be improved by incorporating T2 SI and ADC values into the BI-RADS assessment.

Key Points

• MRI-detected incidental lesions have few specific malignancy indicating features.

• ≥ 1 suspicious morphologic or kinetic feature may warrant biopsy.

• T2 signal intensity and DWI assessment are feasible in primarily MRI-detected lesions.

• T2 SI and DWI assessment improve the BI-RADS specificity in MRI-detected lesions.

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Titel: Incidentally detected enhancing lesions found in breast MRI: analysis of apparent diffusion coefficient and T2 signal intensity significantly improves specificity
verfasst von: Otso Arponen
Amro Masarwah
Anna Sutela
Mikko Taina
Mervi Könönen
Reijo Sironen
Juhana Hakumäki
Ritva Vanninen
Mazen Sudah
Publikationsdatum: 25.04.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 12/2016
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-016-4326-2

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Incidentally detected enhancing lesions found in breast MRI: analysis of apparent diffusion coefficient and T2 signal intensity significantly improves specificity

Abstract

Objectives

Methods

Results

Conclusion

Key Points

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Abstract

Objectives

Methods

Results

Conclusion

Key Points

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