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26.04.2017 | Clinical Trial

Abbreviated breast dynamic contrast-enhanced MR imaging for lesion detection and characterization: the experience of an Italian oncologic center

verfasst von: Antonella Petrillo, Roberta Fusco, Mario Sansone, Marilena Cerbone, Salvatore Filice, Annamaria Porto, Maria Rosaria Rubulotta, Massimiliano D’Aiuto, Franca Avino, Maurizio Di Bonito, Gerardo Botti

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 2/2017

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Abstract

Background

To evaluate the performance of an abbreviated dynamic contrast-enhanced MR imaging (MRI) protocol for breast cancer detection; a comparison with the complete diagnostic protocol has been conducted.

Methods

A retrospective analysis on 508 patients was performed. Abbreviated protocol (AP) included one pre-contrast and the first post-contrast T1-weighted series. Complete protocol (CP) consisted of four post-contrast and one pre-contrast T1-weighted series. Diagnostic performance was assessed for AP and CP. Performance comparison was made using McNemar’s test for sensitivity and specificity and Moskowitz and Pepe’s method as regards negative predictive value (NPV) and positive predictive value (PPV). AP has been realized in two different ways (AP1 and AP2) and they were compared by means of Cohen’s κ.

Results

Both CP and AP revealed 206 of 207 cancers. There were no statistically significant differences between AP and CP diagnostic performance (P > 0.05). NPVs of CP and both versions of AP (99.57 vs. 99.56%, P = 0.39), as well as the specificity (77.08 vs. 75.42%, P = 0.18), were substantially equivalent. Relative predictive value method did not reveal the presence of a statistically significant difference between the PPV of CP and both versions of AP (74.91 vs. 73.57%, P = 0.099). Analysis for single lesion confirmed that both CP and AP had equivalent results: CP and AP revealed 280 of 281 malignancies. NPVs of CP and both AP versions, as well as the specificity (P > 0.05), were substantially equivalent. Relative predictive value method did not reveal the presence of a significant difference between the PPV of CP and both AP versions (70.89 vs. 70.18%, P = 0.25; 70.89 vs. 70.00%, P = 0.13).

Conclusions

Abbreviated approach to breast MRI examination reduces the image acquisition and the reading time associated with MR substantially without influencing the diagnostic accuracy (high sensitivity and NPV >99.5%). AP could translate into cost-savings and could enable a higher number of examinations within the same MR session.

http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx

Morrow M, Waters J, Morris E (2011) MRI for breast cancer screening, diagnosis, and treatment. Lancet 378(9805):1804–1811CrossRefPubMed

Gotzsche PC, Nielsen M (2011) Screening for breast cancer with mammography. Cochrane Database Syst Rev 1:CD001877

Ferris M, Hall MD (2008) The rise and impending decline of screening mammography. Radiology 247:597–601CrossRef

Petrillo A, Fusco R, Petrillo M, Triunfo F, Filice S, Vallone P, Setola SV, Rubulotta M, Di Bonito M, Rinaldo M, D’Aiuto M, Brunetti A (2016) Added value of breast MRI for preoperative diagnosis of ductal carcinoma in situ: diagnostic performance on 362 patients. Clin Breast Cancer. doi:10.1016/j.clbc.2016.12.007 PubMed

Fusco R, Sansone M, Filice S, Carone G, Amato DM, Sansone C, Petrillo A (2016) Pattern recognition approaches for breast cancer DCE-MRI classification: a systematic review. J Med Biol Eng 36(4):449–459CrossRefPubMedPubMedCentral

Petrillo A, Fusco R, Filice S, Granata V, Catalano O, Vallone P, Di Bonito M, D’Aiuto M, Rinaldo M, Capasso I, Sansone M (2016) Breast contrast enhanced MR imaging: semi-automatic detection of vascular map and predominant feeding vessel. PLoS ONE 11(8):e0161691CrossRefPubMedPubMedCentral

Fusco R, Sansone M, Filice S, Granata V, Catalano O, Amato DM, Di Bonito M, D’Aiuto M, Capasso I, Rinaldo M, Petrillo A (2015) Integration of DCE-MRI and DW-MRI quantitative parameters for breast lesion classification. Biomed Res Int 2015:237863CrossRefPubMedPubMedCentral

Fusco R, Sansone M, Filice S, Petrillo A (2016) Breast contrast-enhanced MR imaging: semiautomatic detection of vascular map. Breast Cancer 23(2):266–272CrossRefPubMed

10.

Petrillo A, Porto A, Fusco R, Filice S, Vallone P, Rubulotta MR, Fulciniti F, Di Bonito M, D’Aiuto M, Capasso I, Trimboli RM, Sardanelli F (2013) Surgical impact of preoperative breast MRI in women below 40 years of age. Breast Cancer Res Treat 140(3):527–533CrossRefPubMed

11.

Kuhl C, Weigel S, Schrading S, Arand B, Bieling H, König R, Tombach B, Leutner C, Rieber-Brambs A, Nordhoff D, Heindel W, Reiser M, Schild HH (2010) Prospective multicenter cohort study to refine management recommendations for women at elevated familial risk of breast cancer: the EVA trial. J Clin Oncol 28(9):1450–1457CrossRefPubMed

12.

Stoutjesdijk MJ, Boetes C, Jager GJ, Beex L, Bult P, Hendriks JHCL, Laheij RJF, Massuger L, van Die LE, Wobbes T, Barentsz JO (2001) Magnetic resonance imaging and mammography in women with a hereditary risk of breast cancer. J Natl Cancer Inst 93(14):1095–1102CrossRefPubMed

13.

Kim JY, Cho N, Koo HR, Yi A, Kim WH, Lee SH, Chang JM, Han W, Moon HG, Im SA, Noh DY, Moon WK (2013) Unilateral breast cancer: screening of contralateral breast by using preoperative MR imaging reduces incidence of metachronous cancer. Radiology 267(1):57–66CrossRefPubMed

14.

Kuhl CK, Schrading S, Strobel K, Schild HH, Hilgers RD, Bieling HB (2014) Abbreviated breast magnetic resonance imaging (MRI): first postcontrast subtracted images and maximum-intensity projection—a novel approach to breast cancer screening with MRI. J Clin Oncol 32(22):2304–2310CrossRefPubMed

15.

Petrillo A, Petrillo M, Fulciniti F, Raso MM, Thomas R, Botti G, Siani A. Primary phyllodes tumor of the axilla: DCE-MRI findings with 1.5T breast-dedicated system and pathological correlation. Breast J. 2011 Sep-Oct;17(5):525-7

16.

Sardanelli F, Giuseppetti GM, Canavese G, Cataliotti L, Corcione S, Cossu E, Federico M, Marotti L, Martincich L, Panizza P, Podo F, Rosselli Del Turco M, Zuiani C, Alfano C, Bazzocchi M, Belli P, Bianchi S, Cilotti A, Calabrese M, Carbonaro L, Cortesi L, Di Maggio C, Del Maschio A, Esseridou A, Fausto A, Gennaro M, Girometti R, Ienzi R, Luini A, Manoukian S, Morassutt S, Morrone D, Nori J, Orlacchio A, Pane F, Panzarola P, Ponzone R, Simonetti G, Torricelli P, Valeri G (2008) Indications for breast magnetic resonance imaging. Consensus document “Attualità in senologia”, Florence 2007. Radiol Med 113(8):1085–1095CrossRefPubMed

17.

Kuhl CK, Mielcareck P, Klaschik S, Leutner C, Wardelmann E, Gieseke J, Schild HH (1999) Dynamic breast MR imaging: are signal intensity time course data useful for differential diagnosis of enhancing lesions? Radiology 211(1):101–110CrossRefPubMed

18.

Moskowitz CS, Pepe MS (2006) Comparing the predictive values of diagnostic tests: sample size and analysis for paired study designs. Clin Trials 3(3):272–279CrossRefPubMed

19.

Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33(1):159–174CrossRefPubMed

20.

American Joint Committee on Cancer, AJCC (2002) Chap. 25: breast cancer. In: Cancer staging manual, 6th edn, p 223–240. http://www.cancerstaging.org/products/csmanual6ed-4.pdf

21.

http://www.airc.it/tumori/tumore-al-seno.asp

22.

Mango VL, Morris EA, David Dershaw D, Abramson A, Fry C, Moskowitz CS, Hughes M, Kaplan J, Jochelson MS (2015) Abbreviated protocol for breast MRI: are multiple sequences needed for cancer detection? Eur J Radiol 84(1):65–70CrossRefPubMed

23.

Grimm LJ, Soo MS, Yoon S, Kim C, Ghate SV, Johnson KS (2015) Abbreviated screening protocol for breast MRI: a feasibility study. Acad Radiol 22(9):1157–1162CrossRefPubMed

24.

Harvey SC, Di Carlo PA, Lee B, Obadina E, Sippo D, Mullen L (2016) An abbreviated protocol for high-risk screening breast MRI saves time and resources. J Am Coll Radiol 13(11S):R74–R80CrossRefPubMed

25.

Jain M, Jain A, Hyzy MD, Werth G (2017) FAST MRI breast screening revisited. J Med Imaging Radiat Oncol 61(1):24–28CrossRefPubMed

26.

Moschetta M, Telegrafo M, Rella L, Stabile Ianora AA, Angelelli G (2016) Abbreviated combined MR protocol: a new faster strategy for characterizing breast lesions. Clin Breast Cancer 16(3):207–211CrossRefPubMed

Titel: Abbreviated breast dynamic contrast-enhanced MR imaging for lesion detection and characterization: the experience of an Italian oncologic center
verfasst von: Antonella Petrillo
Roberta Fusco
Mario Sansone
Marilena Cerbone
Salvatore Filice
Annamaria Porto
Maria Rosaria Rubulotta
Massimiliano D’Aiuto
Franca Avino
Maurizio Di Bonito
Gerardo Botti
Publikationsdatum: 26.04.2017
Verlag: Springer US
Erschienen in: Breast Cancer Research and Treatment / Ausgabe 2/2017
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-017-4264-y

Springer Medizin

Abbreviated breast dynamic contrast-enhanced MR imaging for lesion detection and characterization: the experience of an Italian oncologic center