A Comparative Study of the Diagnostic Value of Contrast-Enhanced Breast MR Imaging and Mammography on Patients with BI-RADS 3–5 Microcalcifications

Abstract

ObjectiveTo retrospectively investigate the diagnostic value of breast MRI in patients with BI-RADS 3–5 microcalcifications in mammography.MethodsEighty-four patients with BI-RADS 3–5 microcalcifications on mammography underwent breast MR exams before surgical biopsy with a hookwire position under mammographic guidance. Two radiologists reviewed each lesion with BI-RADS by consensus. The diagnostic value of mammography and MRI was compared.ResultsHistopathological examination revealed 49 benign lesions and 42 malignant lesions. In the assessments of mammography, 21 lesions (23.1%) were assigned to category 3, 51 lesions (56.0%) to category 4, and 19 lesions (20.9%) to category 5. The area under the receiver operating characteristic(ROC) curve for mammography and MR assessment was 0.844, and 0.945, respectively (p<0.05). In cases of category 3 microcalcifications, the specificity of mammography and MR was 100%, and 95.2% (p = 1.000), respectively. In cases of category 4 microcalcifications, the specificity, PPV and accuracy of mammography was 0%, 45.1% and 45.1%; whereas those for MR was 82.1% (p<0.05), 80.8% (P = 0.003) and 86.3% (p<0.05). All microcalcifications of category 5 were correctly diagnosed by mammography and MR.ConclusionsBreast MRI has the potential to significantly improve the diagnosis of category 4 microcalcifications on mammography. Among mammographic category 4 microcalcifications, about 82% of benign lesions can be degraded to BI-RADS 1∼3 by MRI. However for microcalcifications of category 3 and 5, MR exams do not show significant improvement over mammography.

A Comparison of the Diagnostic Value of Magnetic Resonance Mammography Versus Ultrasound Mammography in Moderate- And High-Risk Breast Cancer Patients

“…As seen in our study, MRI imaging had a high degree of specificity in addition to high sensitivity. In a study by Li et al (28) and Warner et al (26) the specificity for MRI was estimated to be 95%, and to be 89% in the study by Keriege et al (25) The results of MRI in the present study for BIRADS 4-5 group showed both higher sensitivity and also specificity in comparison with ultrasonography. On this basis we can say that in the BIRADS 4-5 group, MRI was a more valuable diagnostic method than ultrasonography in diagnosing suspected lesions.…”

“…On this basis we can say that in the BIRADS 4-5 group, MRI was a more valuable diagnostic method than ultrasonography in diagnosing suspected lesions. However, Li et al (28) concluded that MRI has the best results in the group of patients with BIRADS 4 compared with other methods, but would not have better results than other methods in BIRADS 5. Similarly, Strobel et al (29) Also reported the best results for MRI in the BIRADS 4 group.…”

Sonomammography versus MRI in Evaluation of BI-RADS III Breast Lesion

“…The main limitation of MRI in detection of DCIS is the fact that MRI was assessed only in patients with mammographic changes that were classified as suspicious microcalcifications. Thus, non calcified DCIS lesions were not evaluated, even though they might also show enhancement on MRI (20) .…”

MR Imaging for Diagnosis of Malignancy in Mammographic Microcalcifications: A Systematic Review and Meta-Analysis

“…Figure 1 is a summary of the study selection process according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Seven of the 20 studies were published during the past 2 years (6,(28)(29)(30)(33)(34)(35), while the oldest study dated from 1996 (20). Five studies included retrospective groups of patients (12,21,29,30,34), and the remaining 15 studies were prospective (5,6,10,20,22-28, [31][32][33]35).…”

“…All groups used a gadolinium-based contrast agent and a dedicated breast coil. Reader experience was either not declared (22,23,30) or varied substantially throughout the studies (5, 6,10,12,20,21,[24][25][26][27][28][29][31][32][33][34][35]. All MR imaging technical data are summarized in Table 1 and detailed QUADAS-2 assessment is illustrated in Figure 2.…”