Breast Cancer Detection Using Double Reading of Unenhanced MRI Including T1-Weighted, T2-Weighted STIR, and Diffusion-Weighted Imaging: A Proof of Concept Study

Trimboli, Rubina Manuela; Verardi, Nicola; Cartia, Francesco; Carbonaro, Luca A.; Sardanelli, Francesco

doi:10.2214/ajr.13.11816

Cited by 89 publications

(77 citation statements)

References 38 publications

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“…The overall reader sensitivities of 86% and 89% for the abbreviated 1 and 2 protocols, respectively, and 95% for the full protocol were comparable to the 90% sensitivity of breast MRI generally reported by multiple prior investigators (4,6,7). The results of this pilot study contribute to the growing body of data that suggest that shortened breast MRI protocols may become a viable clinical option for screening (28)(29)(30)(31). Kuhl et al (28) recently demonstrated excellent sensitivity (100%) and specificity (94.3%) using an abbreviated protocol that included only a T1-weighted precontrast and a single postcontrast sequence, similar to our abbreviated 1 protocol.…”

Section: Discussionsupporting

confidence: 70%

“…In another study, Mango et al (31) showed that in patients with biopsy-proven cancer, a protocol using only precontrast and postcontrast T1-weighted sequence could be used to accurately localize unicentric tumors with a sensitivity of 96%. Additional research has been directed toward shortening the acquisition time of postcontrast breast MRI sequences by replacing standard dynamic postcontrast sequences with ultrafast time-resolved angiography (29) or diffusion-weighted imaging (30). Reducing breast MRI scan times could address several challenges in current breast MRI screening practices.…”

Section: Discussionmentioning

confidence: 99%

“…The multiple sequences used in a standard breast MRI lead to long scan acquisition times and subsequent long interpretation times, both of which impact the cost of breast MRI. Theoretically, the cost of breast MRI could be reduced if the time for both acquiring and interpreting was decreased; however, few studies have evaluated the feasibility of using a shortened breast MRI protocol for screening (28)(29)(30)(31). Given the potential advantages of a shortened breast MRI protocol, the purpose of this pilot study is to determine the performance of two abbreviated protocols for breast cancer screening compared to a conventional protocol.…”

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confidence: 99%

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Abbreviated Screening Protocol for Breast MRI

et al. 2015

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Section: Discussionmentioning

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Abbreviated Screening Protocol for Breast MRI

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“…This method was previously used in some experimental clinical and reader studies and found to be useful for the diagnosis of breast cancer (24)(25)(26)(27). Lastly, Trimboli et al (28) reported 78% sensitivity and 87% specificity for breast cancer detection with unenhanced MRI of 67 women.…”

Section: Discussionmentioning

confidence: 98%

Can unenhanced breast MRI be used to decrease negative biopsy rates?

Kul

Oguz²,

Eyüboğlu³

et al. 2015

Diagn Interv Radiol

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T he Breast Imaging Reporting and Data Systems (BI-RADS) lexicon (1) of AmericanCollege of Radiology (ACR) provides an efficient and standardized assessment and management of breast lesions. It also stratifies breast cancer risk for a given lesion by classifying them into categories 1 through 5 according to the degree of suspicion.According to this system, solid masses with a circumscribed margin, oval shape (including those with two or three gentle lobulations) and parallel orientation on ultrasonography (US) exam are classified as BI-RADS 3. These types of masses are commonly seen at diagnostic and screening examinations. In this category malignancy is highly unlikely (less than 2%) and a short interval follow-up is recommended (1). However, up to one-third of such masses undergo biopsy mainly because of radiologist, referring clinician, or patient concern about the substantial risk of malignancy (2-4). Many BI-RADS 3 masses are traditionally referred for biopsy if they are palpable, large in size, patient is of advanced age or has a positive family history for breast cancer.The BI-RADS 4 assessment is reserved for findings that do not have the classic appearance of malignancy but are sufficiently suspicious to justify a recommendation for biopsy. This category is largely indeterminate and highly variable in outcome. Breast lesions in this category carry 2% to 95% risk for malignancy (1). Thus, almost all recommendations for breast biopsies come from assessments made using this category. According to BI-RADS classification; category 4 is subgrouped as 4A, 4B, and 4C to better inform the clinicians, pathologists, and patients of the degree of concern. However, the criteria for distinguishing among these subcategories have not been well delineated. BI-RADS 4A designates lesions with a low suspicion for malignancy. In this group, a benign pathologic diagnosis is expected and considered concordant (1). Studies of several institutions by the use of their internal criteria revealed positive predictive value (PPV) of 7%-9% for 4A lesions, and more than 50% of the suspicious lesions fall into this category. On the other hand, BI-RADS 4B and 4C 287From the Department of Radiology (S.K.  sibel_ozy@ yahoo.com) Karadeniz Technical University, School of Medicine, Trabzon, Turkey. BREAST IMAGING ORIGINAL ARTICLE PURPOSE We aimed to determine whether low-risk breast masses can be effectively managed with unenhanced magnetic resonance imaging (MRI) combining T2-weighted sequences with diffusion-weighted imaging (DWI) instead of immediate biopsy to decrease negative biopsy rates. METHODSAfter institutional review board and patient approvals, 141 consecutive women with 156 low-risk breast masses, who underwent unenhanced MRI and later on received a final diagnosis, were included in the study. There were 72 BI-RADS 3 masses in women with relative risk factors and 84 BI-RADS 4A masses, all referred for biopsy. Apparent diffusion coefficient (ADC) cutoff was 0.90×10-3 mm2/s. According to ADC values and T2-weighted imaging charact...

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“…Breast cancer is the most common cancer detected in Chinese women in the past 20 years; the incidence rate is rising, and therefore the early detection, diagnosis and treatment are important for the survival and life quality of these patients (1)(2)(3)(4)(5)(6). When assessing the tumorigenic process of breast cancer, the World Health Organization (WHO) histopathological grade is an important indicator that can be used to evaluate the malignant behavior and prognosis of breast cancer.…”

Section: Introductionmentioning

confidence: 99%

Association between dynamic contrast enhanced MRI imaging features and WHO histopathological grade in patients with invasive ductal breast cancer

Huang

Peng

2016

Oncology Letters

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Abstract. The present study aimed to investigate the dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) and World Health Organization (WHO) histopathological grade in patients with invasive ductal breast cancer. A retrospective analysis on the results of DCE-MRI of 92 patients, who were diagnosed with invasive ductal breast cancer following surgery or biopsy, and these results were correlated with WHO histopathological grade. The statistical analysis demonstrated that the tumor size, shape and characteristics of early enhancement were associated with the WHO histopathological grade: The larger the lesion's long diameter, the higher the WHO histopathological grade; the WHO histopathological grades of round and oval masses were relatively lower, while those of lobulated and irregular masses were higher; and tumors with heterogeneous and ring-like enhancement exhibited higher WHO histopathological grades, while those of homogeneous enhancement were lower. The lesion's margin shape was not associated with the WHO histopathological grade. The present study demonstrates that features of DCE-MRI and WHO histopathological grade in patients with invasive ductal breast cancer are correlated, and these MRI features could be used to evaluate the biological behavior and prognosis of lesions.

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Breast Cancer Detection Using Double Reading of Unenhanced MRI Including T1-Weighted, T2-Weighted STIR, and Diffusion-Weighted Imaging: A Proof of Concept Study

Abstract: An unenhanced breast MRI protocol composed of T1-weighted gradient echo, T2-weighted STIR, and echo-planar DWI enabled breast cancer detection with sensitivity of 76-78% and specificity of 90% without a gain in sensitivity from double reading.

Cited by 89 publications

References 38 publications

Abbreviated Screening Protocol for Breast MRI

Abbreviated Screening Protocol for Breast MRI

Can unenhanced breast MRI be used to decrease negative biopsy rates?

Association between dynamic contrast enhanced MRI imaging features and WHO histopathological grade in patients with invasive ductal breast cancer

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