Breast MRI of pure ductal carcinoma in situ: Sensitivity of diagnosis and influence of lesion characteristics

Baur, A.; Bahrs, SD; Speck, S; Wietek, Beate; Krämer, B.; Vogel, Ulrich; Claussen, Claus D.; Siegmann-Luz, K

doi:10.1016/j.ejrad.2013.05.002

Cited by 41 publications

(22 citation statements)

References 24 publications

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“…The sensitivity of breast MR images in cancer detection is the highest among the mainstream imaging modalities such as mammography or ultrasonography (US), ranging from 77% to 94% ( 2 3 4 5 6 ). Factors contributing to false negative breast MR images include inadequate enhancement of tumors such as invasive lobular carcinoma or ductal carcinoma in situ , inadequate techniques such as contrast infusion failure, motion artifacts, or lesions location beyond the field of view ( 7 8 9 ). Breast cancers can also be undiagnosed due to misperception or misinterpretation ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

Features of Undiagnosed Breast Cancers at Screening Breast MR Imaging and Potential Utility of Computer-Aided Evaluation

et al. 2016

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ObjectiveTo retrospectively evaluate the features of undiagnosed breast cancers on prior screening breast magnetic resonance (MR) images in patients who were subsequently diagnosed with breast cancer, as well as the potential utility of MR-computer-aided evaluation (CAE).Materials and MethodsBetween March 2004 and May 2013, of the 72 consecutive pairs of prior negative MR images and subsequent MR images with diagnosed cancers (median interval, 32.8 months; range, 5.4-104.6 months), 36 (50%) had visible findings (mean size, 1.0 cm; range, 0.3-5.2 cm). The visible findings were divided into either actionable or underthreshold groups by the blinded review by 5 radiologists. MR imaging features, reasons for missed cancer, and MR-CAE features according to actionability were evaluated.ResultsOf the 36 visible findings on prior MR images, 33.3% (12 of 36) of the lesions were determined to be actionable and 66.7% (24 of 36) were underthreshold; 85.7% (6 of 7) of masses and 31.6% (6 of 19) of non-mass enhancements were classified as actionable lesions. Mimicking physiologic enhancements (27.8%, 10 of 36) and small lesion size (27.8%, 10 of 36) were the most common reasons for missed cancer. Actionable findings tended to show more washout or plateau kinetic patterns on MR-CAE than underthreshold findings, as the 100% of actionable findings and 46.7% of underthreshold findings showed washout or plateau (p = 0.008).ConclusionMR-CAE has the potential for reducing the number of undiagnosed breast cancers on screening breast MR images, the majority of which are caused by mimicking physiologic enhancements or small lesion size.

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Section: Introductionmentioning

confidence: 99%

Features of Undiagnosed Breast Cancers at Screening Breast MR Imaging and Potential Utility of Computer-Aided Evaluation

et al. 2016

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“…It is also a superior imaging technique for assessing the extent of disease, especially in the preoperative setting, which is useful in the assessment and planning of breast conservation surgery. (4,15,16) DCIS usually manifests as non-mass enhancement (NME) (17) and occasionally, as enhancing masses. The internal enhancement pattern that is commonly associated with DCIS is the clumped pattern, (15) while segmental and ductal types of distribution are also suspicious for DCIS.…”

Section: Mr Imagingmentioning

confidence: 99%

Clinics in diagnostic imaging (180)

Tan

Moey

Madhukumar

et al. 2017

smedj

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“…The unique role of MRI in the diagnostics of DCIS is still discussed and its benefit for further management is examined carefully by studies (finished studies regarding this question -COMICE, MONET, currently running study MIPA) [10][11][12]. However, MRI features seem to be important for the proper management of DCIS, especially when concerning its potential to progress into invasive tumor [13].…”

Section: Discussionmentioning

confidence: 99%

Multiparametric MRI analysis of morphologico-functional features of DCIS – correlation with the grade of nuclear atypia

Lehotská

Rauova

Vanovcanova

2018

neo

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The aim was to analyze morphologico-functional characteristics of ductal carcinoma in situ (DCIS) in breast MRI to assess signs correlating with the degree of nuclear atypia. From 636 malignant lesions, 114 were DCIS (17.92%): 44 cases of high-grade (38.60%), 37 intermediate (32.45%), 33 low-grade (28.95%). MRI characteristics - T2 signal intensity (SI), shape, margins, contrast enhancement, peripheral/ductal enhancement, kinetic curve, presence of restriction of diffusion were correlated with the nuclear grade of DCIS. Statistical analysis was performed, statistical significance and Odds ratio (OR) were calculated. Signs of high-grade lesions were low SI in T2w (p=0.042), nonhomogeneous contrast enhancement (p=0.012), wash-out phenomenon (p=0.04), high SI in diffusion weighted imaging (DWI) (p<0.0001), restriction of diffusion in apparent diffusion coefficient map (p<0.0001). DWI and wash-out phenomenon reached the highest OR (56.00, 9.76). Breast MRI using DWI and multiparametric analysis provides important information about the degree of nuclear atypia.

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Breast MRI of pure ductal carcinoma in situ: Sensitivity of diagnosis and influence of lesion characteristics

Cited by 41 publications

References 24 publications

Features of Undiagnosed Breast Cancers at Screening Breast MR Imaging and Potential Utility of Computer-Aided Evaluation

Features of Undiagnosed Breast Cancers at Screening Breast MR Imaging and Potential Utility of Computer-Aided Evaluation

Clinics in diagnostic imaging (180)

Multiparametric MRI analysis of morphologico-functional features of DCIS – correlation with the grade of nuclear atypia

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