Investigative radiology · 2014
Improved diagnostic accuracy with multiparametric magnetic resonance imaging of the breast using dynamic contrast-enhanced magnetic resonance imaging, diffusion-weighted imaging, and 3-dimensional proton magnetic resonance spectroscopic imaging.
Сравнительное исследованиеСтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Pinker Katja, Bogner Wolfgang, Baltzer Pascal, Gruber Stephan, Bickel Hubert, Brueck Benedikt, Trattnig Siegfried, Weber Michael, Dubsky Peter, Bago-Horvath Zsuzsanna, Bartsch Rupert, Helbich Thomas H
Аннотация
INTRODUCTION: The purpose of this study was to compare the diagnostic accuracy of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) as a single parameter to multiparametric (MP) MRI with 2 (DCE MRI and diffusion-weighted imaging [DWI]) and 3 (DCE MRI, DWI, and 3-dimensional proton magnetic resonance spectroscopic imaging [3D H-MRSI]) parameters in breast cancer diagnosis.
MATERIALS AND METHODS: This prospective study was approved by the institutional review board. Written informed consent was obtained in all patients. One hundred thirteen female patients (mean age, 52 years; range, 22-86 years) with an imaging abnormality (Breast Imaging Reporting and Data System 0, 4-5) were included in this study. Multiparametric MRI of the breast at 3 T with DCE MRI, DWI, and 3D H-MRSI was performed. The likelihood of malignancy was assessed for DCE MRI and MP MRI with 2 (DCE MRI and DWI) and 3 (DCE MRI, DWI, and 3D H-MRSI) parameters separately. Histopathology was used as the standard of reference. Appropriate statistical tests were used to assess sensitivity, specificity, and diagnostic accuracy for each assessment combination.
RESULTS: There were 74 malignant and 39 benign breast lesions. Multiparametric MRI with 3 MRI parameters yielded significantly higher areas under the curve (0.936) in comparison with DCE MRI alone (0.814) (P<0.001). Multiparametric MRI with just 2 parameters at 3 T did not yield higher areas under the curve (0.808) than did DCE MRI alone (0.814). Multiparametric MRI with 3 parameters resulted in elimination of false-negative lesions and significantly reduced the false-positives ones (P=0.002).
CONCLUSIONS: Multiparametric MRI with 3 parameters increases the diagnostic accuracy of breast cancer in comparison with DCE-MRI alone and MP MRI with 2 parameters.
MATERIALS AND METHODS: This prospective study was approved by the institutional review board. Written informed consent was obtained in all patients. One hundred thirteen female patients (mean age, 52 years; range, 22-86 years) with an imaging abnormality (Breast Imaging Reporting and Data System 0, 4-5) were included in this study. Multiparametric MRI of the breast at 3 T with DCE MRI, DWI, and 3D H-MRSI was performed. The likelihood of malignancy was assessed for DCE MRI and MP MRI with 2 (DCE MRI and DWI) and 3 (DCE MRI, DWI, and 3D H-MRSI) parameters separately. Histopathology was used as the standard of reference. Appropriate statistical tests were used to assess sensitivity, specificity, and diagnostic accuracy for each assessment combination.
RESULTS: There were 74 malignant and 39 benign breast lesions. Multiparametric MRI with 3 MRI parameters yielded significantly higher areas under the curve (0.936) in comparison with DCE MRI alone (0.814) (P<0.001). Multiparametric MRI with just 2 parameters at 3 T did not yield higher areas under the curve (0.808) than did DCE MRI alone (0.814). Multiparametric MRI with 3 parameters resulted in elimination of false-negative lesions and significantly reduced the false-positives ones (P=0.002).
CONCLUSIONS: Multiparametric MRI with 3 parameters increases the diagnostic accuracy of breast cancer in comparison with DCE-MRI alone and MP MRI with 2 parameters.
Предметные рубрики MeSH
AdultAgedAged, 80 and overBreast NeoplasmsContrast MediaDiagnosis, DifferentialDiffusion Magnetic Resonance ImagingFemaleHumansImage EnhancementImage Interpretation, Computer-AssistedImaging, Three-DimensionalMagnetic Resonance ImagingMagnetic Resonance SpectroscopyMeglumineMiddle AgedOrganometallic CompoundsProspective StudiesQuality Improvement