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Published in: Japanese Journal of Radiology 3/2018

01-03-2018 | Original Article

Grading system to categorize breast MRI using BI-RADS 5th edition: a statistical study of non-mass enhancement descriptors in terms of probability of malignancy

Authors: Tatsunori Asada, Takayuki Yamada, Yoshihide Kanemaki, Keishi Fujiwara, Satoko Okamoto, Yasuo Nakajima

Published in: Japanese Journal of Radiology | Issue 3/2018

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Abstract

Purpose

To analyze the association of breast non-mass enhancement descriptors in the BI-RADS 5th edition with malignancy, and to establish a grading system and categorization of descriptors.

Materials and methods

This study was approved by our institutional review board. A total of 213 patients were enrolled. Breast MRI was performed with a 1.5-T MRI scanner using a 16-channel breast radiofrequency coil. Two radiologists determined internal enhancement and distribution of non-mass enhancement by consensus. Corresponding pathologic diagnoses were obtained by either biopsy or surgery. The probability of malignancy by descriptor was analyzed using Fisher’s exact test and multivariate logistic regression analysis. The probability of malignancy by category was analyzed using Fisher’s exact and multi-group comparison tests.

Results

One hundred seventy-eight lesions were malignant. Multivariate model analysis showed that internal enhancement (homogeneous vs others, p < 0.001, heterogeneous and clumped vs clustered ring, p = 0.003) and distribution (focal and linear vs segmental, p < 0.001) were the significant explanatory variables. The descriptors were classified into three grades of suspicion, and the categorization (3, 4A, 4B, 4C, and 5) by sum-up grades showed an incremental increase in the probability of malignancy (p < 0.0001).

Conclusion

The three-grade criteria and categorization by sum-up grades of descriptors appear valid for non-mass enhancement.
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Metadata
Title
Grading system to categorize breast MRI using BI-RADS 5th edition: a statistical study of non-mass enhancement descriptors in terms of probability of malignancy
Authors
Tatsunori Asada
Takayuki Yamada
Yoshihide Kanemaki
Keishi Fujiwara
Satoko Okamoto
Yasuo Nakajima
Publication date
01-03-2018
Publisher
Springer Japan
Published in
Japanese Journal of Radiology / Issue 3/2018
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI
https://doi.org/10.1007/s11604-017-0717-9

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Acknowledgment

Acknowledgment