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European Radiology
Published in: European Radiology 7/2013

01-07-2013 | Breast

Combined contrast-enhanced magnetic resonance and diffusion-weighted imaging reading adapted to the “Breast Imaging Reporting and Data System” for multiparametric 3-T imaging of breast lesions

Authors: K. Pinker, H. Bickel, T. H. Helbich, S. Gruber, P. Dubsky, U. Pluschnig, M. Rudas, Z. Bago-Horvath, M. Weber, S. Trattnig, W. Bogner

Published in: European Radiology | Issue 7/2013

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Abstract

Objective

To develop and assess a combined reading for contrast-enhanced magnetic resonance (CE-MRI) and diffusion weighted imaging (DWI) adapted to the BI-RADS for multiparametric MRI of the breast at 3 T.

Methods

A total of 247 patients with histopathologically verified breast lesions were included in this IRB-approved prospective study. All patients underwent CE-MR and DWI at 3 T. MRIs were classified according to BI-RADS and assessed for apparent diffusion coefficient (ADC) values. A reading method that adapted ADC thresholds to the assigned BI-RADS classification was developed. Sensitivity, specificity, diagnostic accuracy and the area under the curve were calculated. BI-RADS-adapted reading was compared with previously published reading methods in the same population. Inter- and intra-reader variability was assessed.

Results

Sensitivity of BI-RADS-adapted reading was not different from the high sensitivity of CE-MRI (P = 0.4). BI-RADS-adapted reading maximised specificity (89.4 %), which was significantly higher compared with CE-MRI (P < 0.001). Previous reading methods did not perform as well as the BI-RADS method except for a logistic regression model. BI-RADS-adapted reading was more sensitive in non-mass-like enhancements (NMLE) and was more robust to inter- and intra-reader variability.

Conclusion

Multiparametric 3-T MRI of the breast using a BI-RADS-adapted reading is fast, simple to use and significantly improves the diagnostic accuracy of breast MRI.

Keypoints

• Multiparametric breast 3-T MRI with BI-RADS-adapted reading improves diagnostic accuracy.
• BI-RADS-adapted reading of CE-MRI and DWI is based on established reporting guidelines.
• BI-RADS-adapted reading is fast and easy to use in routine clinical practice.
• BI-RADS-adapted reading is robust to intra- and inter-reader variability.
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Metadata
Title
Combined contrast-enhanced magnetic resonance and diffusion-weighted imaging reading adapted to the “Breast Imaging Reporting and Data System” for multiparametric 3-T imaging of breast lesions
Authors
K. Pinker
H. Bickel
T. H. Helbich
S. Gruber
P. Dubsky
U. Pluschnig
M. Rudas
Z. Bago-Horvath
M. Weber
S. Trattnig
W. Bogner
Publication date
01-07-2013
Publisher
Springer-Verlag
Published in
European Radiology / Issue 7/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-013-2771-8

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