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European Radiology
Published in: European Radiology 8/2020

Open Access 01-08-2020 | Magnetic Resonance Imaging | Breast

Diagnostic performance of standard breast MRI compared to dedicated axillary MRI for assessment of node-negative and node-positive breast cancer

Authors: Sanaz Samiei, Marjolein L. Smidt, Sigrid Vanwetswinkel, Sanne M. E. Engelen, Robert-Jan Schipper, Marc B. I. Lobbes, Thiemo J. A. van Nijnatten

Published in: European Radiology | Issue 8/2020

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Abstract

Objectives

To investigate whether breast MRI has comparable diagnostic performance as dedicated axillary MRI regarding assessment of node-negative and node-positive breast cancer.

Methods

Forty-seven patients were included. All had undergone both breast MRI and dedicated axillary MRI, followed by surgery. All included breast MRI exams had complete field of view (FOV) of the axillary region. First, unenhanced T2-weighted (T2W) and subsequent diffusion-weighted (DW) images of both MRI exams were independently analyzed by two breast radiologists using a confidence scale and compared to histopathology. ADC values were measured by two researchers independently. Diagnostic performance parameters were calculated on a patient-by-patient basis.

Results

T2W breast MRI had the following diagnostic performance: sensitivity of 50.0% and 62.5%, specificity of 92.3%, PPV of 57.1% and 62.5%, NPV of 90.0% and 92.3%, and AUC of 0.72 for reader 1 and 0.78 for reader 2. T2W dedicated axillary MRI had the following diagnostic performance: sensitivity of 37.5% and 62.5%, specificity of 82.1% and 92.3%, PPV of 44.6% and 50.0%, NPV of 87.8% and 91.4%, and AUC of 0.65 for reader 1 and 0.73 for reader 2. In both evaluations, addition of DW images resulted in comparable diagnostic performance. For both breast MRI and dedicated axillary MRI, there was no significant difference between mean ADC values of benign and malignant lymph nodes.

Conclusions

T2W breast MRI with complete FOV of the axillary region has comparable diagnostic performance as T2W dedicated axillary MRI regarding assessment of node-negative and node-positive breast cancer. Optimization of T2W breast MRI protocol by including a complete FOV of the axillary region can, therefore, be recommended in clinical practice.

Key Points

• Breast MRI with complete field of view of the axillary region has comparable diagnostic performance as dedicated axillary MRI regarding assessment of node-negative and node-positive breast cancer.
• Optimization of breast MRI protocol by including a complete field of view of the axillary region is recommended in clinical practice.
• For both breast MRI and dedicated axillary MRI, DW imaging (including ADC measurements) is of no added value.
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Metadata
Title
Diagnostic performance of standard breast MRI compared to dedicated axillary MRI for assessment of node-negative and node-positive breast cancer
Authors
Sanaz Samiei
Marjolein L. Smidt
Sigrid Vanwetswinkel
Sanne M. E. Engelen
Robert-Jan Schipper
Marc B. I. Lobbes
Thiemo J. A. van Nijnatten
Publication date
01-08-2020
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 8/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-020-06760-6

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