The value of DCE- MRI of the breast as a diagnostic tool in assessing amorphous calcifications in screening mammography

Frontiers in Oncology

Oncology

Qigui Zou¹  Shouju Wang¹  Yuxia Tang¹  Yanni Jiang¹  Jianjuan Lou¹  Feiyun Wu¹  Siqi Wang¹  Yang Li¹  Hui Wang² 

[1] Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China;Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China;Department of Radiology, Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing, China;

关键词: breast cancer;    mammography;    magnetic resonance imaging;    microcalcifications;    biopsy;   

DOI  :  10.3389/fonc.2023.1151500

 received in 2023-01-31, accepted in 2023-04-10,  发布年份 2023

来源: Frontiers

【 摘 要 】

PurposeTo evaluate the diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging in differentiating benign and malignant amorphous calcifications.MethodsThis study included 193 female patients with 197 suspicious amorphous calcifications detected on screening mammography. The patients’ demographics, clinical follow-up, imaging, and pathology outcomes were reviewed, and sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of DCE-MRI were calculated.ResultsOf 197 lesions (193 patients) included in the study, 50 (25.4%) were histologically proved to be malignant. DCE-MRI based on breast imaging report and diagnosis system (BI-RADS) had a sensitivity of 94.4%, specificity of 85.7%, PPV of 69.1%, and NPV of 97.7% for the detection of malignant amorphous calcifications. Notably, diagnosis solely based on the presence or absence of DCE-MRI enhancement showed the same sensitivity but significantly decreased specificity (44.8%, p < 0.001) and PPV (44.8%, p < 0.001). In patients with a minimal or mild degree of background parenchymal enhancement (BPE), the sensitivity, specificity, PPV, and NPV increased to 100%, 90.6%, 78.6%, and 100%, respectively. However, in patients with a moderate degree of BPE, MRI resulted in three false negatives of ductal carcinoma in situ (DCIS). Overall, the addition of DCE-MRI detected all invasive lesions and could decrease unnecessary biopsy by 65.5%.ConclusionDCE-MRI based on BI-RADS has the potential to improve the diagnosis of suspicious amorphous calcifications and avoid unnecessary biopsy, especially for those with low-degree BPE.

【 授权许可】

Unknown   
Copyright © 2023 Wang, Wang, Li, Lou, Zou, Jiang, Wu, Tang and Wang