The diagnostic efficacy of tailored multiparametric breast MRI in indeterminate mammographic lesions: A single tertiary oncology center | ||||
Egyptian Journal of Cancer and Biomedical Research | ||||
Article 8, Volume 4, Issue 3, December 2020, Page 217-228 PDF (11.41 MB) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/jcbr.2020.36193.1057 | ||||
View on SCiNiTO | ||||
Authors | ||||
Gehan Seifeldein 1; Tarek M. Elsaba2; Adel Gabr3; Dalia O. Mohamed4; Summer Elmorshidy5; Haisam Atta 6 | ||||
1Diagnostic and Interventional Radiology Department, Assiut University, Egypt. | ||||
2Pathology Department, South Egypt Cancer Institute, Assiut University, Egypt | ||||
3Medical Oncology Department, South Egypt Cancer Institute, Assiut | ||||
4Radiotherapy Department, South Egypt Cancer Institute, Assiut University, Egypt | ||||
5Clinical Oncology Department, Faculty of Medicine, Assiut University,Egypt | ||||
6South Egypt Cancer Institute-Assiut University, Assiut University, Egypt | ||||
Abstract | ||||
Aim: Assessing the diagnostic role of multiparametric MRI (mpMRI) in indeterminate mammographic breast lesions and postulated a diagnostic model for MRI interpretation integrating the morphological, and functional parameters. Material and Methods: Two hundred forty patients included in a self-control retrospective study in a tertiary center. All patients examined with 1.5T MR unit using multiparametric studies including morphological analysis followed by functional evaluation via MR diffusion (MR-DWI), spectroscopy(MRS), and kinetic enhanced curves (DCE-MRI). Diagnostic performance of each parameter was evaluated alone and in combination. The histopathological results were the standard of reference. Results: Combined mpMRI parameters possess a moderate agreement (κ=0.435) with 23.5% false discovery rate (FDR) and an overall accuracy of 78%.On the other hand, combined mpMRI data after omitting MRS data show almost perfect agreement (κ=0.923)with histopathological data and recorded 100% specificity, 90% specificity, 5% FDR and zero% for both false omission rate (FOR) and false-negative rate (FNR). The Quantitative analysis of DWI with ADC map shows a significant statistical value for mean ADC (m-ADC) value and relative ADC (r-ADC) value. The former has cutoff value 1.1x10-3 mm2/sec with higher specificity 97.5% while r-ADC has cutoff value 0.42x10-3 mm2/sec with quite lower specificity 85%. Perfect agreement in the interpretation of DCE-MRI curves, MR-DWI, and MRS with κ =0.92,0.9 and 0.84 respectively. Conclusion: Tailored combined multiparametric MRI is a potent diagnostic tool in the characterization of indeterminate mammographic breast lesions. | ||||
Keywords | ||||
BI-RADS; Diffusion-weighted imaging; Magnetic resonance spectroscopy; MRI; Multiparametric | ||||
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