Independent value of image fusion in unenhanced breast MRI using diffusion-weighted and morphological T2-weighted images for lesion characterization in patients with recently detected BI-RADS 4/5 X-ray mammography findings

• Verfasst von: Bickelhaupt, Sebastian [VerfasserIn]
• Verfasst von: Laun, Frederik B. [VerfasserIn]
• Verfasst von: Maier-Hein, Klaus H. [VerfasserIn]
• Verfasst von: Stieber, Anne [VerfasserIn]
• Verfasst von: Schlemmer, Heinz-Peter [VerfasserIn]
• Titel: Independent value of image fusion in unenhanced breast MRI using diffusion-weighted and morphological T2-weighted images for lesion characterization in patients with recently detected BI-RADS 4/5 X-ray mammography findings
• Verf.angabe: Sebastian Bickelhaupt, Jana Tesdorff, Frederik Bernd Laun, Tristan Anselm Kuder, Wolfgang Lederer, Susanne Teiner, Klaus Maier-Hein, Heidi Daniel, Anne Stieber, Stefan Delorme, Heinz-Peter Schlemmer
• Jahr: 2017
• Jahr des Originals: 2016
• Umfang: 8 S.
• Teil: volume:27
• Teil: year:2017
• Teil: number:2
• Teil: pages:562-569
• Teil: extent:8
• Fussnoten: Gesehen am 22.06.2018 ; Published online: 18 May 2016
• Titel Quelle: Enthalten in: European radiology
• Ort Quelle: Berlin : Springer, 1991
• Jahr Quelle: 2017
• Band/Heft Quelle: 27(2017), 2, Seite 562-569
• ISSN Quelle: 1432-1084
• ISSN Quelle: 1613-3757
• DOI: doi:10.1007/s00330-016-4400-9
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1576776751

Abstract

ObjectivesThe aim of this study was to evaluate the accuracy and applicability of solitarily reading fused image series of T2-weighted and high-b-value diffusion-weighted sequences for lesion characterization as compared to sequential or combined image analysis of these unenhanced sequences and to contrast- enhanced breast MRI.MethodsThis IRB-approved study included 50 female participants with suspicious breast lesions detected in screening X-ray mammograms, all of which provided written informed consent. Prior to biopsy, all women underwent MRI including diffusion-weighted imaging (DWIBS, b = 1500s/mm2). Images were analyzed as follows: prospective image fusion of DWIBS and T2-weighted images (FU), side-by-side analysis of DWIBS and T2-weighted series (CO), combination of the first two methods (CO+FU), and full contrast-enhanced diagnostic protocol (FDP). Diagnostic indices, confidence, and image quality of the protocols were compared by two blinded readers.ResultsReading the CO+FU (accuracy 0.92; NPV 96.1 %; PPV 87.6 %) and the CO series (0.90; 96.1 %; 83.7 %) provided a diagnostic performance similar to the FDP (0.95; 96.1 %; 91.3 %; p > 0.05). FU reading alone significantly reduced the diagnostic accuracy (0.82; 93.3 %; 73.4 %; p = 0.023).ConclusionsMR evaluation of suspicious BI-RADS 4 and 5 lesions detected on mammography by using a non-contrast-enhanced T2-weighted and DWIBS sequence protocol is most accurate if MR images were read using the CO+FU protocol. Key Points • Unenhanced breast MRI with additional DWIBS/T2w-image fusion allows reliable lesion characterization. • Abbreviated reading of fused DWIBS/T2w-images alone decreases diagnostic confidence and accuracy. • Reading fused DWIBS/T2w-images as the sole diagnostic method should be avoided.