Non-contrast MRI for breast screening: preliminary study on detectability of benign and malignant lesions in women with dense breasts
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The importance of breast cancer screening has long been known. Unfortunately, there is no imaging modality for screening women with dense breasts that is both sensitive and without concerns regarding potential side effects. The purpose of this study is to explore the possibility of combined diffusion-weighted imaging and turbo inversion recovery magnitude MRI (DWI + TIRM) to overcome the difficulty of detection sensitivity and safety.
One hundred and seventy-six breast lesions from 166 women with dense breasts were retrospectively evaluated. The lesion visibility, area under the curve (AUC), sensitivity and specificity of cancer detection by MG, DWI + TIRM, and clinical MRI were evaluated and compared. MG plus clinical MRI served as the gold standard for lesion detection and pathology served as the gold standard for cancer detection.
Lesion visibility of DWI + TIRM (96.6%) was significantly superior to MG (67.6%) in women with dense breasts (p < 0.001). There was no significant difference compared with clinical MRI. DWI + TIRM showed higher accuracy (AUC = 0.935) and sensitivity (93.68%) for breast cancer detection than MG (AUC = 0.783, sensitivity = 46.32%), but was comparable to clinical MRI (AUC = 0.944, sensitivity = 93.68%). The specificity of DWI + TIRM (83.95%) was lower than MG (98.77%), but higher than clinical MRI (77.78%).
DWI combined with TIRM could be a safe, sensitive, and practical alternative for screening women with dense breasts.
KeywordsDense breasts Non-contrast MRI Diffusion-weighted imaging Mammography Breast cancer screening
Apparent diffusion coefficient
Area under the curve
Breast imaging reporting and data system
- DWI + TIRM
Diffusion-weighted and turbo inversion recovery magnitude MRI
Magnetic resonance imaging
Picture archiving and communications system
Receiver operating characteristic
Region of interest
Short time inversion recovery
Turbo inversion recovery magnitude
XZ, JW, SW, and JH conceived and designed the study. SW, MX, YY, and YB enrolled the patients eligible for the study. XZ, MX, YY, and YB performed the analysis and interpretation of data. XZ, JW, YB, and SW drafted the manuscript. JH, BJ, AZ, and KS revised the manuscript critically. All authors read and approved the final manuscript.
This work was supported by the Chinese medicine research foundation project of Zhejiang Province (Grant Number 2018ZA037); Zhejiang provincial medicine and health discipline platform project (Grant Number 2018RC058); Zhejiang provincial health department platform backbone project (Grant Number 2016147237).
Compliance with ethical standards
Conflict of interest
This work is supported in part by research grants from Chinese medicine research foundation project of Zhejiang Province, Zhejiang provincial medicine and health discipline platform project, and Zhejiang provincial health department platform backbone project.
The institutional review board of the 1st Affiliated Hospital of Zhejiang Chinese Medical University approved the protocol (2018-KL-017-01).
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