Combined contrast-enhanced magnetic resonance and diffusion-weighted imaging reading adapted to the “Breast Imaging Reporting and Data System” for multiparametric 3-T imaging of breast lesions
To develop and assess a combined reading for contrast-enhanced magnetic resonance (CE-MRI) and diffusion weighted imaging (DWI) adapted to the BI-RADS for multiparametric MRI of the breast at 3 T.
A total of 247 patients with histopathologically verified breast lesions were included in this IRB-approved prospective study. All patients underwent CE-MR and DWI at 3 T. MRIs were classified according to BI-RADS and assessed for apparent diffusion coefficient (ADC) values. A reading method that adapted ADC thresholds to the assigned BI-RADS classification was developed. Sensitivity, specificity, diagnostic accuracy and the area under the curve were calculated. BI-RADS-adapted reading was compared with previously published reading methods in the same population. Inter- and intra-reader variability was assessed.
Sensitivity of BI-RADS-adapted reading was not different from the high sensitivity of CE-MRI (P = 0.4). BI-RADS-adapted reading maximised specificity (89.4 %), which was significantly higher compared with CE-MRI (P < 0.001). Previous reading methods did not perform as well as the BI-RADS method except for a logistic regression model. BI-RADS-adapted reading was more sensitive in non-mass-like enhancements (NMLE) and was more robust to inter- and intra-reader variability.
Multiparametric 3-T MRI of the breast using a BI-RADS-adapted reading is fast, simple to use and significantly improves the diagnostic accuracy of breast MRI.
• Multiparametric breast 3-T MRI with BI-RADS-adapted reading improves diagnostic accuracy.
• BI-RADS-adapted reading of CE-MRI and DWI is based on established reporting guidelines.
• BI-RADS-adapted reading is fast and easy to use in routine clinical practice.
• BI-RADS-adapted reading is robust to intra- and inter-reader variability.
KeywordsMRI DWI Breast imaging 3 Tesla BI-RADS
The Austrian National Bank ‘Jubiläumsfond’ project no. 13652, 13834, 13629 and 13418 and the Medical Scientific Fund of the Mayor of Vienna project no. 10029.
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