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Diagnostic value of MR elastography in addition to contrast-enhanced MR imaging of the breast—initial clinical results

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Abstract

Objective

The purpose of the study was to assess the additional value of magnetic resonance (MR) elastography (MRE) to contrast-enhanced (ce) MR imaging (MRI) for breast lesion characterisation.

Methods

Fifty-seven suspected breast lesions in 57 patients (mean age 52.4 years) were examined by ce MRI and MRE. All lesions were classified into BI-RADS categories. Viscoelastic parameters, e.g. α0 as an indicator of tissue stiffness, were calculated. Histology of the lesions was correlated with BI-RADS and viscoelastic properties. The positive predictive value (PPV) for malignancy, and the sensitivity and specificity of ce MRI were calculated. Receiver-operating characteristics (ROC) curves were separately calculated for both ce MRI and viscoelastic properties and conjoined to analyse the accuracy of diagnostic performance.

Results

The lesions (mean size 27.6 mm) were malignant in 64.9% (n = 37) of cases. The PPV for malignancy was significantly (p < 0.0001) dependent on BI-RADS classification. The sensitivity of ce MRI for breast cancer detection was 97.3% (36/37), whereas specificity was 55% (11/20). If ce MRI was combined with α0, the diagnostic accuracy could be significantly increased (p < 0.05; AUCceMRI = 0.93, AUCcombined = 0.96).

Conclusions

In this study, the combination of MRE and ce MRI could increase the diagnostic performance of breast MRI. Further investigations of larger cohorts and smaller lesions (in particular those only visible on MRI) are necessary to validate these results.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076, Tuebingen, Germany

    Katja C. Siegmann & Claus D. Claussen

  2. Practice of Diagnostic and Interventional Radiology, Jewish Hospital, Heinz-Galinski-Strasse 1, Berlin 13347, Germany

    Tanja Xydeas

  3. Laboratoire Ondes et Acoustique, ESPCI, 10 rue Vauquelin, 75005, Paris, France

    Ralph Sinkus

  4. Department of Obstetrics and Gynaecology, University Hospital Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany

    Bernhard Kraemer

  5. Institute of Pathology, University Hospital Tuebingen, Liebermeisterstrasse 8, 72076, Tuebingen, Germany

    Ulrich Vogel

Authors
  1. Katja C. Siegmann
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  2. Tanja Xydeas
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  3. Ralph Sinkus
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  4. Bernhard Kraemer
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  5. Ulrich Vogel
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  6. Claus D. Claussen
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Correspondence to Katja C. Siegmann.

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Siegmann, K.C., Xydeas, T., Sinkus, R. et al. Diagnostic value of MR elastography in addition to contrast-enhanced MR imaging of the breast—initial clinical results. Eur Radiol 20, 318–325 (2010). https://doi.org/10.1007/s00330-009-1566-4

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  • DOI: https://doi.org/10.1007/s00330-009-1566-4

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