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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

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Abstract

Objective

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.

Methods

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.

Results

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.

Conclusion

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.

Keypoints

• 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.

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Acknowledgments

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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Authors and Affiliations

  1. Department of Radiology, Molecular and Gender Imaging, Medical University Vienna, Vienna, Austria

    K. Pinker, H. Bickel, T. H. Helbich & M. Weber

  2. Department of Radiology, MR Centre of Excellence, Medical University Vienna, Vienna, Austria

    S. Gruber, S. Trattnig & W. Bogner

  3. Department of Surgery, Medical University Vienna, Vienna, Austria

    P. Dubsky

  4. Department of Internal Medicine, Division of Oncology, Medical University Vienna, Vienna, Austria

    U. Pluschnig

  5. Clinical Institute of Pathology, Medical University Vienna, Vienna, Austria

    M. Rudas & Z. Bago-Horvath

  6. Department of Radiology, Medical University Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    T. H. Helbich

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  1. K. Pinker
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  11. W. Bogner
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Correspondence to T. H. Helbich.

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Pinker, K., Bickel, H., Helbich, T.H. et al. 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. Eur Radiol 23, 1791–1802 (2013). https://doi.org/10.1007/s00330-013-2771-8

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  • DOI: https://doi.org/10.1007/s00330-013-2771-8

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