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Non-contrast MRI for breast screening: preliminary study on detectability of benign and malignant lesions in women with dense breasts

  • Preclinical study
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

A Correction to this article was published on 20 August 2019

This article has been updated

Abstract

Purpose

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.

Methods

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.

Results

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%).

Conclusions

DWI combined with TIRM could be a safe, sensitive, and practical alternative for screening women with dense breasts.

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Data availability

All datasets analyzed during the present study are available from the corresponding author on reasonable request.

Change history

  • 20 August 2019

    In the original version of the article, the image of Figure 2 was erroneously duplicated as Figure 4. The correct version of Figure 4 is given below. The original article has been corrected.

Abbreviations

ADC:

Apparent diffusion coefficient

AUC:

Area under the curve

BI-RADS:

Breast imaging reporting and data system

CC:

Craniocaudal

DWI:

Diffusion-weighted imaging

DWI + TIRM:

Diffusion-weighted and turbo inversion recovery magnitude MRI

MG:

Mammography

MLO:

Mediolateral oblique

MRI:

Magnetic resonance imaging

PACS:

Picture archiving and communications system

ROC:

Receiver operating characteristic

ROI:

Region of interest

STIR:

Short time inversion recovery

TIRM:

Turbo inversion recovery magnitude

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Funding

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).

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    Authors and Affiliations

    1. The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China

      Yangyang Bu, Xianjing Zhao, Maosheng Xu, Yingxing Yu & Shiwei Wang

    2. Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, 54 Youdian Road, Hangzhou, 310006, China

      Yangyang Bu, Xianjing Zhao, Maosheng Xu, Yingxing Yu & Shiwei Wang

    3. Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People’s Hospital, Shenzhen, 518037, China

      Jun Xia

    4. Department of Radiology, Wayne State University, Detroit, MI, 48201, USA

      Bobby Joseph, Kamran A. Shah & Jiani Hu

    5. Sino-Dutch Biomedical and Information Engineering School of Northeastern University, Shenyang, China

      Shouliang Qi

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    Contributions

    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.

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    Correspondence to Shiwei Wang or Jiani Hu.

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    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.

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    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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    The original version of this article was revised: The image of Figure 2 was erroneously duplicated as Figure 4. The correct version of Figure 4 is updated in the article.

    Yangyang Bu and Jun Xia contributed equally to this study.

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    Bu, Y., Xia, J., Joseph, B. et al. Non-contrast MRI for breast screening: preliminary study on detectability of benign and malignant lesions in women with dense breasts. Breast Cancer Res Treat 177, 629–639 (2019). https://doi.org/10.1007/s10549-019-05342-5

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