Potential of noncontrast magnetic resonance imaging with diffusion-weighted imaging in characterization of breast lesions: Intraindividual comparison with dynamic contrast-enhanced magnetic resonance imaging Journal Article


Authors: Baltzer, P. A. T.; Bickel, H.; Spick, C.; Wengert, G.; Woitek, R.; Kapetas, P.; Clauser, P.; Helbich, T. H.; Pinker, K.
Article Title: Potential of noncontrast magnetic resonance imaging with diffusion-weighted imaging in characterization of breast lesions: Intraindividual comparison with dynamic contrast-enhanced magnetic resonance imaging
Abstract: Objectives The aim of this study was to assess the potential of noncontrast magnetic resonance imaging (NC-MRI) with diffusion-weighted imaging (DWI) in characterization of breast lesions in comparison to dynamic contrast-enhanced MRI (DCE-MRI) at 3 T. Materials and Methods Consecutive patients with conventional imaging (mammography, ultrasound) BI-RADS 4/5 findings were included in this institutional review board-approved single-center study. All underwent 3 T breast MRI including readout-segmented DWI, DCE, and T2-weighted sequences. Final diagnosis was defined by histopathology or follow-up (>24 months). Two experienced radiologists (R1, R2) independently assigned lesion conspicuity (0 = minimal to 3 = excellent) and BI-RADS scores to NC-MRI (readout-segmented DWI including apparent diffusion coefficient maps) and DCE-MRI (DCE and T2-weighted). Receiver operating characteristics, κ statistics, and visual grading characteristics analysis were applied. Results Sixty-seven malignant and 56 benign lesions were identified in 113 patients (mean age, 54 ± 14 years). Areas under the receiver operating characteristics curves were similar: DCE-MRI: 0.901 (R1), 0.905 (R2); NC-MRI: 0.882 (R1), 0.854 (R2); P > 0.05, respectively. The κ agreement was 0.968 (DCE-MRI) and 0.893 (NC-MRI). Visual grading characteristics analysis revealed superior lesion conspicuity by DCE-MRI (0.661, P < 0.001). Conclusions Diagnostic performance and interreader agreement of both NC-MRI and DCE-MRI is high, indicating a potential use of NC-MRI as an alternative to DCE-MRI. However, inferior lesion conspicuity and lower interreader agreement of NC-MRI need to be considered. © 2018 Wolters Kluwer Health, Inc. All rights reserved.
Keywords: adult; controlled study; human tissue; aged; major clinical study; sensitivity and specificity; mammography; contrast enhancement; image quality; breast carcinoma; needle biopsy; colloid carcinoma; dynamic contrast-enhanced magnetic resonance imaging; diffusion weighted imaging; intraductal carcinoma; breast biopsy; breast mri; breast lesion; receiver operating characteristic; dna polymorphism; comparative effectiveness; diagnostic test accuracy study; lobular carcinoma; apparent diffusion coefficient; gadoterate meglumine; human; female; priority journal; article; gadolinium-based contrast agents; noncontrast mri
Journal Title: Investigative Radiology
Volume: 53
Issue: 4
ISSN: 0020-9996
Publisher: Lippincott Williams & Wilkins  
Date Published: 2018-04-01
Start Page: 229
End Page: 235
Language: English
DOI: 10.1097/rli.0000000000000433
PROVIDER: scopus
PUBMED: 29190227
PMCID: PMC8158059
DOI/URL:
Notes: Article -- Export Date: 2 April 2018 -- Source: Scopus
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