Diagnostic value of mammography for accompanying non-mass enhancement on preoperative breast MRI

2021 ◽  
pp. 028418512110307
Author(s):  
Yunju Kim ◽  
Hae Kyoung Jung ◽  
Ah Young Park ◽  
Kyung Hee Ko ◽  
Hyunkyung Jang
Keyword(s):  
Breast Cancer ◽  
Characteristic Curve ◽  
Breast Mri ◽  
Diagnostic Value ◽  
Benign Lesions ◽  
Mri Findings ◽  
Chi Square ◽  
Preoperative Breast Mri ◽  
Index Cancer ◽  
Mass Enhancement

Background Successful surgical treatment for localized breast cancer can depend on accurate diagnosis for accompanying non-mass enhancement (NME) on preoperative breast magnetic resonance imaging (MRI). Purpose To evaluate the diagnostic value of mammography for accompanying NME adjacent to index cancer on preoperative breast MRI Material and Methods Among 569 consecutive patients who underwent preoperative breast MRI from January 2016 to August 2018 for ultrasound-guided biopsy-proven breast cancer, 471 patients who underwent initial mammography and subsequent surgery were finally included. Two radiologists retrospectively reviewed preoperative MRI findings of the 471 patients and detected accompanying NME adjacent to index cancer. MRI, mammography, and histopathology findings of the accompanying NME were evaluated using Pearson’s chi-square test, Mann–Whitney U test, and logistic regression analysis. The area under the receiver operating characteristic curve (AUC) of MRI and combined MRI and mammography was calculated in differentiating benign from malignant accompanying NME. The reference standard was surgical pathologic findings. Results MRI revealed 93 accompanying NME lesions in 92 (19.5%) of the 471 patients, showing 55 (59.1%) malignant and 38 (40.9%) benign lesions. On multivariate analysis, malignant NME lesions were more associated with mammography-positive findings ( P = 0.000), clumped or clustered ring internal enhancement ( P = 0.015), and extensive intraductal component presence of index tumor ( P = 0.007) compared with benign lesions. The AUC increased after correlation with mammography showing 0.649 (95% confidence interval [CI] 0.533–0.765) for MRI and 0.833 (95% CI 0.747–0.919) for combined MRI and mammography. Conclusion Mammography is valuable in predicting malignancy for accompanying NME on preoperative breast MRI.

Textural Characteristics of Biopsy-proven Metastatic Axillary Nodes on Preoperative Breast MRI in Breast Cancer Patients: A Feasibility Study

2020 ◽  
Vol 2 (4) ◽  
pp. 361-371
Author(s):  
Rifat A Wahab ◽  
Kyle Lewis ◽  
Charmi Vijapura ◽  
Bin Zhang ◽  
Su-Ju Lee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Nodes ◽  
Characteristic Curve ◽  
Breast Mri ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Institutional Review ◽  
Preoperative Breast Mri ◽  
Malignant Lymph Nodes

Abstract Objective To determine the diagnostic accuracy of MRI textural analysis (TA) to differentiate malignant from benign axillary lymph nodes in patients with breast cancer. Methods This was an institutional review board–approved retrospective study of axillary lymph nodes in women with breast cancer that underwent ultrasound-guided biopsy and contrast-enhanced (CE) breast MRI from January 2015 to December 2018. TA of axillary lymph nodes was performed on 3D dynamic CE T1-weighted fat-suppressed, 3D delayed CE T1-weighted fat-suppressed, and T2-weighted fat-suppressed MRI sequences. Quantitative parameters used to measure TA were compared with pathologic diagnoses. Areas under the curve (AUC) were calculated using receiver operating characteristic curve analysis to distinguish between malignant and benign lymph nodes. Results Twenty-three biopsy-proven malignant lymph nodes and 24 benign lymph nodes were analyzed. The delayed CE T1-weighted fat-suppressed sequence had the greatest ability to differentiate malignant from benign outcome at all spatial scaling factors, with the highest AUC (0.84–0.93), sensitivity (0.78 [18/23] to 0.87 [20/23]), and specificity (0.76 [18/24] to 0.88 [21/24]). Kurtosis on the 3D delayed CE T1-weighted fat-suppressed sequence was the most prominent TA parameter differentiating malignant from benign lymph nodes (P < 0.0001). Conclusion This study suggests that MRI TA could be helpful in distinguishing malignant from benign axillary lymph nodes. Kurtosis has the greatest potential on 3D delayed CE T1-weighted fat-suppressed sequences to distinguish malignant and benign lymph nodes.

Positron emission mammography in the diagnosis of breast cancer

2016 ◽  
Vol 55 (01) ◽  
pp. 15-20 ◽  
Author(s):  
J. Farahati ◽  
A. G. Müller ◽  
E. Gillman ◽  
M. Hentschel ◽  
F. H. H. Müller
Keyword(s):  
Breast Cancer ◽  
High Specificity ◽  
Diagnostic Value ◽  
Glandular Tissue ◽  
Breast Cancer Patients ◽  
Malignant Tumours ◽  
Benign Lesions ◽  
Interventional Study ◽  
Positron Emission Mammography ◽  
Positron Emission

SummaryAim: To evaluate the diagnostic value (sensitivity, specificity) of positron emission mammography (PEM) in a single site non-interventional study using the maximum PEM uptake value (PUVmax). Patients, methods: In a singlesite, non-interventional study, 108 patients (107 women, 1 man) with a total of 151 suspected lesions were scanned with a PEM Flex Solo II (Naviscan) at 90 min p.i. with 3.5 MBq 18F-FDG per kg of body weight. In this ROI(region of interest)-based analysis, maximum PEM uptake value (PUV) was determined in lesions, tumours (PUVmaxtumour), benign lesions (PUVmaxnormal breast) and also in healthy tissues on the contralateral side (PUVmaxcontralateral breast). These values were compared and contrasted. In addition, the ratios of PUVmaxtumour / PUVmaxcontralateral breast and PUVmaxnormal breast / PUVmaxcontralateral breast were compared. The image data were interpreted independently by two experienced nuclear medicine physicians and compared with histology in cases of suspected carcinoma. Results: Based on a criteria of PUV>1.9, 31 out of 151 lesions in the patient cohort were found to be malignant (21%). A mean PUVmaxtumour of 3.78 ± 2.47 was identified in malignant tumours, while a mean PUVmaxnormal breast of 1.17 ± 0.37 was reported in the glandular tissue of the healthy breast, with the difference being statistically significant (p < 0.001). Similarly, the mean ratio between tumour and healthy glandular tissue in breast cancer patients (3.15 ± 1.58) was found to be significantly higher than the ratio for benign lesions (1.17 ± 0.41, p < 0.001). Conclusion: PEM is capable of differentiating breast tumours from benign lesions with 100% sensitivity along with a high specificity of 96%, when a threshold of PUVmax >1.9 is applied.

Diagnostic Value of MicroRNA 21 in Endometrial Cancer and Benign Lesions and its Differential Expression in Relation to Clinicopathological Parameters

MicroRNA ◽  
2021 ◽  
Vol 10 ◽  
Author(s):  
Amal Bouziyane ◽  
Maryame Lamsisi ◽  
Hicham Benaguida ◽  
Mustapha Benhessou ◽  
Mohamed El Kerroumi ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Characteristic Curve ◽  
Myometrial Invasion ◽  
Figo Stage ◽  
Diagnostic Value ◽  
Clinicopathological Parameters ◽  
Benign Lesions ◽  
Tumor Tissues ◽  
Potential Biomarker ◽  
Noninvasive Samples

Background: Endometrial cancer is one of the most common malignancies among women worldwide. Although this cancer is often diagnosed at early stages, the need for biomarkers of diagnosis remains a necessity to overcome conventional invasive procedures of diagnosis. Objective: In our study, we aim to investigate the diagnostic value of microRNA-21 in endometrial cancer and its relation to clinicopathological features. Methods: We used RT-qPCR to measure the expression of microRNA-21 in 71 tumor tissues, 53 adjacent tissues, and 54 benign lesions. Results: Our results show that microRNA-21 is a potential biomarker for endometrial cancer with an area under the receiver operating characteristic curve of 0.925 (95% CI = 0.863 - 0.964, P<0.0001). The sensitivity was 84.51% (95% CI = 74.0 - 92.0) and specificity was 86.79% (95% CI = 74.7 - 94.5). For discrimination between benign lesions and controls the AUC was 0,881 with a sensitivity of 100% (95% CI = 93.4 - 100.0) and specificity of 66.04 % (95% CI = 51.7 - 78.5), and for discriminating benign lesions from tumors the AUC was 0,750 with a sensitivity of 54.93% (95% CI = 42.7 - 66.8) and specificity of 90.74% (95% CI = 79.7 - 96.9). We also found that tumors with elevated microRNA-21 expression are of advanced FIGO stage, high histological grades, and have cervical invasion, myometrial invasion and distant metastasis. Conclusion: Our findings support the important role of miR-21 as a biomarker for the diagnosis of endometrial cancer. Further studies on minimally invasive/noninvasive samples such as serum, blood, and urine are necessary to provide a better alternative to current diagnosis methods.

Clinical suspicion of spondylodiscitis with equivocal MRI findings: does diffusion-weighted imaging prove helpful here?

2020 ◽  
pp. 028418512092790
Author(s):  
Jeanette Henkelmann ◽  
Kristina Bremicker ◽  
Timm Denecke ◽  
Karl-Titus Hoffmann ◽  
Ralf Henkelmann ◽  
...  
Keyword(s):  
Diffusion Weighted Imaging ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Region Of Interest ◽  
High Sensitivity ◽  
Diagnostic Value ◽  
Mri Findings ◽  
Adc Value ◽  
Diffusion Weighted ◽  
Adc Values

Background Despite the high sensitivity of magnetic resonance imaging (MRI), early detection of spondylodiscitis (SpD) remains challenging due to its low specificity. Purpose To assess the diagnostic value of diffusion-weighted imaging (DWI) in suspected cases of SpD with ambiguous early MRI findings in the differentiation of degenerative disorders (DD). Material and Methods In this prospective study, 52 patients suspected of having SpD underwent a whole-spine 3-T MRI scan comprising sagittal DWI. Of 58 conspicuous, T2-weighted, signal increased discs, 39 were successfully evaluated using DWI. Apparent diffusion coefficient (ADC) values and ADC maps were blindly analyzed using the region of interest of the conspicuous disc and a normal adjacent reference disc. Intraindividual ratios (conspicuous disc: reference disc) were calculated. Results All conspicuous discs showed increased absolute ADC values, which did not differ significantly between SpD (n = 22) and DD (n = 17). However, ADC ratio was significantly higher in SpD vs. DD ( P < 0.05). In receiver operating characteristic curve analysis, an ADC ratio threshold of 1.6 resulted in 45% sensitivity and 88% specificity (area under the curve = 0.69) for SpD diagnosis. Conclusion The absolute ADC value does not provide a reliable diagnosis of SpD. Increased diffusivity can be an indication of infection but should always be discussed in the context of existing disc degeneration.

Outcomes after Surgery for Early Stage Breast Cancer in Women Staged With Preoperative Breast Magnetic Resonance Imaging According to Breast Tissue Density

2019 ◽  
Vol 1 (2) ◽  
pp. 115-121
Author(s):  
Renata Faermann ◽  
Jonathan Weidenfeld ◽  
Leonid Chepelev ◽  
Wayne Kendal ◽  
Raman Verma ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Tissue ◽  
Early Stage ◽  
Disease Free Survival ◽  
Breast Mri ◽  
Early Stage Breast Cancer ◽  
Free Survival ◽  
Tissue Density ◽  
Breast Tissue Density ◽  
Preoperative Breast Mri

Abstract Purpose To determine surgical outcomes and breast cancer disease-free survival outcomes of women with early stage breast cancer with and without use of preoperative breast MRI according to breast tissue density. Methods Women with early stage breast cancer diagnosed from 2004 to 2009 were classified into 2 groups: 1) those with dense and heterogeneously dense breasts (DB); 2) those with nondense breasts (NDB) (scattered fibroglandular and fatty replaced tissue). The 2 groups were reviewed to determine who underwent preoperative MRI. Breast tissue density was determined with mammography according to ACR BI-RADS. Patients were compared according to tumor size, grade, stage, and treatment. Survival analysis was performed using Kaplan-Meier estimates. Results In total, 261 patients with mean follow-up of 85 months (25–133) were included: 156 DB and 105 NDB. Disease-free survival outcomes were better in the DB group in patients with MRI than in those without MRI: patients with MRI had significantly fewer local recurrences (P &lt; 0.016) and metachronous contralateral breast cancers (P &lt; 0.001), but this was not the case in the NDB group. Mastectomies were higher in the DB group with preoperative MRI than in those without MRI (P &lt; 0.01), as it was in the NDB group (P &gt; 0.05). Conclusions Preoperative breast MRI was associated with reduced local recurrence and metachronous contralateral cancers in the DB group, but not in the NDB group; however, the DB patients with MRI had higher mastectomy rates.

scholarly journals Trends and clinical implications of preoperative breast MRI in Medicare beneficiaries with breast cancer

2013 ◽  
Vol 141 (1) ◽  
pp. 155-163 ◽  
Author(s):  
Brigid K. Killelea ◽  
Jessica B. Long ◽  
Anees B. Chagpar ◽  
Xiaomei Ma ◽  
Pamela R. Soulos ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Mri ◽  
Clinical Implications ◽  
Medicare Beneficiaries ◽  
Preoperative Breast Mri

Influence of preoperative MRI on the surgical management of patients with operable breast cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 613-613 ◽  
Author(s):  
M. W. Braun ◽  
M. Pölcher ◽  
S. Schrading ◽  
O. Zivanovic ◽  
T. Kowalski ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Surgical Management ◽  
Clinical Management ◽  
Menopausal Status ◽  
Breast Mri ◽  
Breast Ultrasound ◽  
Operable Breast Cancer ◽  
Tumor Characteristics ◽  
Mri Findings ◽  
The Impact

613 Background: To evaluate the impact of preoperative magnetic resonance imaging (MRI) of the breast on the clinical management of patients with operable breast cancer (BC). Methods: Retrospective analysis of 160 patients with operable breast cancer (stages Tis, through T4), who were treated from 2002 through 2004. All patients underwent a full mammographic assessment, high frequency breast ultrasound, and breast MRI. The impact of preoperative MRI was evaluated for each patient with regard to changes in the therapeutic procedure. Patient and tumor characteristics were analysed to identify possible patient subgroups that predominantly benefit from preoperative MRI. Results: Preoperative MRI affected the clinical management in 44 of 160 patients (27.5%). In 30 cases (18.75%) additional in-situ or invasive cancers or a more widespread tumor extent were diagnosed correctly which went undetected by clinical palpation, mammography, and breast ultrasound. In 14 cases (8.75%) additional, surgical procedures were performed based on suspicious MRI findings with benign pathology. Age, menopausal status, breast density, tumor characteristics (type, tumor size, grading), ER-, PR- and HER2- receptor features did not significantly differ between patients in which breast MRI affected the clinical management and patients that experienced no additional information from MRI. Conclusions: Preoperative breast MRI changes surgical management in a considerable amount of patients with operable breast cancer. MRI detects additional invasive carcinoma and proves to be a meaningful supplement to the conventional work-up in the clinical management of breast cancer. This benefit is independent from patients and tumor characteristics. No significant financial relationships to disclose.

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