A Comparative Study of the Diagnostic Value of Dynamic Contrast-enhanced Magnetic Resonance Imaging and Mammography on Patients with BI-RADS 4-5 Microcalcifications

doi:10.7517/issn.1674-0475.200302

Abstract

Abstract: To explore the diagnostic value of mammography (MG) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in lesions only appeared as microcalcifications requiring histological diagnosis suggested by BI-RADS evaluation. A retrospective analysis was made on 298 lesions requiring histological diagnosis suggested by BI-RADS evaluation, only appeared as microcalcifications, and classified as BI-RADS categories 4, 5 after MG evaluation, of which 52 patients underwent DCE-MRI examination within one week after MG examination. This study considered BI-RADS categories 1-3 as negative and BI-RADS categories 4-5 as positive through DCE-MRI, considered BI-RADS category 4A 815 as negative and BI-RADS 4B, 4C and 5 as positive through MG. The BI-RADS evaluation of the two imaging examinations was compared with the histopathology. The sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV) and positive likelihood ratio of DCE-MRI were all higher than MG. The sensitivity and negative predictive value of DCE-MRI combined with MG were higher than those of DCE-MRI and MG alone. The results showed that MRI diagnosis was more effective than mammography. The combined application of the two imaging methods can improve the diagnosis accuracy of suspicious lesions and avoid unnecessary biopsy.

Key words: dynamic contrast-enhanced magnetic resonance imaging, mammography, microcalcifications, histological diagnosis

XU Jinliang, TENG Xinrui, LIU Baoliang, MA Jie. A Comparative Study of the Diagnostic Value of Dynamic Contrast-enhanced Magnetic Resonance Imaging and Mammography on Patients with BI-RADS 4-5 Microcalcifications[J]. Imaging Science and Photochemistry, 2020, 38(5): 815-821.

References

[1] Bluekens A M, Holland R, Karssemeijer N, et al. Comparison of digital screening mammography and screen-film mammography in the early detection of clinically relevant cancers:a multicenter study[J]. Radiology, 2012, 265(3):707-714.
[2] Karamouzis M V, Likaki-Karatza E, Ravazoula P, et al. Non-palpable breast carcinomas:Correlation of mammographically detected malignant-appearing microcalcifications and molecular prognostic factors[J]. International Journal of Cancer, 2002, 102(1):86-90.
[3] Stomper P C, Connolly J L, Meyer J E, et al. Clinically occult ductal carcinoma in situ detected with mammography:analysis of 100 cases with radiologic-pathologic correlation[J]. Radiology, 1989, 172(1):235-241.
[4] Menell J H, Morris E A, Dershaw D D, et al. Determination of the presence and extent of pure ductal carcinoma in situ by mammography and magnetic resonance imaging[J]. Clinical Imaging, 2006, 30(3):225-225.
[5] Rinaldi P, Buccheri C, Giuliani M, et al. Sensitivity of breast MRI for ductal carcinoma in situ appearing as microcalcifications only on mammography[J]. Clinical Imaging, 2016, 40(6):1207-1212.
[6] Cilotti A, Iacconi C, Marini C, et al. Contrast-enhanced MR imaging in patients with BI-RADS 3-5 microcalcifications[J]. La Radiologia Medica, 2007, 112(2):272-286.
[7] Westerhof J P, Fischer U, Moritz J D, et al. MR imaging of mammographically detected clustered microcalcifications:is there any value?[J]. Radiology, 1998, 207(3):675-681.
[8] Bazzocchi M, Zuiani C, Panizza P, et al. Contrast-enhanced breast MRI in patients with suspicious microcalcifications on mammography:results of a multicenter trial[J]. American Journal of Roentgenology, 2006, 186(6):1723-1732.
[9] Sardanelli F, Boetes C, Borisch B, et al. Magnetic resonance imaging of the breast:Recommendations from the EUSOMA working group[J]. European Journal of Cancer, 2010, 46(8):1296-1316.
[10] Bennani-Baiti B, Dietzel M, Baltzer P A, MRI for the assessment of malignancy in BI-RADS 4 mammographic microcalcifications[J]. PLoS One, 2017, 12(11):e0188679.
[11] Fiaschetti V, Pistolese C A, Perretta T, et al. 3-5 BI-RADs microcalcifications:correlation between MRI and histological findings[J]. ISRN Oncology, 2011, 2011(6):643890.
[12] Kuhl C K, Schrading S, Bieling H B, et al. MRI for diagnosis of pure ductal carcinoma in situ:a prospective observational study[J]. Lancet,2007, 370(9586):485-492.
[13] Kuhl C K. MRI of breast tumors[J]. European Radiology, 2000, 10(1):46-58.
[14] Di Giovanni P, Azlan C A, Ahearn T S, et al. The accuracy of pharmacokinetic parameter measurement in DCE-MRI of the breast at 3T[J]. Physics in Medicine and Biology, 2010, 55(1):121-132.
[15] Iglesias A, Arias M, Santiago P, et al. Benign breast lesions that simulate malignancy:magnetic resonance imaging with radiologic-pathologic correlation[J]. Current Problems in Diagnostic Radiology,2007, 36(2):66-82.
[16] Wilkinson L, Thomas V, Sharma N. Microcalcification on mammography:approaches to interpretation and biopsy[J]. British Journal of Radiology, 2016, 90(1069):20160594.
[17] Boetes C, Mus R D M, Holland R, et al.Breast tumors:comparative accuracy of MR imag ing relative to mammography and US for demonstrating extent[J].Radiology, 1995, 197(3):743-747.
[18] Sardanelli F, Giuseppetti G M, Panizza P, et al. Sensitivity of MRI versus mammography for detecting foci of multifocal, multicentric breast cancer in fatty and dense breasts using the whole-breast pathologic examination as a gold standard[J]. American Journal of Roentgenology, 2004, 183(4):1149-1157.
[19] Houserkova D, Prasad S N, Svach I, et al. The value of dynamic contrast enhanced breast MRI in mammographically detected BI-RADS 5 microcalcifications[J]. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 2008, 152(1):107-115.
[20] Hansen N L, Kuhl C K, Barabasch A, et al. Does MRI breast "density" (degree of background enhancement) correlate with mammographic breast density?[J]. Journal of Magnetic Resonance Imaging, 2014, 40(2):483-489.
[21] Uematsu T, Kasami M, Watanabe J. Background enhancement of mammary glandular tissue on breast dynamic MRI:imaging features and effect on assessment of breast cancer extent[J]. Breast Cancer, 2012, 19(3):259-265.
[22] Klifa C, Suzuki S, Aliu S, et al. Quantification of background enhancement in breast magnetic resonance imaging[J]. Journal of Magnetic Resonance Imaging Jmri, 2011, 33(5):1229-1234.
[23] Jiang Y, Lou J, Wang S, et al. Evaluation of the role of dynamic contrast-enhanced MR imaging for patients with BI-RADS 3-4 microcalcifications[J]. PLoS One, 2014, 9(6):e99669.