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

• Published in: European radiology Vol. 23; no. 7; pp. 1791 - 1802
• Main Authors: Pinker, K., Bickel, H., Helbich, T. H., Gruber, S., Dubsky, P., Pluschnig, U., Rudas, M., Bago-Horvath, Z., Weber, M., Trattnig, S., Bogner, W.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.07.2013; Springer Nature B.V
• Subjects: Accuracy; Adult; Aged; Aged, 80 and over; Area Under Curve; Bandwidths; Breast; Breast - pathology; Breast Neoplasms - diagnosis; Breast Neoplasms - pathology; Contrast Media - pharmacology; Diagnostic Radiology; Diffusion Magnetic Resonance Imaging - methods; False Positive Reactions; Female; Humans; Imaging; Internal Medicine; Interventional Radiology; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Mammography; Medicine; Medicine & Public Health; Methods; Middle Aged; Morphology; Neuroradiology; Observer Variation; Prospective Studies; Radiology; Reading; Reproducibility of Results; Sensitivity and Specificity; Time Factors; Ultrasound; Young Adult; Austria; BI-RADS; 3 Tesla; MRI; Breast imaging; DWI
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-013-2771-8

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.