Diffusion-weighted imaging allows for downgrading mr bi-rads 4 lesions in contrast-enhanced mri of the breast to avoid unnecessary biopsy
Clauser P, Krug B, Bickel H, Dietzel M, Pinker K, Neuhaus VF, Marino MA, Moschetta M, Troiano N, Helbich TH, Baltzer PAT (2021)
Publication Type: Journal article
Publication year: 2021
Journal
Book Volume: 27
Pages Range: 1941-1948
Journal Issue: 7
DOI: 10.1158/1078-0432.CCR-20-3037
Abstract
Purpose: Diffusion-weighted imaging with the calculation of an apparent diffusion coefficient (ADC) has been proposed as a quantitative biomarker on contrast-enhanced MRI (CE-MRI) of the breast. There is a need to approve a generalizable ADC cutoff. The purpose of this study was to evaluate whether a predefined ADC cutoff allows downgrading of BI-RADS 4 lesions on CE-MRI, avoiding unnecessary biopsies. Experimental Design: This was a retrospective, multicentric, cross-sectional study. Data from five centers were pooled on the individual lesion level. Eligible patients had a BI-RADS 4 rating on CE-MRI. For each center, two breast radiologists evaluated the images. Data on lesion morphology (mass, non-mass), size, and ADC were collected. Histology was the standard of reference. A previously suggested ADC cutoff (≥1.5 × 10-3 mm2/second) was applied. A negative likelihood ratio of 0.1 or lower was considered as a rule-out criterion for breast cancer. Diagnostic performance indices were calculated by ROC analysis. Results: There were 657 female patients (mean age, 42; SD, 14.1) with 696 BI-RADS 4 lesions included. Disease prevalence was 59.5% (414/696). The area under the ROC curve was 0.784. Applying the investigated ADC cutoff, sensitivity was 96.6% (400/414). The potential reduction of unnecessary biopsies was 32.6% (92/282). Conclusions: An ADC cutoff of .1.5×10-3 mm2/second allows downgrading of lesions classified as BI-RADS 4 on breast CE-MRI. One-third of unnecessary biopsies could thus be avoided.
Authors with CRIS profile
Involved external institutions
Medizinische Universität Wien
Austria (AT)
Universitätsklinikum Köln
Germany (DE)
Memorial Sloan Kettering Cancer Center
United States (USA) (US)
University of Messina / Università degli Studi di Messina
Italy (IT)
University of Bari Aldo Moro / Università degli Studi di Bari Aldo Moro
Italy (IT)
Austria (AT)
Universitätsklinikum Köln
Germany (DE)
Memorial Sloan Kettering Cancer Center
United States (USA) (US)
University of Messina / Università degli Studi di Messina
Italy (IT)
University of Bari Aldo Moro / Università degli Studi di Bari Aldo Moro
Italy (IT)
How to cite
APA:
Clauser, P., Krug, B., Bickel, H., Dietzel, M., Pinker, K., Neuhaus, V.-F.,... Baltzer, P.A.T. (2021). Diffusion-weighted imaging allows for downgrading mr bi-rads 4 lesions in contrast-enhanced mri of the breast to avoid unnecessary biopsy. Clinical Cancer Research, 27(7), 1941-1948. https://doi.org/10.1158/1078-0432.CCR-20-3037
MLA:
Clauser, Paola, et al. "Diffusion-weighted imaging allows for downgrading mr bi-rads 4 lesions in contrast-enhanced mri of the breast to avoid unnecessary biopsy." Clinical Cancer Research 27.7 (2021): 1941-1948.
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