Independent value of image fusion in unenhanced breast MRI using diffusion-weighted and morphological T2-weighted images for lesion characterization in patients with recently detected BI-RADS 4/5 x-ray mammography findings
Bickelhaupt S, Tesdorff J, Laun FB, Kuder TA, Lederer W, Teiner S, Maier-Hein K, Daniel H, Stieber A, Delorme S, Schlemmer HP (2017)
Publication Type: Journal article
Publication year: 2017
Journal
Book Volume: 27
Pages Range: 562-569
Journal Issue: 2
DOI: 10.1007/s00330-016-4400-9
Abstract
Objectives: The aim of this study was to evaluate the accuracy and applicability of solitarily reading fused image series of T2-weighted and high-b-value diffusion-weighted sequences for lesion characterization as compared to sequential or combined image analysis of these unenhanced sequences and to contrast- enhanced breast MRI. Methods: This IRB-approved study included 50 female participants with suspicious breast lesions detected in screening X-ray mammograms, all of which provided written informed consent. Prior to biopsy, all women underwent MRI including diffusion-weighted imaging (DWIBS, b = 1500s/mm2). Images were analyzed as follows: prospective image fusion of DWIBS and T2-weighted images (FU), side-by-side analysis of DWIBS and T2-weighted series (CO), combination of the first two methods (CO+FU), and full contrast-enhanced diagnostic protocol (FDP). Diagnostic indices, confidence, and image quality of the protocols were compared by two blinded readers. Results: Reading the CO+FU (accuracy 0.92; NPV 96.1 %; PPV 87.6 %) and the CO series (0.90; 96.1 %; 83.7 %) provided a diagnostic performance similar to the FDP (0.95; 96.1 %; 91.3 %; p > 0.05). FU reading alone significantly reduced the diagnostic accuracy (0.82; 93.3 %; 73.4 %; p = 0.023). Conclusions: MR evaluation of suspicious BI-RADS 4 and 5 lesions detected on mammography by using a non-contrast-enhanced T2-weighted and DWIBS sequence protocol is most accurate if MR images were read using the CO+FU protocol. Key Points: • Unenhanced breast MRI with additional DWIBS/T2w-image fusion allows reliable lesion characterization. • Abbreviated reading of fused DWIBS/T2w-images alone decreases diagnostic confidence and accuracy. • Reading fused DWIBS/T2w-images as the sole diagnostic method should be avoided.
Authors with CRIS profile
Involved external institutions
Deutsches Krebsforschungszentrum (DKFZ)
Germany (DE)
ATOS-Praxisklinik Heidelberg
Germany (DE)
RadiologieZentrum Mannheim
Germany (DE)
Universitätsklinikum Heidelberg
Germany (DE)
Germany (DE)
ATOS-Praxisklinik Heidelberg
Germany (DE)
RadiologieZentrum Mannheim
Germany (DE)
Universitätsklinikum Heidelberg
Germany (DE)
How to cite
APA:
Bickelhaupt, S., Tesdorff, J., Laun, F.B., Kuder, T.A., Lederer, W., Teiner, S.,... Schlemmer, H.-P. (2017). Independent value of image fusion in unenhanced breast MRI using diffusion-weighted and morphological T2-weighted images for lesion characterization in patients with recently detected BI-RADS 4/5 x-ray mammography findings. European Radiology, 27(2), 562-569. https://doi.org/10.1007/s00330-016-4400-9
MLA:
Bickelhaupt, Sebastian, et al. "Independent value of image fusion in unenhanced breast MRI using diffusion-weighted and morphological T2-weighted images for lesion characterization in patients with recently detected BI-RADS 4/5 x-ray mammography findings." European Radiology 27.2 (2017): 562-569.
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