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
ObjectivesThe 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 c...
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| Main Authors: | , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2017
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| In: |
European radiology
Year: 2016, Volume: 27, Issue: 2, Pages: 562-569 |
| ISSN: | 1432-1084 |
| DOI: | 10.1007/s00330-016-4400-9 |
| Online Access: | Verlag, Volltext: http://dx.doi.org/10.1007/s00330-016-4400-9 Verlag, Volltext: https://link.springer.com/article/10.1007/s00330-016-4400-9 
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| Author Notes: | Sebastian Bickelhaupt, Jana Tesdorff, Frederik Bernd Laun, Tristan Anselm Kuder, Wolfgang Lederer, Susanne Teiner, Klaus Maier-Hein, Heidi Daniel, Anne Stieber, Stefan Delorme, Heinz-Peter Schlemmer |
| Summary: | ObjectivesThe 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.MethodsThis 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.ResultsReading 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).ConclusionsMR 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. |
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| Item Description: | Gesehen am 22.06.2018 Published online: 18 May 2016 |
| Physical Description: | Online Resource |
| ISSN: | 1432-1084 |
| DOI: | 10.1007/s00330-016-4400-9 |