Breast MRI: Are T2 IR sequences useful in the evaluation of breast lesions?

Autor: Ballesio L; Department of Radiological Sciences, Umberto I Hospital, 'Sapienza' University of Rome, Viale Del Policlinico 155, 00161 Rome, Italy., Savelli S, Angeletti M, Porfiri LM, D'Ambrosio I, Maggi C, Castro ED, Bennati P, Fanelli GP, Vestri AR, Manganaro L
Jazyk: angličtina
Zdroj: European journal of radiology [Eur J Radiol] 2009 Jul; Vol. 71 (1), pp. 96-101. Date of Electronic Publication: 2008 May 13.
DOI: 10.1016/j.ejrad.2008.03.025
Abstrakt: Aim: To evaluate the potential role of signal intensities calculated in T2 images as an adjunctive parameter in the analysis of mass-like enhancements classified as BIRADS (Breast Imaging Reporting and Data System) assessment categories 2, 3, 4 or 5 with the standard T1 criteria.
Materials and Methods: After a retrospective review of 338-breast Magnetic Resonance Imaging (MRI) performed for the evaluation of a suspicious lesion we selected a group of 65 mass-like enhancements ranging from 5 to 20mm, classified as BIRADS assessment categories 2, 3, 4 or 5, histologically proved. In all cases we calculated the ratio between the signal intensity (SI) of the nodule and the pectoralis major muscle (LMSIR, lesion to muscle signal intensity ratio) with a multiROIs (region of interest) analysis on T2 images. A ROC analysis was performed to test the ability of the two diagnostic parameters separately considered (BIRADS and LMSIR) and combined in a new mono-dimensional variable obtained by a computerized discriminant function.
Results: Histological examination assessed 34 malignant lesions (52.3%) and 31 benign lesions (47.7%). The evaluation of ROC curves gave the following results: BIRADS area under the curve (AUC) 0.913, S.E. 0.0368, LMSIR AUC 0.854, S.E. 0.0487, combined BIRADS-LMSIR AUC 0.965, S.E. 0.0191 with a definitive increase in the AUC between the overall ROC area and those of the two diagnostic modalities separately considered.
Discussion: T2-weighted SI assessment with LMSIR measurement improves the diagnostic information content of standard breast MRI and can be considered a promising potential tool in the differential diagnosis of mass-like enhancements judged as borderline lesions (BIRADS 3 and 4).
Databáze: MEDLINE
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