PPV(3) of suspicious breast MRI findings.

Autor:	Smith H; Department of Chemistry, Clemson University, Clemson, South Carolina., Chetlen AL; Department of Radiology, Penn State Hershey Breast Imaging, Penn State Milton S. Hershey Medical Center, EC 008, 30 Hope Drive, Suite 1800, Hershey, PA 17033-0859. Electronic address: achetlen@hmc.psu.edu., Schetter S; Department of Radiology, Penn State Hershey Breast Imaging, Penn State Milton S. Hershey Medical Center, EC 008, 30 Hope Drive, Suite 1800, Hershey, PA 17033-0859., Mack J; Department of Radiology, Penn State Hershey Breast Imaging, Penn State Milton S. Hershey Medical Center, EC 008, 30 Hope Drive, Suite 1800, Hershey, PA 17033-0859., Watts M; Department of Radiology, Penn State Hershey Breast Imaging, Penn State Milton S. Hershey Medical Center, EC 008, 30 Hope Drive, Suite 1800, Hershey, PA 17033-0859., Zhu JJ; Biostatistics Core, Penn State Hershey Cancer Institute, Hershey, Pennsylvania.
Jazyk:	angličtina
Zdroj:	Academic radiology [Acad Radiol] 2014 Dec; Vol. 21 (12), pp. 1553-62. Date of Electronic Publication: 2014 Sep 26.
DOI:	10.1016/j.acra.2014.07.013
Abstrakt:	Rationale and Objectives: Magnetic resonance imaging (MRI) characteristics of Breast Imaging Reporting and Data System (BI-RADS) 4 and 5 lesions were evaluated to identify characteristics that may improve the positive predictive value (PPV) of a biopsy. Materials and Methods: MRI BI-RADS 4 or 5 breast findings in 101 women who underwent biopsy leading to a diagnosis of cancer within 1 year (PPV3; n = 115 cases) were reviewed. Patient history, lesion morphology, enhancement pattern and kinetics, and T2 characteristics were examined. Results: The PPV3 of all BI-RADS 4 and 5 breast lesions seen on MRI was 22.6% (26 of 115). Excluding lesions with second-look imaging correlates decreased the PPV3 to 11.8% (6/51). Of the MRI-guided biopsies, 20.9% (24 of 115) yielded a high-risk lesion, altering surgical management. MRI lesion type did not significantly affect the PPV3: the PPV3 was 26.3% (15 of 57) for masses, 21.4% (9 of 42) for non mass enhancement (NME) and 12.5% (2 of 16) for suspicious foci. The PPV3 for lesions found on diagnostic MRI in women with newly diagnosed cancer was 30.8% (20 of 65) which was statistically significantly greater compared to a PPV3 of 11.9% (5 of 42) for lesions identified on high-risk screening MRI. Conclusions: Suspicious MRI findings identified on a second-look examination are more likely malignant than those seen only on MRI. Suspicious MRI findings discovered in patients with concurrent malignancy have a greater PPV3 than those detected on high-risk screening MRIs. However, the type of MRI finding (mass vs. NME vs. foci) does not significantly affect the PPV3 and should not be used as a discriminator for determining biopsy threshold. (Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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