The Value of Second-look Ultrasound and Mammography for Assessment and Biopsy of MRI-detected Breast Lesions.

Autor:	Sauer ST; Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany (S.T.S., J.G., S.A.C., J.F.H., T.A.B., J-P.G.). Electronic address: Sauer_S3@ukw.de., Geerling J; Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany (S.T.S., J.G., S.A.C., J.F.H., T.A.B., J-P.G.). Electronic address: Julius@Geerling.co.uk., Christner SA; Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany (S.T.S., J.G., S.A.C., J.F.H., T.A.B., J-P.G.). Electronic address: Christner_S@ukw.de., Schlaiß T; Department of Obstetrics and Gynecology, University Hospital Würzburg, Josef-Schneider-Str. 4, 97080 Würzburg, Germany (T.S., M.K., A.C.S-Q.). Electronic address: Schlaiss_T@ukw.de., Kiesel M; Department of Obstetrics and Gynecology, University Hospital Würzburg, Josef-Schneider-Str. 4, 97080 Würzburg, Germany (T.S., M.K., A.C.S-Q.). Electronic address: Kiesel_M2@ukw.de., Scherer-Quenzer AC; Department of Obstetrics and Gynecology, University Hospital Würzburg, Josef-Schneider-Str. 4, 97080 Würzburg, Germany (T.S., M.K., A.C.S-Q.). Electronic address: Quenzer_A@ukw.de., Müller L; Department of Diagnostic and Interventional Radiology, University Hospital Mainz, Langenbeckstr. 1, 55131 Mainz, Germany (L.M.); Department of Radiology, University of Wisconsin-Madison, 600 Highland Ave, 53792 Madison, WI (L.M., J.F.H., J-P.G.). Electronic address: Lukas.Mueller@unimedizin-mainz.de., Heidenreich JF; Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany (S.T.S., J.G., S.A.C., J.F.H., T.A.B., J-P.G.); Department of Radiology, University of Wisconsin-Madison, 600 Highland Ave, 53792 Madison, WI (L.M., J.F.H., J-P.G.). Electronic address: Heidenreic_J@ukw.de., Bley TA; Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany (S.T.S., J.G., S.A.C., J.F.H., T.A.B., J-P.G.). Electronic address: Bley_T@ukw.de., Grunz JP; Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany (S.T.S., J.G., S.A.C., J.F.H., T.A.B., J-P.G.); Department of Radiology, University of Wisconsin-Madison, 600 Highland Ave, 53792 Madison, WI (L.M., J.F.H., J-P.G.). Electronic address: Grunz_J@ukw.de.
Jazyk:	angličtina
Zdroj:	Academic radiology [Acad Radiol] 2024 Nov 06. Date of Electronic Publication: 2024 Nov 06.
DOI:	10.1016/j.acra.2024.10.037
Abstrakt:	Rationale and Objectives: Suspicious lesions detected in multiparametric breast MRI can be further analyzed with second-look ultrasound (SLUS) and/or mammography. This study aims to assess the value of second-look imaging in selecting the appropriate biopsy method for different lesion characteristics. Materials and Methods: Between January 2021 and December 2023, 212 women underwent contrast-enhanced multiparametric breast MRI at 3 Tesla. A total of 241 suspicious lesions (108 malignancies, 44.8%) were further assessed with SLUS and second-look mammography. Subsequent image-guided biopsy of each lesion was performed using the most suitable modality. Size-dependent lesion detection rates in SLUS and mammography were compared by means of the McNemar test. Results: Lesions referred to MRI-guided biopsy were predominantly ≤ 10 mm in size (52.8%). SLUS allowed for higher detection rates than mammography in mass lesions (55.6% [95% confidence interval 46.4-64.4%] versus 16.7% [10.6-24.3%]; p < 0.001) with a particularly high sensitivity for malignant mass lesions > 10 mm (88.5% [69.9-97.6%]). In contrast, the detection rate for malignant non-mass lesions was lower in SLUS than in second-look mammography (22.0% [11.5-36.0%] versus 38.0% [24.7-52.8%]; p < 0.001). The malignancy rates in ultrasound-, mammography-, and MRI-guided biopsies were 53.7%, 55.2%, and 35.0%, respectively. Conclusion: SLUS is an excellent tool for further assessment and biopsy of suspicious mass lesions > 10 mm without associated calcifications. In contrast, supplemental ultrasound is of limited value in the evaluation and biopsy guidance of suspicious non-mass lesions compared to second-look mammography. Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Jan-Peter Grunz [grant number Z-3BC/02] is financially supported by the Interdisciplinary Center of Clinical Research Würzburg. Stephanie Sauer, Thorsten Bley, and Jan-Peter Grunz report a relationship with Siemens Healthineers that includes consulting or advisory and paid expert testimony. The Department of Diagnostic and Interventional Radiology receives ongoing research funding by Siemens Healthineers outside of the presented work. (Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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