Value of breast MRI for patients with a biopsy showing atypical ductal hyperplasia (ADH)
Autor: | David V Schacht, Keiko Tsuchiya, Deepa Sheth, Hiroyuki Abe, Gillian M. Newstead, Gregory S. Karczmar, Naoko Mori |
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Rok vydání: | 2017 |
Předmět: |
medicine.medical_specialty
Stereotactic biopsy medicine.diagnostic_test business.industry Breast imaging Magnetic resonance imaging Malignancy medicine.disease 030218 nuclear medicine & medical imaging Surgical pathology 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Biopsy medicine Breast MRI Radiology Nuclear Medicine and imaging Radiology Stage (cooking) business |
Zdroj: | Journal of Magnetic Resonance Imaging. 46:1738-1747 |
ISSN: | 1053-1807 |
Popis: | Purpose To evaluate the diagnostic value of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) for patients with atypical ductal hyperplasia (ADH) in predicting malignant upgrade. Materials and Methods 3T DCE-MRI was performed for 17 patients with ADH (median age 52, range 42–76) proven by stereotactic biopsy (n = 15), and ultrasound-guided biopsy (n = 2) from January 2011 to April 2015. All patients underwent surgical excision after the MRI. Two radiologists prospectively reviewed the MRI to determine the presence or absence of suspicious findings at the site of biopsy, and evaluated the MR features of any lesion present according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon. MRI findings and clinical information were correlated with the final surgical pathology by multivariate analysis. Results Nine of 17 lesions were upgraded to malignancy. MRI demonstrated suspicious nonmass enhancement (NME) at the site of biopsy in all upgraded patients. The median size was 19.5 mm (range, 9–44 mm). In the eight patients without upgrade, no enhancement (n = 2), linear enhancement along the biopsy track (n = 4), thin rim enhancement around hematoma (n = 1), and a focal NME (n = 1) were seen. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRI findings were 100, 87.5, 90, and 100%, respectively. Multivariate analysis revealed that the presence of suspicious enhancement on MRI was the most significant predictor of upgrade to malignancy (P = 0.0006) Conclusion Our study revealed a high NPV of DCE-MRI for patients with ADH in terms of malignant upgrade at subsequent surgery. This suggests that patients with ADH without suspicious enhancement on DCE-MRI might be followed with DCE-MRI rather than undergoing surgical excision. Level of Evidence: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017;46:1738–1747. |
Databáze: | OpenAIRE |
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