Real-time MRI navigated US: Role in diagnosis and guided biopsy of incidental breast lesions and axillary lymph nodes detected on breast MRI but not on second look US
| Autor: | F. M. Azcón, Salvador Martínez Meca, José Luis García Espona, Elena Pastor Pons, María Culiañez Casas |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Image-Guided Biopsy medicine.medical_specialty Axillary lymph nodes Sentinel lymph node Breast Neoplasms Malignancy Multimodal Imaging Sensitivity and Specificity Breast cancer Computer Systems Biopsy medicine Humans Breast MRI Radiology Nuclear Medicine and imaging Aged Ultrasonography Incidental Findings medicine.diagnostic_test business.industry Carcinoma Reproducibility of Results Cancer General Medicine Middle Aged Image Enhancement medicine.disease Magnetic Resonance Imaging Exact test medicine.anatomical_structure Lymphatic Metastasis Axilla Female Lymph Nodes Radiology business |
| Zdroj: | European Journal of Radiology. 83:942-950 |
| ISSN: | 0720-048X |
| Popis: | Objectives To prospectively evaluate the accuracy of real-time ultrasound combined with supine-MRI using volume navigation technique (RtMR-US) in diagnosis and biopsy of incidental breast lesions (ILSM) and axillary lymph nodes (LNSM) suspicious of malignancy on contrast enhanced magnetic resonance imaging (CE-MRI). Materials and methods Five hundred and seventy-seven women were examined using breast CE-MRI. Those with incidental breast lesions not identified after second-look ultrasound (US) were recruited for RtMR-US. Biopsy was performed in ILSM. Breast lesions were categorized with BI-RADS system and Fisher’ exact test. Axillary lymph nodes morphology was described. To assess efficacy of RtMR-US, diagnostic accuracy, sensitivity, specificity, detection rate and Kappa index of conventional-US and RtMR-US were calculated. Results Forty-three lesions were detected on CE-MRI before navigation. Eighteen were carcinomas and 25 ILSM. Of these, 21 underwent a RtMR-US. Detection rate on RtMR-US (90.7%) was higher than on conventional-US (43%) ( p k = 0.138). Twenty ILSM and 2 LNSM were biopsied. Sixty-five percent were benign (100% of BI-RADS3 and 56% of BI-RADS4-5). Diagnostic performance of RtMR-US identifying malignant nodules for overall lesions and for the subgroup of ILSM was respectively: sensitivity 96.3% and 100%, specificity 18.8% and 30.7%, positive predictive value 66.7% and 43.7%, negative predictive value 75% and 100%. In addition RtMR-US enabled biopsy of 2 metastatic lymph nodes. Conclusions Real time-US with supine-MRI using a volume navigation technique increases the detection of ILSM. RtMR-US may be used to detect occult breast carcinomas and to assess cancer extension, preventing unnecessary MRI-guided biopsies and sentinel lymph node biopsies. Incidental lesions BI-RADS 3 non-detected on conventional-US are probably benign. |
| Databáze: | OpenAIRE |
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