Clauser, Paola, Krug, Barbara, Bickel, Hubert, Dietzel, Matthias, Pinker, Katja, Neuhaus, Victor-Frederic, Marino, Maria Adele, Moschetta, Marco, Troiano, Nicoletta, Helbich, Thomas H. and Baltzer, Pascal A. T. (2021). Diffusion-weighted Imaging Allows for Downgrading MR BI-RADS 4 Lesions in Contrast-enhanced MRI of the Breast to Avoid Unnecessary Biopsy. Clin. Cancer Res., 27 (7). S. 1941 - 1949. PHILADELPHIA: AMER ASSOC CANCER RESEARCH. ISSN 1557-3265
Full text not available from this repository.Abstract
Purpose Diffusion-weighted imaging with the calculation of an apparent diffusion coefficient (ADC) has been proposed as a quantitative biomarker on contrast-enhanced MRI (CE-MRI) of the breast. There is a need to approve a generalizable ADC cutoff. The purpose of this study was to evaluate whether a predefined ADC cutoff allows downgrading of BI-RADS 4 lesions on CE-MRI, avoiding unnecessary biopsies. Experimental Design: This was a retrospective, multicentric, cross-sectional study. Data from five centers were pooled on the individual lesion level. Eligible patients had a BI-RADS 4 rating on CE-MRI. For each center, two breast radiologists evaluated the images. Data on lesion morphology (mass, non-mass), size, and ADC were collected. Histology was the standard of reference. A previously suggested ADC cutoff (>= 1.5 x 10(-3) mm(2)/second) was applied. A negative likelihood ratio of 0.1 or lower was considered as a rule-out criterion for breast cancer. Diagnostic performance indices were calculated by ROC analysis. Results: There were 657 female patients (mean age, 42; SD, 14.1) with 696 BI-RADS 4 lesions included. Disease prevalence was 59.5% (414/696). The area under the ROC curve was 0.784. Applying the investigated ADC cutoff, sensitivity was 96.6% (400/414). The potential reduction of unnecessary biopsies was 32.6% (92/282). Conclusions: An ADC cutoff of >= 1.5 x 10(-3) mm(2)/second allows downgrading of lesions classified as BI-RADS 4 on breast CE-MRI. One-third of unnecessary biopsies could thus be avoided.
| Item Type: | Journal Article | ||||||||||||||||||||||||||||||||||||||||||||||||
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| URN: | urn:nbn:de:hbz:38-594761 | ||||||||||||||||||||||||||||||||||||||||||||||||
| DOI: | 10.1158/1078-0432.CCR-20-3037 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Journal or Publication Title: | Clin. Cancer Res. | ||||||||||||||||||||||||||||||||||||||||||||||||
| Volume: | 27 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Number: | 7 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Page Range: | S. 1941 - 1949 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Date: | 2021 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Publisher: | AMER ASSOC CANCER RESEARCH | ||||||||||||||||||||||||||||||||||||||||||||||||
| Place of Publication: | PHILADELPHIA | ||||||||||||||||||||||||||||||||||||||||||||||||
| ISSN: | 1557-3265 | ||||||||||||||||||||||||||||||||||||||||||||||||
| Language: | English | ||||||||||||||||||||||||||||||||||||||||||||||||
| Faculty: | Unspecified | ||||||||||||||||||||||||||||||||||||||||||||||||
| Divisions: | Unspecified | ||||||||||||||||||||||||||||||||||||||||||||||||
| Subjects: | no entry | ||||||||||||||||||||||||||||||||||||||||||||||||
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| URI: | http://kups.ub.uni-koeln.de/id/eprint/59476 |
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