The effectiveness of an ultrafast breast MRI protocol in the differentiation of benign and malignant breast lesions

Hamid, M. T. Ramli and Ab Mumin, N. and Wong, Y. V. and Chan, W. Y. and Rozalli, Faizatul Izza and Rahmat, K. (2023) The effectiveness of an ultrafast breast MRI protocol in the differentiation of benign and malignant breast lesions. Clinical Radiology, 78 (6). pp. 444-450. ISSN 0009-9260, DOI

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AIM: To evaluate the effectiveness of an ultrafast breast magnetic resonance imaging (MRI) protocol in differentiating benign and malignant breast lesions.MATERIALS AND METHODS: Fifty-four patients with Breast Imaging Reporting and Data System (BI-RADS) 4 or 5 lesions were recruited between July 2020 to May 2021. A standard breast MRI was performed with the inclusion of the ultrafast protocol between the unen-hanced sequence and the first contrast-enhanced sequence. Three radiologists performed image interpretation in consensus. Ultrafast kinetic parameters analysed included the maximum slope (MS), time to enhancement (TTE), and arteriovenous index (AVI). These pa-rameters were compared using receiver operating characteristics with p-values of <0.05 considered to indicate statistical significance.RESULTS: Eighty-three histopathological proven lesions from 54 patients (mean age 53.87 years, SD 12.34, range 26-78 years) were analysed. Forty-one per cent (n=34) were benign and 59% (n=49) were malignant. All malignant and 38.2% (n=13) benign lesions were visualised on the ultrafast protocol. Of the malignant lesions, 77.6% (n=53) were invasive ductal carcinoma (IDC) and 18.4% (n=9) were ductal carcinoma in situ (DCIS). The MS for malignant lesions (13.27%/s) were significantly larger than for benign (5.45%/s; p<0.0001). No significant dif-ferences were seen for TTE and AVI. The area under the ROC curve (AUC) for the MS, TTE, and AVI were 0.836, 0.647, and 0.684, respectively. Different types of invasive carcinoma had similar MS and TTE. The MS of high-grade DCIS was also similar to that of IDC. Lower MS values were observed for low-grade (5.3%/s) compared to high-grade DCIS (14.8%/s) but the results were not significant statistically.CONCLUSION: The ultrafast protocol showed potential to discriminate between malignant and benign breast lesions with high accuracy using MS.(c) 2023 Published by Elsevier Ltd on behalf of The Royal College of Radiologists.

Item Type: Article
Uncontrolled Keywords: Adult; Aged; Breast carcinoma In Situ; Breast neoplasms
Subjects: R Medicine
R Medicine > R Medicine (General) > Medical technology
Divisions: Faculty of Medicine
Faculty of Medicine > Biomedical Imaging Department
Depositing User: Ms Zaharah Ramly
Date Deposited: 01 Dec 2023 12:38
Last Modified: 01 Dec 2023 12:38

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