Role of MR DWIBS in Evaluation of Breast Cancer Patients; Loco-Regional Assessment
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- Category: Vol. 85, June 2017
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Role of MR DWIBS in Evaluation of Breast Cancer Patients; Loco-Regional Assessment, MAHMOUD M. ALY REZK, MOHAMED A. MAHER, MAHA H. HELAL, NAGLAA M. ABD EL-RAZEK, NOHA A. EL-DEIB and ESMAT EL-FAYOUMY
Abstract
Background: The detection of neoplastic lesions in cancer patients is recently introduced by MRI whole body with developing safe non contrast diffusion based sequence make it easier in improving the diagnostic accuracy.
Purpose: To evaluate the ability of Magnetic Resonance (MR) Diffusion-Weighted Imaging with Background Suppres-sion (DWIBS); unenhanced sequence to assess suspicious breast lesions.
Material and Methods: This prospective institutional review board-approved study included 50 women (mean age, 57.1 years; range, 50-69 years), who gave informed consent and who had suspicious mammograms and an indication for biopsy, from July 2014 to January 2016. Before biopsy; MR imaging was performed that included DWIBS (b=0 & 1000 sec/mm2). Findings were correlated with histopathologic findings.
Results: Twenty-four of 50 participants had a breast carcinoma. With AP1 (DWIBS), the sensitivity was 0.92 (95% Confidence Interval [CI]: 0.73, 0.98), the specificity was 0.94 (95% CI: 0.77, 0.99), the Negative Predictive Value (NPV) was 0.92 (95% CI: 0.75, 0.99), and the Positive Predictive Value (PPV) was 0.93 (95% CI: 0.75, 0.99). The mean reading time was 29.7 seconds (range, 4.9-110.0 seconds) and was less than 3 seconds (range, 1.2-7.6 seconds) in the absence of suspicious findings on the DWIBS MIPs. With the AP2 protocol, the sensitivity was 0.85 (95% CI: 0.78, 0.95), the specificity was 0.90 (95% CI: 0.72, 0.97), the NPV was 0.87 (95% CI: 0.69, 0.95), the PPV was 0.89 (95% CI: 0.69, 0.97), and the mean reading time was 29.6 seconds (range, 6.0-100.0 seconds).
Conclusion: MR imaging (DWIBS mammography) with its high negative predictive value could help exclude malig-nancy in women with suspicious X-ray mammograms.