High-resolution diffusion-weighted MRI plus mammography for detecting clinically occult breast cancers in women with dense breasts

•Dense breasts have increased cancer risk, but low sensitivity of mammography necessitates supplemental screening modalities.•DW-MRI had sensitivity higher than mammography but lower than DCE-MRI in detecting clinically occult cancers in dense breasts.•DW-MRI is expected to be an effective supplemen...

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Veröffentlicht in:European journal of radiology 2024-06, Vol.175, p.111440-111440, Article 111440
Hauptverfasser: Kim, Hee Jeong, Shin, Hee Jung, Baek, Seunghee, Lee, Chae Woon, Choi, Woo Jung, Chae, Eun Young, Cha, Joo Hee, Kim, Hak Hee, Moon, Woo Kyung
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Sprache:eng
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Zusammenfassung:•Dense breasts have increased cancer risk, but low sensitivity of mammography necessitates supplemental screening modalities.•DW-MRI had sensitivity higher than mammography but lower than DCE-MRI in detecting clinically occult cancers in dense breasts.•DW-MRI is expected to be an effective supplemental screening tool for mammography in women with dense breasts. To compare the performance of mammography, high-resolution DW-MRI, DCE-MRI, and their combinations in detecting clinically occult breast cancer in women with dense breasts. 544 breasts from 281 consecutive asymptomatic women with dense breasts were retrospectively identified. They underwent breast MRI for preoperative evaluation of breast cancers (n = 214) or as supplemental screening (n = 67) including DCE-MRI and DW-MRI (b values, 0 and 1000 sec/mm2; in-plane resolution, 1.1 × 1.1 mm2 and 1.3 × 1.3 mm2; section thickness, 3 mm), in addition to mammography. Three readers independently reviewed each examination on a per-breast basis. Histopathology and at least two year of imaging follow-up served as the gold standard. The sensitivities and specificities of different imaging modalities were compared using McNemar test. 230 of 544 breasts (42 %) had malignant lesions. The sensitivity of DW-MRI was higher than that of mammography (77.0 % vs 57.9 %; adjusted p  0.999) and DCE-MRI (97.1 %; adjusted p > 0.999). DW-MRI plus mammography had a comparable sensitivity and specificity to those of DCE-MRI plus mammography (88.6 % vs 90.9 % and 97.1 % vs 96.2 %; adjusted p > 0.999 for both). High-resolution DW-MRI had a sensitivity higher than mammography and lower than DCE-MRI. Nevertheless, DW-MRI plus mammography showed a comparable sensitivity and specificity to DCE-MRI plus mammography for detecting clinically occult cancers in women with dense breasts.
ISSN:0720-048X
1872-7727
DOI:10.1016/j.ejrad.2024.111440