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THE MRI CHARACTERISTICS OF NON-MASS ENHANCEMENT LESIONS OF THE BREAST: ASSOCIATIONS WITH MALIGNANCY
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Abstract
Objective: Describing imaging characteristic of MRI in the diagnosis of malignant non-mass enhancement lesions (NME). Subject and methods: The patients with suspected breast cancer had preoperative MRI and had images on MRI of non-mass enhancement lesions. The patient underwent needle biopsy and/or surgery for histopathology from August 2020 to July 2022 at National Cancer Hospital. Determination characteristics of non-mass enhancement lesions on MRI and comparison with histopathology: sensitivity (Se), specificity (Sp), and positive predictive value (PPV) were calculated for each characteristic; determine the optimal threshold for breast cancer diagnosis based on the ROC curve according to ADC value. Results: This study included 48 NME lesions (48 patients) including 40 malignant and 8 benign. The results of the study showed that segmental distribution of non-mass enhancement lesions (NMEs) had the potential for malignancy (p=0.048) with Se, Sp, and PPV being 57.5%, 87.5%, and 95.8%, respectively. Clustered ring enhancement is a feature suggestive of malignancy (p=0.017) with Se, Sp, PPV being 62.5%, 87.5%, 96.1%, respectively. When combining segmental distribution and clustered ring enhancement, the probability of malignancy was significantly higher (p=0.039) with Se, 66.67%; Sp, 100%; PPV 100%. Kinetic curve analysis was not reliable for differentiating benign and malignant NME lesions (p>0.05). Analysis of the ROC curve by ADC value below the threshold of 1.33x10-3 mm2/s suggested a diagnosis of breast cancer (p=0.012) with Se, Sp, PPV, and NPV were 75%, 75%, 93.75%, and 37.5%, respectively. The area under the curve (AUC) of the ADC value is 0.748. Conclusion: In the current study, segmental distribution, and clustered-ring enhancement are features suggestive of breast cancer. Kinetic curve analysis was not reliable for differentiating benign and malignant NME lesions. The ADC value can be used to differentiate between benign and malignant NME lesions.
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Keywords
Breast cancer, Non-mass enhancement (NME), magnetic resonance imaging
References
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