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DOI: 10.1055/s-0039-1687954
Application of DWI in abbreviated breast MRI (ABM): quantitative tissue analysis increases diagnostic-performance within a short examination time
Publikationsverlauf
Publikationsdatum:
28. Mai 2019 (online)
Objectives:
Abbreviated breast-MRI (ABM) optimizes accessibility and costs of breast-MRI. However, this comes on the price of a reduced diagnostic-accuracy. We investigated whether fast diffusion-weighted-imaging (DWI) could increase diagnostic-accuracy without sacrificing rapidity of ABM.
Methods:
In 132 consecutive patients, breast-MRI according to international recommendations was performed (10:10 min). The MRI-protocol consisted of three section:
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ABM: one pre- and one postcontrast scan (2:40 minutes)
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Postinitial: Five additional postcontrast scans (+5 minutes).
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DWI (+2:30 minutes).
Histopathological verification served as referenced-standard.
ROIs (region-of-interest: 10 – 15 mm2) were drawn within the enhancing part of the lesion at the first postcontrast scan. ROIs were automatically transferred to the ADC-maps (apparent diffusion coefficient) of the DWI as well as to the precontrast, the first and the last postcontrast scan.
This gave one semi-/quantitative parameter for every section of the protocol (ABM/wash-in, Postinitial/wash-out; DWI/ADC).
We investigated whether the following extensions of ABM could increase diagnostic-accuracy.
I. ABM+: ABM+DWI
II. Curve: ABM+Postinitial
III. Curve+: Curve+DWI
Diagnostic accuracy of I. to III was quantified (area under the curve: AUC) and compared intra-individually (AUC-comparison; logistic-regression, alpha = 5%).
Results:
145 lesions were included (malignant/benign: 101/44). ABM+ (AUC = 0.877) outperformed both ABM (AUC = 0.743) and Curve (AUC = 0.788; P < 0.03). Further inclusion of Postinitial (Curve+) did not change diagnostic performance compared to ABM+ (P = 1).
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Conclusions:
Inclusion of DWI into ABM added significant diagnostic-value, but did not sacrifice rapidity. Accordingly, this approach should be further investigated in order to optimize accessibility and costs of breast-MRI.
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![](https://www.thieme-connect.de/media/senologie/201902/thumbnails/10-1055-s-0039-1687954-i001.jpg)
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