Detection of non-palpable breast cancer in asymptomatic women by using unenhanced diffusion-weighted and T2-weighted MR imaging: comparison with mammography and dynamic contrast-enhanced MR imaging

Yabuuchi, Hidetake; Matsuo, Yoshio; Sunami, Shunya; Kamitani, Takeshi; Kawanami^1, Satoshi; Setoguchi, Taro; Sakai, Shuji; Hatakenaka, Masamitsu; Kubo, Makoto; Tokunaga, Eriko; Yamamoto, Hidetaka; Honda, Hiroshi
January 2011
European Radiology;Jan2011, Vol. 21 Issue 1, p11
Academic Journal
Objective: To compare the detectability of non-palpable breast cancer in asymptomatic women by using mammography (MMG), dynamic contrast-enhanced MR imaging (DCE-MRI) and unenhanced MR imaging with combined diffusion-weighted and T2-weighted images (DWI + T2WI). Methods: Forty-two lesions in 42 patients with non-palpable breast cancer in asymptomatic women were enrolled. For the reading test, we prepared a control including 13 normal and 8 benign cases. Each imaging set included biplane MMG, DCE-MRI and DWI + T2WI. Five readers were asked to rate the images on a scale of 0 to 100 for the likelihood of the presence of cancer and the BI-RADS category. Confidence level results were used to construct receiver operating characteristic analysis. Sensitivity and specificity were calculated for each technique. Results: DWI + T2WI showed higher observer performances (area under the curve, AUC, 0.73) and sensitivity (50%) for the detection of non-palpable breast cancer than MMG alone (AUC 0.64; sensitivity 40%) but lower than those of DCE-MRI (AUC 0.93; sensitivity 86%). A combination of MMG and DWI + T2WI exhibited higher sensitivity (69%) compared with that of MMG alone (40%). Conclusion: DWI + T2WI could be useful in screening breast cancer for patients who cannot receive contrast medium and could be used as a new screening technique for breast cancer.


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