Seifeldein, G., Elsaba, T., Gabr, A., Mohamed, D., Elmorshidy, S., Atta, H. (2020). The diagnostic efficacy of tailored multiparametric breast MRI in indeterminate mammographic lesions: A single tertiary oncology center. International Journal of Cancer and Biomedical Research, 4(3), 217-228. doi: 10.21608/jcbr.2020.36193.1057
Gehan Seifeldein; Tarek M. Elsaba; Adel Gabr; Dalia O. Mohamed; Summer Elmorshidy; Haisam Atta. "The diagnostic efficacy of tailored multiparametric breast MRI in indeterminate mammographic lesions: A single tertiary oncology center". International Journal of Cancer and Biomedical Research, 4, 3, 2020, 217-228. doi: 10.21608/jcbr.2020.36193.1057
Seifeldein, G., Elsaba, T., Gabr, A., Mohamed, D., Elmorshidy, S., Atta, H. (2020). 'The diagnostic efficacy of tailored multiparametric breast MRI in indeterminate mammographic lesions: A single tertiary oncology center', International Journal of Cancer and Biomedical Research, 4(3), pp. 217-228. doi: 10.21608/jcbr.2020.36193.1057
Seifeldein, G., Elsaba, T., Gabr, A., Mohamed, D., Elmorshidy, S., Atta, H. The diagnostic efficacy of tailored multiparametric breast MRI in indeterminate mammographic lesions: A single tertiary oncology center. International Journal of Cancer and Biomedical Research, 2020; 4(3): 217-228. doi: 10.21608/jcbr.2020.36193.1057
The diagnostic efficacy of tailored multiparametric breast MRI in indeterminate mammographic lesions: A single tertiary oncology center
1Diagnostic and Interventional Radiology Department, Assiut University, Egypt.
2Pathology Department, South Egypt Cancer Institute, Assiut University, Egypt
3Medical Oncology Department, South Egypt Cancer Institute, Assiut
4Radiotherapy Department, South Egypt Cancer Institute, Assiut University, Egypt
5Clinical Oncology Department, Faculty of Medicine, Assiut University,Egypt
6South Egypt Cancer Institute-Assiut University, Assiut University, Egypt
Abstract
Aim: Assessing the diagnostic role of multiparametric MRI (mpMRI) in indeterminate mammographic breast lesions and postulated a diagnostic model for MRI interpretation integrating the morphological, and functional parameters. Material and Methods: Two hundred forty patients included in a self-control retrospective study in a tertiary center. All patients examined with 1.5T MR unit using multiparametric studies including morphological analysis followed by functional evaluation via MR diffusion (MR-DWI), spectroscopy(MRS), and kinetic enhanced curves (DCE-MRI). Diagnostic performance of each parameter was evaluated alone and in combination. The histopathological results were the standard of reference. Results: Combined mpMRI parameters possess a moderate agreement (κ=0.435) with 23.5% false discovery rate (FDR) and an overall accuracy of 78%.On the other hand, combined mpMRI data after omitting MRS data show almost perfect agreement (κ=0.923)with histopathological data and recorded 100% specificity, 90% specificity, 5% FDR and zero% for both false omission rate (FOR) and false-negative rate (FNR). The Quantitative analysis of DWI with ADC map shows a significant statistical value for mean ADC (m-ADC) value and relative ADC (r-ADC) value. The former has cutoff value 1.1x10-3 mm2/sec with higher specificity 97.5% while r-ADC has cutoff value 0.42x10-3 mm2/sec with quite lower specificity 85%. Perfect agreement in the interpretation of DCE-MRI curves, MR-DWI, and MRS with κ =0.92,0.9 and 0.84 respectively. Conclusion: Tailored combined multiparametric MRI is a potent diagnostic tool in the characterization of indeterminate mammographic breast lesions.
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