Faculty Collaboration Database

Enhancing foci on breast MRI: Identifying criteria that increase levels of suspicion. Clin Imaging 2022 Apr;84:104-109

Date

02/18/2022

Pubmed ID

35176571

DOI

10.1016/j.clinimag.2022.02.001

Scopus ID

2-s2.0-85124519349 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

OBJECTIVE: Prior studies evaluating features of foci associated with malignancy have not been conclusive. This study evaluates foci that were deemed suspicious and assesses multiple imaging and clinical findings with the goal of identifying criteria that can increase diagnostic confidence when evaluating foci on breast MRI.

METHODS: After Institutional Review Board approval, a retrospective chart review was performed to identify patients who underwent an image-guided biopsy of an enhancing focus. To be included in the study, a breast MRI performed between 2012 and 2019 must have been classified as suspicious for an enhancing focus or foci, and a biopsy using imaging guidance must have been subsequently performed. Patient and imaging characteristics as well as the corresponding biopsy results were recorded and statistically analyzed.

RESULTS: There were 74 patients with 85 foci of enhancement who underwent biopsy within the study period. Thirteen of the 85 foci yielded malignant results for an overall positive predictive value of 15.3% (95% confidence interval: 7.7-22.9%). Additionally, twenty-six of the 85 cases (30.6%) yielded high risk lesions. There was a statistically significant negative correlation between screening breast MRIs and biopsies that yielded cancer or atypia (p = 0.04). There was also a significant association between foci and malignant results if the focus was in the same quadrant of a known malignancy (p = 0.001).

CONCLUSION: Clinical information, such as the indication for a breast MRI or the location of a focus relative to a known cancer, can play an important role in evaluating foci of enhancement. Diagnostic confidence in identifying suspicious foci can be aided by incorporating clinical context with imaging findings deemed suspicious by prior research studies.

Author List

Cherian S, Vagvala S, Majidi SS, Deitch SG, Dykstra DS, Sullivan JR, Field LR, Wadhwa A

Authors

Solomon Cherian MD Associate Professor in the Radiology department at Medical College of Wisconsin
Sarah G. Deitch MD Assistant Professor in the Radiology department at Medical College of Wisconsin
Daniel S. Dykstra MD Assistant Professor in the Radiology department at Medical College of Wisconsin
Laura R. Field MD Adjunct Assistant Professor in the Radiology department at Medical College of Wisconsin
Julie R. Sullivan MD Assistant Professor in the Radiology department at Medical College of Wisconsin
Anubha Wadhwa MD Associate Professor in the Radiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Breast
Breast Neoplasms
Female
Humans
Image-Guided Biopsy
Magnetic Resonance Imaging
Radiography
Retrospective Studies