Details

Autor(en) / Beteiligte

• Nissan, Noam
• Sorin, Vera
• Bauer, Ethan
• Anaby, Debbie
• Samoocha, David
• Yagil, Yael
• Faermann, Renata
• Halshtok-Neiman, Osnat
• Shalmon, Anat
• Gotlieb, Michael
• Sklair-Levy, Miri

Titel

MRI of the Lactating Breast: Computer-Aided Diagnosis False Positive Rates and Background Parenchymal Enhancement Kinetic Features

Ist Teil von

• Academic radiology, 2022-09, Vol.29 (9), p.1332-1341

Ort / Verlag

Elsevier Inc

Erscheinungsjahr

2022

Quelle

Elsevier ScienceDirect Journals Complete

Beschreibungen/Notizen

• •BPE-induced CAD coloring in the healthy lactating breast is very common and characteristically appears in bilateral, symmetric, non-mass enhancement-like appearance.•High variability in CAD scoring grade and kinetic curve dominance, were found among the lactating group, thus complicating its prototype characterization.•Medium uptake and larger coloring diameter and volume were significantly associated with lactating BPE, rather than with breast cancer. To investigate the application of computer-added diagnosis (CAD) in dynamic contrast-enhanced (DCE) MRI of the healthy lactating breast, focusing on false-positive rates and background parenchymal enhancement (BPE) coloring patterns in comparison with breast cancer features in non-lactating patients. The study population was composed of 58 healthy lactating patients and control groups of 113 healthy premenopausal non-lactating patients and 55 premenopausal non-lactating patients with newly-diagnosed breast cancer. Patients were scanned on 1.5-T MRI using conventional DCE protocol. A retrospective analysis of DCE-derived CAD properties was conducted using a commercial software that is regularly utilized in our routine radiological work-up. Qualitative morphological characterization and automatically-obtained quantitative parametric measurements of the BPE-induced CAD coloring were categorized and subgroups’ trends and differences between the lactating and cancer cohorts were statistically assessed. CAD false-positive coloring was found in the majority of lactating cases (87%). Lactation BPE coloring was characteristically non-mass enhancement (NME)-like shaped (87%), bilateral (79%) and symmetric (64%), whereas, unilateral coloring was associated with prior irradiation (p <0.0001). Inter-individual variability in CAD appearance of both scoring-grade and kinetic-curve dominance was found among the lactating cohort. When compared with healthy non-lactating controls, CAD false positive probability was significantly increased [Odds ratio 40.2, p <0001], while in comparison with the breast cancer cohort, CAD features were mostly inconclusive, even though increased size parameters were significantly associated with lactation-BPE (p <0.00001). BPE was identified as a common source for false-positive CAD coloring on breast DCE-MRI among lactating population. Despite several typical characteristics, overlapping features with breast malignancy warrant a careful evaluation and clinical correlation in all cases with suspected lactation induced CAD coloring.