ArticleBMC medical imaging2023
The value of MRI for downgrading of breast suspicious lesions detected on ultrasound.
Article in BMC medical imaging, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The diagnostic performance of ultrafast MRI to differentiate benign from malignant breast lesions: a systematic review and meta-analysis.European radiology · 2024Pooled it
- Preoperative Breast MRI and Histopathology in Breast Cancer: Concordance, Challenges and Emerging Role of CEM and mpMRI.Diagnostics (Basel, Switzerland) · 2025Review
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMost of suspicious lesions classified as breast imaging reporting and data system (BI-RADS) 4A and 4B categories on ultrasound (US) were benign, resulting in unnecessary biopsies. MRI has a high sensitivity to detect breast cancer and high negative predictive value (NPV) to exclude malignancy. The purpose of this study was to investigate the value of breast MRI for downgrading of suspicious lesions with BI-RADS 4A and 4B categories on US.
methodsPatients who underwent breast MRI for suspicious lesions classified as 4A and 4B categories were included in this retrospective study. Two radiologists were aware of the details of suspicious lesions detected on US and evaluated MR images. MRI BI-RADS categories were given by consensus on the basis on dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI). Pathological results and imaging follow-up at least 12 months were used as a reference standard. Sensitivity, specificity, positive predictive value (PPV), NPV and their 95% confidence interval (CI) were calculated for MRI findings.
resultsOne sixty seven patients with 186 lesions (US 4A category: 145, US 4B category: 41) consisted of the study cohort. The malignancy rate was 34.9% (65/186). On MRI, all malignancies showed true-positive results and 92.6% (112/121) benign lesions were correctly diagnosed. MRI increased PPV from 34.9% (65/186) to 87.8% (65/74) and reduced the false-positive biopsies by 92.6% (112/121). The sensitivity, specificity, PPV and NPV of MRI were 100% (95% CI: 94.5%-100%), 92.6% (95% CI: 86.3%-96.5%), 87.8% (95% CI: 78.2%-94.3%) and 100% (95% CI: 96.8%-100%), respectively. 2.2% (4/186) of suspicious lesions were additionally detected on MRI, 75% (3/4) of which were malignant.
conclusionMRI could downgrade suspicious lesions classified as BI-RADS 4A and 4B categories on US and avoided unnecessary benign biopsies without missing malignancy. Additional suspicious lesions detected on MRI needed further work-up.
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