Evidence map›Paper›PMID 38522915›Full record

ArticleMagnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine2025

Characteristics of Suspicious Breast Lesions Visible Only on MR Imaging: Is It Possible to Classify into Immediate Biopsy and Careful Observation Groups?

Ryozo Kai, Mitsuhiro Tozaki, Yuya Koike, Aya Nagata, Kanae Taruno, Yoshimitsu Ohgiya

Abstract read
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Article in Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Ryozo KaiDepartment of Radiology, Division of Radiology, Showa University School of Medicine, Tokyo, Japan.
Mitsuhiro TozakiDepartment of Radiology, Division of Radiology, Showa University School of Medicine, Tokyo, Japan.
Yuya KoikeDepartment of Radiology, Division of Radiology, Showa University School of Medicine, Tokyo, Japan.
Aya NagataDepartment of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan.
Kanae TarunoDepartment of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan.
Yoshimitsu OhgiyaDepartment of Radiology, Division of Radiology, Showa University School of Medicine, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo investigate the characteristics of suspicious MRI-only visible lesions and to explore the validity of subcategorizing these lesions into the following two groups: lesions that would require immediate biopsy (4Bi) and lesions for which careful clinical follow-up could be recommended (4Fo).

methodsA retrospective review of 108 MRI-only visible lesions in 106 patients who were diagnosed as Breast Imaging Reporting and Data System (BI-RADS) category 4 between June 2018 and June 2022 at our institution was performed by two radiologists. The breast MR images were evaluated according to BI-RADS and additional MRI descriptors (linear ductal, branching, and apparent diffusion coefficient values). The lesions were categorized by previously reported classification systems, and the positive predictive values (PPVs) for the different categories were determined and compared. Subsequently, a new classification system was developed in this study.

resultsThe total malignancy rate was 31% (34/108). No significant differences between benign and malignant lesions were identified for focus and mass lesions. For non-mass lesions, linear ductal and heterogeneous internal enhancement suggested a benign lesion (P = 0.0013 and P = 0.023, respectively), and branching internal enhancement suggested malignancy (P = 0.0066). Segmental distribution suggested malignancy (P = 0.0097). However, the PPV of segmental distribution with heterogeneous enhancement was significantly lower than that of category 4 segmental lesions with other enhancement patterns (11% vs. 59%; P = 0.0198).As a new classification, the distribution of focal, linear, and segmental was given a score of 0, 1, or 2, and the internal enhancement of heterogeneous, linear-ductal, clumped, branching, and clustered-ring enhancement was given a score of 0, 1, 2, 3, and 4, respectively. When categorized using a scoring system, a statistically significant difference in PPV was observed between 4Fo (n = 27) and 4Bi (n = 33) (7% vs. 61%, P = 0.000029).

conclusionThe new classification system was found to be highly capable of subcategorizing BI-RADS category 4 MRI-only visible non-mass lesions into 4Fo and 4Bi.

Indexed as

Breast NeoplasmsMagnetic Resonance ImagingAdultAgedAged, 80 and overBiopsyBreastFemaleHumansMiddle AgedPredictive Value of TestsReproducibility of ResultsRetrospective StudiesBI-RADS MRI subcategoriesbreast MRIbreast MRI descriptorsMRI-only visible lesions

Identifiers

PMID38522915
PMCPMC11996254

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.