J Korean Soc Radiol.  2021 Jul;82(4):889-902. 10.3348/jksr.2020.0115.

Assessment of Additional MRI-Detected Breast Lesions Using the Quantitative Analysis of ContrastEnhanced Ultrasound Scans and Its Comparability with Dynamic Contrast-Enhanced MRI Findings of the Breast

Affiliations
  • 1Department of Radiology, Korea University Guro Hospital, College of Medicine, Korea University, Seoul, Korea
  • 2Department of Radiology, Korea University Anam Hospital, College of Medicine, Korea University, Seoul, Korea
  • 3Department of Radiology, Korea University Ansan Hospital, College of Medicine, Korea University, Seoul, Korea
  • 4Medical Science Research Support Center, Division of Medical Statistics, Korea University Guro Hospital, College of Medicine, Korea University, Seoul, Korea

Abstract

Purpose
To assess the diagnostic performance of contrast-enhanced ultrasound (CEUS) for additional MR-detected enhancing lesions and to determine whether or not kinetic pattern results comparable to dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the breast can be obtained using the quantitative analysis of CEUS.
Materials and Methods
In this single-center prospective study, a total of 71 additional MR-detected breast lesions were included. CEUS examination was performed, and lesions were categorized according to the Breast Imaging-Reporting and Data System (BI-RADS). The sensitivity,specificity, and diagnostic accuracy of CEUS were calculated by comparing the BI-RADS category to the final pathology results. The degree of agreement between CEUS and DCE-MRI kinetic patterns was evaluated using weighted kappa.
Results
On CEUS, 46 lesions were assigned as BI-RADS category 4B, 4C, or 5, while 25 lesions category 3 or 4A. The diagnostic performance of CEUS for enhancing lesions on DCE-MRI was excellent, with 84.9% sensitivity, 94.4% specificity, and 97.8% positive predictive value. A total of 57/71 (80%) lesions had correlating kinetic patterns and showed good agreement (weighted kappa = 0.66) between CEUS and DCE-MRI. Benign lesions showed excellent agreement (weighted kappa = 0.84), and invasive ductal carcinoma (IDC) showed good agreement (weighted kappa = 0.69).
Conclusion
The diagnostic performance of CEUS for additional MR-detected breast lesions was excellent. Accurate kinetic pattern assessment, fairly comparable to DCE-MRI, can be obtained for benign and IDC lesions using CEUS.

Keyword

Diagnostic Ultrasound; Contrast Media; Microbubbles; Magnetic Resonance Imaging; Breast Tumors; Breast Cancer
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