An Unenhanced Breast MRI Protocol Based on Diffusion-Weighted Imaging: A Retrospective Single-Center Study on High-Risk Population for Breast Cancer
Purpose: This study aimed to investigate the use of contrast-free magnetic resonance imaging (MRI) as an innovative screening method for detecting breast cancer in high-risk asymptomatic women. Specifically, the researchers evaluated the diagnostic performance of diffusion-weighted imaging (DWI) in...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-06-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/12/1996 |
| _version_ | 1827737779862241280 |
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| author | Anna Rotili Filippo Pesapane Giulia Signorelli Silvia Penco Luca Nicosia Anna Bozzini Lorenza Meneghetti Cristina Zanzottera Sara Mannucci Bernardo Bonanni Enrico Cassano |
| author_facet | Anna Rotili Filippo Pesapane Giulia Signorelli Silvia Penco Luca Nicosia Anna Bozzini Lorenza Meneghetti Cristina Zanzottera Sara Mannucci Bernardo Bonanni Enrico Cassano |
| author_sort | Anna Rotili |
| collection | DOAJ |
| description | Purpose: This study aimed to investigate the use of contrast-free magnetic resonance imaging (MRI) as an innovative screening method for detecting breast cancer in high-risk asymptomatic women. Specifically, the researchers evaluated the diagnostic performance of diffusion-weighted imaging (DWI) in this population. Methods: MR images from asymptomatic women, carriers of a germline mutation in either the BRCA1 or BRCA2 gene, collected in a single center from January 2019 to December 2021 were retrospectively evaluated. A radiologist with experience in breast imaging (R1) and a radiology resident (R2) independently evaluated DWI/ADC maps and, in case of doubts, T2-WI. The standard of reference was the pathological diagnosis through biopsy or surgery, or ≥1 year of clinical and radiological follow-up. Diagnostic performances were calculated for both readers with a 95% confidence interval (CI). The agreement was assessed using Cohen’s kappa (κ) statistics. Results: Out of 313 women, 145 women were included (49.5 ± 12 years), totaling 344 breast MRIs with DWI/ADC maps. The per-exam cancer prevalence was 11/344 (3.2%). The sensitivity was 8/11 (73%; 95% CI: 46–99%) for R1 and 7/11 (64%; 95% CI: 35–92%) for R2. The specificity was 301/333 (90%; 95% CI: 87–94%) for both readers. The diagnostic accuracy was 90% for both readers. R1 recalled 40/344 exams (11.6%) and R2 recalled 39/344 exams (11.3%). Inter-reader reproducibility between readers was in moderate agreement (κ = 0.43). Conclusions: In female carriers of a BRCA1/2 mutation, breast DWI supplemented with T2-WI allowed breast cancer detection with high sensitivity and specificity by a radiologist with extensive experience in breast imaging, which is comparable to other screening tests. The findings suggest that DWI and T2-WI have the potential to serve as a stand-alone method for unenhanced breast MRI screening in a selected population, opening up new perspectives for prospective trials. |
| first_indexed | 2024-03-11T02:34:15Z |
| format | Article |
| id | doaj.art-022234de092547ad94d1875d7420c906 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T02:34:15Z |
| publishDate | 2023-06-01 |
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| series | Diagnostics |
| spelling | doaj.art-022234de092547ad94d1875d7420c9062023-11-18T09:59:40ZengMDPI AGDiagnostics2075-44182023-06-011312199610.3390/diagnostics13121996An Unenhanced Breast MRI Protocol Based on Diffusion-Weighted Imaging: A Retrospective Single-Center Study on High-Risk Population for Breast CancerAnna Rotili0Filippo Pesapane1Giulia Signorelli2Silvia Penco3Luca Nicosia4Anna Bozzini5Lorenza Meneghetti6Cristina Zanzottera7Sara Mannucci8Bernardo Bonanni9Enrico Cassano10Breast Imaging Division, IEO European Institute of Oncology IRCCS, 20141 Milan, ItalyBreast Imaging Division, IEO European Institute of Oncology IRCCS, 20141 Milan, ItalyBreast Imaging Division, IEO European Institute of Oncology IRCCS, 20141 Milan, ItalyBreast Imaging Division, IEO European Institute of Oncology IRCCS, 20141 Milan, ItalyBreast Imaging Division, IEO European Institute of Oncology IRCCS, 20141 Milan, ItalyBreast Imaging Division, IEO European Institute of Oncology IRCCS, 20141 Milan, ItalyBreast Imaging Division, IEO European Institute of Oncology IRCCS, 20141 Milan, ItalyDivision of Cancer Prevention and Genetics, IEO European Institute of Oncology IRCCS, 20141 Milan, ItalyDivision of Cancer Prevention and Genetics, IEO European Institute of Oncology IRCCS, 20141 Milan, ItalyDivision of Cancer Prevention and Genetics, IEO European Institute of Oncology IRCCS, 20141 Milan, ItalyBreast Imaging Division, IEO European Institute of Oncology IRCCS, 20141 Milan, ItalyPurpose: This study aimed to investigate the use of contrast-free magnetic resonance imaging (MRI) as an innovative screening method for detecting breast cancer in high-risk asymptomatic women. Specifically, the researchers evaluated the diagnostic performance of diffusion-weighted imaging (DWI) in this population. Methods: MR images from asymptomatic women, carriers of a germline mutation in either the BRCA1 or BRCA2 gene, collected in a single center from January 2019 to December 2021 were retrospectively evaluated. A radiologist with experience in breast imaging (R1) and a radiology resident (R2) independently evaluated DWI/ADC maps and, in case of doubts, T2-WI. The standard of reference was the pathological diagnosis through biopsy or surgery, or ≥1 year of clinical and radiological follow-up. Diagnostic performances were calculated for both readers with a 95% confidence interval (CI). The agreement was assessed using Cohen’s kappa (κ) statistics. Results: Out of 313 women, 145 women were included (49.5 ± 12 years), totaling 344 breast MRIs with DWI/ADC maps. The per-exam cancer prevalence was 11/344 (3.2%). The sensitivity was 8/11 (73%; 95% CI: 46–99%) for R1 and 7/11 (64%; 95% CI: 35–92%) for R2. The specificity was 301/333 (90%; 95% CI: 87–94%) for both readers. The diagnostic accuracy was 90% for both readers. R1 recalled 40/344 exams (11.6%) and R2 recalled 39/344 exams (11.3%). Inter-reader reproducibility between readers was in moderate agreement (κ = 0.43). Conclusions: In female carriers of a BRCA1/2 mutation, breast DWI supplemented with T2-WI allowed breast cancer detection with high sensitivity and specificity by a radiologist with extensive experience in breast imaging, which is comparable to other screening tests. The findings suggest that DWI and T2-WI have the potential to serve as a stand-alone method for unenhanced breast MRI screening in a selected population, opening up new perspectives for prospective trials.https://www.mdpi.com/2075-4418/13/12/1996breast neoplasmradiologymagnetic resonance imagingdiffusion weighted imagingpreventionpersonalized medicine |
| spellingShingle | Anna Rotili Filippo Pesapane Giulia Signorelli Silvia Penco Luca Nicosia Anna Bozzini Lorenza Meneghetti Cristina Zanzottera Sara Mannucci Bernardo Bonanni Enrico Cassano An Unenhanced Breast MRI Protocol Based on Diffusion-Weighted Imaging: A Retrospective Single-Center Study on High-Risk Population for Breast Cancer Diagnostics breast neoplasm radiology magnetic resonance imaging diffusion weighted imaging prevention personalized medicine |
| title | An Unenhanced Breast MRI Protocol Based on Diffusion-Weighted Imaging: A Retrospective Single-Center Study on High-Risk Population for Breast Cancer |
| title_full | An Unenhanced Breast MRI Protocol Based on Diffusion-Weighted Imaging: A Retrospective Single-Center Study on High-Risk Population for Breast Cancer |
| title_fullStr | An Unenhanced Breast MRI Protocol Based on Diffusion-Weighted Imaging: A Retrospective Single-Center Study on High-Risk Population for Breast Cancer |
| title_full_unstemmed | An Unenhanced Breast MRI Protocol Based on Diffusion-Weighted Imaging: A Retrospective Single-Center Study on High-Risk Population for Breast Cancer |
| title_short | An Unenhanced Breast MRI Protocol Based on Diffusion-Weighted Imaging: A Retrospective Single-Center Study on High-Risk Population for Breast Cancer |
| title_sort | unenhanced breast mri protocol based on diffusion weighted imaging a retrospective single center study on high risk population for breast cancer |
| topic | breast neoplasm radiology magnetic resonance imaging diffusion weighted imaging prevention personalized medicine |
| url | https://www.mdpi.com/2075-4418/13/12/1996 |
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