MRI technique differentiates benign breast lesions from malignancies

February 20, 2018, Radiological Society of North America
Two-dimensional sections of a three-dimensional acquisition of images of a malignant tumor. Diffusion weighted imaging (DWI) with b values of (a) 0, (b) 100, (c) 750, and (d) 1500 sec/mm2. Apparent diffusion coefficient (ADC) map and apparent kurtosis coefficient (AKC) map show the resulting pixel values after Kurtosis fitting. Notably, white pixels inside lesion constitute background after exclusion for not matching the fit criteria. Credit: Radiological Society of North America

An MRI breast imaging technique that requires no contrast agent, combined with sophisticated data analysis, could reduce the number of unnecessary breast biopsies, according to a new study appearing online in the journal Radiology.

Breast MRI currently is used to screen women at high risk of cancer and as a diagnostic adjunct to mammography. The examination relies on gadolinium-based contrast agents that need to be injected intravenously.

Researchers recently studied an alternative approach that eliminates the need for in some cases by using diffusion-weighted imaging (DWI) measurements derived from MRI. The technique, known as diffusion kurtosis imaging, provides a picture of breast tissue on a microstructural level.

"Diffusion kurtosis imaging has been introduced in DWI to provide important information on at a microscopic level," said study lead author Sebastian Bickelhaupt, M.D., from the German Cancer Research Center in Heidelberg, Germany. "Since malignant lesions disrupt the tissue structures at this level, diffusion kurtosis might serve as a relevant marker of changes."

Dr. Bickelhaupt, co-lead author Paul Jaeger, M.Sc., and colleagues evaluated a retrospective analysis of data collected from 222 women at two independent study sites. The women had suspicious findings on mammography that were classified under the Breast Imaging Reporting and Data System (BI-RADS) as BI-RADS 4 and 5 . A BI-RADS 4 lesion is considered a suspicious abnormality, while a 5 is considered highly suspicious of malignancy. The women underwent DWI followed by biopsy.

Receiver operating characteristic plot for the radiomics model, apparent kurtosis coefficient (AKC) median and apparent diffusion coefficient (ADC) median. Dots illustrate the resulting thresholds. Credit: Radiological Society of North America

For the analysis, a software algorithm was developed for lesion characterization, and imaging features were extracted using a kurtosis-based radiomics model. Radiomics is a rapidly growing field that enables the extraction of a large amount of quantifiable data from .

In an independent test set of 127 women, the radiomics analysis reduced false-positive findings by 70 percent, while detecting 60 of 61 , or 98 percent.

"The model might help to lower the number of BI-RADS 4 lesions suspected of being cancer on the basis of screening mammography while retaining a high sensitivity similar to the sensitivity reported for biopsies themselves," Jaeger said.

Should the results hold in larger trials, the model has potential advantages in the clinic beyond its ability to reduce unnecessary biopsies in women with BI-RADS 4 . The software algorithm makes the assessment reader-independent, ensuring that its accuracy is maintained across different imaging facilities.

Flow diagram shows patient selection in the independent test set. DWI = Diffusion weighted imaging, t = result of the threshold calculation; tc = cut-off threshold to differentiate between benign and malignant lesions. Credit: Radiological Society of North America

The new approach is not intended to replace current contrast-enhanced breast MRI protocols in general, Dr. Bickelhaupt emphasized, but to expand the spectrum of options available for answering specific clinical questions.

"This might also improve the efficiency of reporting," he said.

Explore further: MRI technique could reduce need for breast biopsies

More information: "Radiomics Based on Adapted Diffusion Kurtosis Imaging Helps to Clarify Most Mammographic Findings Suspicious for Cancer" Radiology, 2018.

Related Stories

MRI technique could reduce need for breast biopsies

September 29, 2015
A magnetic resonance (MR) breast imaging technique that uses no ionizing radiation or contrast agent could reduce unnecessary biopsies by providing additional information about suspicious findings on X-ray screening mammography, ...

Multicenter trial finds BI-RADS 3 breast lesions have low cancer rate

August 20, 2013
Based on data from a multi-site imaging trial involving more than 2,600 women, researchers say breast lesions categorized as 'probably benign' on supplemental screening ultrasound could be re-evaluated with imaging in 12 ...

Low rate of malignancy for BI-RADS category 3 lesions

December 4, 2013
(HealthDay)—A low malignancy rate is observed for Breast Imaging Reporting and Data System (BI-RADS) category 3 breast lesions detected by screening ultrasonography (US), according to research published in the December ...

Study examines BI-RADS and MRI in predicting breast cancer

May 15, 2012
A large, multicenter study found that the Breast Imaging and Reporting Data Systems (BI-RADS) terminology used by radiologists to classify breast imaging results is useful in predicting malignancy in breast lesions detected ...

MR imaging clarifies ambiguous mammography results

February 5, 2018
A study of around 300 volunteers, conducted in Austria by MedUni Vienna in collaboration with Diagnostic Graz, convincingly shows that Magnetic Resonance Imaging (MRI) is the best choice for clarifying ambiguous mammography ...

Recommended for you

Mechanism that drives development of liver cancer brought on by non-alcoholic fatty liver disease discovered

April 19, 2018
A team of researchers from several institutions in China has found a mechanism that appears to drive the development of a type of liver cancer not caused by alcohol consumption. In their paper published in the journal Science ...

Discovery adds to evidence that some children are predisposed to develop leukemia

April 19, 2018
St. Jude Children's Research Hospital researchers have made a discovery that expands the list of genes to include when screening individuals for possible increased susceptibility to childhood leukemia. The finding is reported ...

Scientists identify 170 potential lung cancer drug targets using unique cellular library

April 19, 2018
After testing more than 200,000 chemical compounds, UT Southwestern's Simmons Cancer Center researchers have identified 170 chemicals that are potential candidates for development into drug therapies for lung cancer.

Chip-based blood test for multiple myeloma could make bone biopsies a relic of the past

April 19, 2018
The diagnosis and treatment of multiple myeloma, a cancer affecting plasma cells, traditionally forces patients to suffer through a painful bone biopsy. During that procedure, doctors insert a bone-biopsy needle through an ...

Study may explain why some triple-negative breast cancers are resistant to chemotherapy

April 19, 2018
Triple-negative breast cancer (TNBC) is an aggressive form of the disease accounting for 12 to 18 percent of breast cancers. It is a scary diagnosis, and even though chemotherapy can be effective as standard-of-care, many ...

Protein can slow intestinal tumor growth

April 19, 2018
A new mechanism for regulating stem cells in the intestine of fruit flies has been discovered by researchers at Stockholm University. In addition, it was discovered that a certain protein can slow the growth of tumours in ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.