2013 Volume 22 Issue 3 Pages 403-410
Purpose: The purpose of this study was to retrospectively evaluate the feasibility of dynamic contrast enhancement MRI (DCE-MRI)for stereotactic vacuum-assisted breast biopsy (ST-VAB) in cases of category 3 (C-3) micro-calcification detected by mammographic breast cancer screening. Materials and methods: A retrospective study was performed on 42 patients (no particular findings; N.P.： 10, Mastopathy: 27, DCIS： 5) diagnosed as having C-3 lesions who had undergone ST-VAB and DCE-MRI. After pre-contrast MRI had been performed using 1.5T or 3.0T systems, DCE-MRI was performed four times following intravenous administration of contrast medium. We categorized the lesion morphology as ”focus”, ”mass” or ”non-mass” according to the Breast-Imaging Reporting and Data System MRI (BI-RADS-MRI). Mass lesions and non-mass lesions were classified according to shape, margin, distribution and internal enhancement pattern. In addition, we set the volumes of interest (VOIs) on the lesions and normal mammary gland tissue, and calculated the wash-in rate (WRin), washout rate (WRout), Slopeearly and Slopelate. Results: Three cases were not enhanced by DCE-MRI, and all were non-DCIS. Differentiation according to feature type and descriptors demonstrated no significant difference among the N.P., Mastopathy and DCIS groups. On the other hand, WRin and Slopeearly of DCIS showed higher values than the N.P. and Mastopathy groups. There were significant differences in WRin and Slopeearly among the N.P., Mastopathy and DCIS groups. In particular, Slopeearly showed high diagnostic performance(sensitivity: 100%, specificity: 97.1%, positive predictive value: 83.3%, negative predictive value: 100%, and accuracy: 97.4%). Conclusion: WRin and Slopeearly of DCE-MRI are useful for deciding on the use of ST-VAB for C-3 lesions with micro-calcification.
