Purpose: To determine the role and the diagnostic accuracy of breast Magnetic Resonance Imaging in the evaluation of patients with suspicious discharge from the nipple. Methods: 79 patients with suspicious nipple discharge underwent 3 Tesla MRI. Images were acquired with T2-IDEAL sequences, diffusion-weighted sequences as well as 3D T1-weighted sequences before and after the administration of 0.1 mmol/kg of gadobenate dimeglumine. MRI findings were classified according to Breast Imaging Reporting and Data System criteria as benign (BIRADS 1-2-3) or malignant (BIRADS 4-5). Reference diagnoses were based on histologic samples obtained at surgery for 51 patients and on clinical and instrumental follow-up over 24 months for 28 patients. Results: MRI identified 32 cases of BIRADS 4-5, 27 of which were found to be malignant at histological examination. In the 47 cases classified as BIRADS 1-2-3, 17 lesions were confirmed as benign by definitive histological examination, 2 lesions were found to be a malignant tumor and 28 patients had negative follow-up at 24 months. Sensitivity, specificity and diagnostic accuracy of MRI were respectively 93.1%, 90% and 91.1% with a positive predictive value of 84.3% and negative predictive value of 95.7%. The performance of MRI was also evaluated in comparison of positive cases of mammography and ultrasound. Conclusion: Breast MRI is an accurate method in the evaluation of patients with suspicious nipple secretion. A negative MRI can direct patients to follow-up rather than surgery. Keywords Magnetic resonance imaging, Nipple discharge, Breast cancer, Breast imaging
Diagnostic accuracy of breast MRI compared with conventional imaging, in the evaluation of patients with suspicious nipple discharge / Panzironi, Giovanna; Galati, Francesca; Marzocca, Flaminia; Kirchin, Miles; Pediconi, Federica. - In: INTERNATIONAL JOURNAL OF BIOLOGICAL INSTRUMENTATION. - ISSN 2631-5025. - 1:1(2018). [10.35840/2631-5025/5103]
Diagnostic accuracy of breast MRI compared with conventional imaging, in the evaluation of patients with suspicious nipple discharge
Giovanna Panzironi
Primo
;Francesca GalatiSecondo
;Flaminia Marzocca;Federica PediconiUltimo
2018
Abstract
Purpose: To determine the role and the diagnostic accuracy of breast Magnetic Resonance Imaging in the evaluation of patients with suspicious discharge from the nipple. Methods: 79 patients with suspicious nipple discharge underwent 3 Tesla MRI. Images were acquired with T2-IDEAL sequences, diffusion-weighted sequences as well as 3D T1-weighted sequences before and after the administration of 0.1 mmol/kg of gadobenate dimeglumine. MRI findings were classified according to Breast Imaging Reporting and Data System criteria as benign (BIRADS 1-2-3) or malignant (BIRADS 4-5). Reference diagnoses were based on histologic samples obtained at surgery for 51 patients and on clinical and instrumental follow-up over 24 months for 28 patients. Results: MRI identified 32 cases of BIRADS 4-5, 27 of which were found to be malignant at histological examination. In the 47 cases classified as BIRADS 1-2-3, 17 lesions were confirmed as benign by definitive histological examination, 2 lesions were found to be a malignant tumor and 28 patients had negative follow-up at 24 months. Sensitivity, specificity and diagnostic accuracy of MRI were respectively 93.1%, 90% and 91.1% with a positive predictive value of 84.3% and negative predictive value of 95.7%. The performance of MRI was also evaluated in comparison of positive cases of mammography and ultrasound. Conclusion: Breast MRI is an accurate method in the evaluation of patients with suspicious nipple secretion. A negative MRI can direct patients to follow-up rather than surgery. Keywords Magnetic resonance imaging, Nipple discharge, Breast cancer, Breast imagingFile | Dimensione | Formato | |
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