US and MRI in the evaluation of mammographic BI-RADS 4 and 5 microcalcifications

Scientific paper - Original scientific paper

• Author: Ana Hrkac Pustahija
• Author: Gordana Ivanac
• Author: Boris Brkljačić
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

PURPOSE:

The aim of this study was to assess diagnostic accuracies of ultrasonography (US) and magnetic resonance imaging (MRI) in lesions that manifest as mammographic BI-RADS 4 and 5 microcalcifications, in the setting of conjoined use of mammography, US, and MRI. -----

METHODS:

Patients with mammographic BI-RADS 4 or 5 microcalcifications, without additional findings, were included in this prospective study. All patients subsequently underwent breast US and MRI. Histopathologic diagnosis, obtained by US-guided core-needle biopsy or surgical excision, served as a reference standard. Diagnostic accuracies of US and MRI were calculated, and positive predictive value for different MRI BI-RADS imaging features were determined. -----

RESULTS:

The study group consisted of 113 women with 125 areas of suspicious microcalcifications. MRI reached sensitivity, specificity, positive predictive value 3 (PPV3), and negative predictive value (NPV) of 100%, 70.1%, 67.6%, and 100%, respectively. Statistically significant differences in MRI morphologic features and kinetic enhancement curves were observed between malignant and benign microcalcifications. Sensitivity, specificity, PPV3, and NPV for US were: 85.4%, 66.2%, 61.2%, and 87.9%. There was statistically significant difference in presentation of malignant and benign microcalcifications at US. -----

CONCLUSION:

In the setting of conjoined use of mammography, US, and MRI, MRI can reliably exclude malignancy in suspicious microcalcifications. Thus, negative MRI findings may influence the decision to biopsy the microcalcifications.

• Keywords (english): Adult; Aged; Breast/diagnostic imaging; Breast/pathology; Breast Neoplasms/diagnostic imaging; Breast Neoplasms/pathology; Calcinosis/diagnostic imaging; Calcinosis/pathology; Female; Humans; Magnetic Resonance Imaging/methods; Middle Aged; Prospective Studies; Radiology Information Systems; Reproducibility of Results; Sensitivity and Specificity; Severity of Illness Index; Ultrasonography, Mammary/methods
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Diagnostic and Interventional Radiology
• Numbering: vol. 24, no. 4, pp. 187-194
• p-ISSN: 1305-3612
• DOI: https://doi.org/10.5152/dir.2018.17414
• URN:NBN: urn:nbn:hr:105:705549
• Publication: 2018-07
• Document URL: https://doi.org/10.5152/dir.2018.17414
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-28 09:57:49