Differentiation of ductal carcinoma in situ versus fibrocystic changes by magnetic resonance imaging: are there pathognomonic imaging features?

Dietzel M, Kaiser CG, Wenkel E, Clauser P, Uder M, Schulz-Wendtland R, Baltzer PAT (2017)

Publication Type: Journal article

Publication year: 2017

Journal

Acta Radiologica SAGE Publications

Pages Range: 284185117690420

DOI: 10.1177/0284185117690420

Abstract

Background In breast magnetic resonance imaging (MRI), the diagnosis of ductal carcinoma in situ (DCIS) remains controversial; the most challenging cause of false-positive DCIS diagnosis is fibrocystic changes (FC). Purpose To search for typical and pathognomonic patterns of DCIS and FC using a standard clinical MRI protocol. Material and Methods Consecutive patients scheduled for breast MRI (standardized protocols @ 1.5T: dynamic-T1-GRE before/after Gd-DTPA [0.1 mmol/kg body weight (BW)]; T1-TSE), with subsequent pathological sampling, were investigated. Sixteen MRI descriptors were prospectively assessed by two experienced radiologists in consensus (blinded to pathology) and explored in patients with DCIS (n = 77) or FC (n = 219). Univariate and multivariate statistics were performed to identify the accuracy of descriptors (alone, combined). Furthermore, pathognomonic descriptor-combinations with an accuracy of 100% were explored (?(2) statistics; decision trees). Results Six breast MRI descriptors significantly differentiated DCIS from FC ( Pcorrected < 0.05; odds ratio < 7.9). Pathognomonic imaging features were present in 33.8% (n = 100) of all cases allowing the identification of 42.9% of FC (n = 94). Conclusion Pathognomonic patterns of DCIS and FC were frequently observed in a standard clinical MRI protocol. Such imaging patterns could decrease the false-positive rate of breast MRI and hence might help to decrease the number of unnecessary biopsies in this clinically challenging subgroup.

Authors with CRIS profile

Evelyn Wenkel Medizinische Fakultät Michael Uder Lehrstuhl für Diagnostische Radiologie

Involved external institutions

Medizinische Universität Wien AT Austria (AT) Universitätsklinikum Mannheim DE Germany (DE)

How to cite

APA:

Dietzel, M., Kaiser, C.G., Wenkel, E., Clauser, P., Uder, M., Schulz-Wendtland, R., & Baltzer, P.A.T. (2017). Differentiation of ductal carcinoma in situ versus fibrocystic changes by magnetic resonance imaging: are there pathognomonic imaging features? Acta Radiologica, 284185117690420. https://dx.doi.org/10.1177/0284185117690420

MLA:

Dietzel, Matthias, et al. "Differentiation of ductal carcinoma in situ versus fibrocystic changes by magnetic resonance imaging: are there pathognomonic imaging features?" Acta Radiologica (2017): 284185117690420.

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