Morphology evaluation of nonmass enhancement on breast MRI: Effect of a three-step interpretation model for readers' performances and biopsy recommendations

Akiko Shimauchi, Hideki Ota, Youichi Machida, Tamiko Yoshida, Nozomi Satani, Naoko Mori, Kei Takase, Mitsuhiro Tozaki

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective To evaluate and compare the use of a newly introduced interpretation model for breast nonmass enhancement (NME, defined as an area of enhancement without a three-dimensional, space-occupying lesion) with the use of the standard interpretation method based on BI-RADS. Materials and methods Two expert and two less-experienced breast imaging radiologists performed reading sessions of 86 malignant and 64 benign NME lesions twice. First, radiologists characterized NME using BI-RADS descriptors and assessed the likelihood of malignancy and need for a biopsy. Second, the likelihood of malignancy and need for a biopsy were assessed with the use of the model, in which three-step characterization of morphological features were performed: (1) selection of distribution modifiers, (2) homogeneous vs. heterogeneous internal enhancement (IE) pattern, and (3) evaluation of presence of "clumped", "clustered ring enhancement (CRE)", and "branching" IE signs. Multireader-multicase receiver operating characteristic analysis was used to evaluate observers' performances. Univariate and multivariate logistic regression analyses were performed for morphology descriptors. Results With use of the model, average Az of less-experienced radiologists (0.77-0.83; p = 0.013) and average sensitivity of all radiologists (96.2-98.2%; p = 0.007) improved significantly. NPV also improved but nonsignificantly (81.1-91.9%; p = 0.055). Multivariate analyses of the second reading showed branching, clumped, and CRE signs to be significant predictors of malignancy in the results of 3, 2, and 2 readers, respectively. Conclusion The three-step interpretation model for NME has the potential to improve less-experienced radiologists' performances, making them comparable to expert breast imagers.

Original languageEnglish
Pages (from-to)480-488
Number of pages9
JournalEuropean Journal of Radiology
Volume85
Issue number2
DOIs
Publication statusPublished - 2016 Feb 1

Keywords

  • Breast
  • Breast tumors
  • Cancer
  • Magnetic resonance imaging
  • Radiology

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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