Enhanced Detection of Residual Breast Cancer Post-Excisional Biopsy: Comparative Analysis of Contrast-Enhanced MRI with and Without Diffusion-Weighted Imaging
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Clinical and Histopathology Review
2.3. MRI Protocols
2.4. MRI Analysis
2.5. Mammography/Ultrasound Interpretation
2.6. Statistical Analysis
3. Results
3.1. Clinical and Pathologic Characteristics, Along with Final Treatment Results
3.2. Image Analysis Results
3.3. The Diagnostic Performance of the Imaging Modalities
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Total | |
---|---|
n = 152 | |
Age (years) | |
Mean ± SD | 51 ± 11 |
Median (IQR) | 49 (44, 57) |
Excisional biopsy pathology | |
Non-invasive | 97 (63.8) |
Invasive | 55 (36.2) |
Excisional biopsy to MRI time interval (days) | |
Mean ± SD | 15.9 ± 9.4 |
Median (IQR) | 14 (9, 20) |
Treatment options | |
Surgery (n = 99, 65.1%) | |
Breast-conserving surgery | 36 (36.4) |
Breast-conserving surgery with SLNB | 34 (34.3) |
Mastectomy only | 1 (1) |
Mastectomy with SLNB | 16 (16.2) |
SLNB only | 12 (12.1) |
Non-surgical management (n = 53, 34.9%) | |
Radiation therapy | 45 (84.9) |
Surveillance with follow-up MRI | 8 (15.1) |
MRI to surgery time interval (days) | |
Mean ± SD | 14.7 ± 12.1 |
Median (IQR) | 11 (6, 19) |
Final results for presence of residual lesion | |
Absent | 97 (63.8) |
Present | 55 (36.2) |
Final residual lesion size (cm) | |
Mean ± SD | 2.6 ± 3 |
Median (IQR) | 1.2 (0.4, 4.2) |
Final diagnosis of lymph node metastasis | |
Absent | 146 (96.1) |
Present | 6 (4) |
Total | Absent | Present | ||
---|---|---|---|---|
n = 152 | n = 97 | n = 55 | p-Value | |
Fibroglandular tissue | 0.435 | |||
Non-dense | 27 (17.8) | 19 (19.6) | 8 (14.6) | |
Dense | 125 (82.2) | 78 (80.4) | 47 (85.5) | |
BPE | 0.764 | |||
Minimal to mild | 86 (56.6) | 54 (55.7) | 32 (58.2) | |
Moderate to marked | 66 (43.4) | 43 (44.3) | 23 (41.8) | |
Morphology of enhancement | <0.001 | |||
No or minimal | 11 (7.2) | 8 (8.3) | 3 (5.5) | |
Linear and thin (<2 mm) | 59 (38.8) | 58 (59.8) | 1 (1.8) | |
Thick or irregular | 36 (23.7) | 19 (19.6) | 17 (30.9) | |
Nodular or non-mass | 46 (30.3) | 12 (12.4) | 34 (61.8) | |
Predicted residual size (cm) | <0.001 | |||
Mean ± SD | 1.5 ± 2.2 | 0.6 ± 1.4 | 2.9 ± 2.7 | |
Median (IQR) | 0.6 (0, 1.6) | 0 (0, 0.8) | 1.5 (0.8, 5.1) | |
Categorized into groups | <0.001 | |||
≤1 cm | 99 (65.1) | 78 (80.4) | 21 (38.2) | |
>1 cm | 53 (34.9) | 19 (19.6) | 34 (61.8) | |
Kinetics | <0.001 | |||
Unassessable | 7 (4.6) | 3 (3.1) | 4 (7.3) | |
Delayed persistent/plateau | 130 (85.5) | 93 (95.9) | 37 (67.3) | |
Delayed washout | 15 (9.9) | 1 (1) | 14 (25.5) | |
ADC value (mm2/s) | <0.001 | |||
≥1.5 × 10−3 or unassessable | 120 (79) | 95 (97.9) | 25 (45.5) | |
1.0 to <1.5 × 10−3 | 23 (15.1) | 2 (2.1) | 21 (38.2) | |
<1.0 × 10−3 | 9 (5.9) | - | 9 (16.4) | |
CE- MRI diagnosis | <0.001 | |||
Absent | 77 (50.7) | 71 (73.2) | 6 (10.9) | |
Present | 75 (49.3) | 26 (26.8) | 49 (89.1) | |
CE-MRI with DWI diagnosis | <0.001 | |||
Absent | 78 (51.3) | 73 (75.3) | 5 (9.1) | |
Present | 74 (48.7) | 24 (24.7) | 50 (90.9) | |
MRI for LN metastasis | 0.069 | |||
Absent | 134 (88.2) | 89 (91.8) | 45 (81.8) | |
Present | 18 (11.8) | 8 (8.3) | 10 (18.2) |
Sensitivity | Specificity | PPV | NPV | Accuracy | |
---|---|---|---|---|---|
(95% CI) | (95% CI) | (95% CI) | (95% CI) | (95% CI) | |
MG | 57.1 | 62.9 | 55.2 | 64.7 | 60.3 |
(37.2–75.5) | (44.9–78.5) | (35.7–73.6) | (46.5–80.3) | (47.2–72.4) | |
US | 38.7 | 77.8 | 60.0 | 59.6 | 59.7 |
(21.9–57.8) | (60.9–89.9) | (36.1–80.9) | (44.3–73.6) | (47.0–71.5) | |
CE-MRI | 89.1 | 73.2 | 65.3 | 92.2 | 79.0 |
(77.8–95.9) | (63.2–81.7) | (53.5–76.0) | (83.8–97.1) | (71.6–85.1) | |
CE-MRI with DWI | 90.9 | 75.3 | 67.6 | 93.6 | 80.9 |
(80.1–97.0) | (65.5–83.5) | (55.7–78.0) | (85.7–97.9) | (73.8–86.8) | |
≤14 days | |||||
CE-MRI | 82.8 | 81.0 | 75.0 | 87.2 | 81.7 |
(64.2–94.2) | (65.9–91.4) | (56.6–88.5) | (72.6–95.7) | (70.7–89.9) | |
CE-MRI with DWI | 86.2 | 83.3 | 78.1 | 89.7 | 84.5 |
(68.3–96.1) | (68.6–93.0) | (60.0–90.7) | (75.8–97.1) | (74.0–92.0) | |
>14 days | |||||
CE-MRI | 100 | 66.7 | 52.8 | 100 | 75.7 |
(82.4–100) | (52.1–79.2) | (35.5–69.6) | (89.7–100) | (64.0–85.2) | |
CE-MRI with DWI | 100 | 68.6 | 54.3 | 100 | 77.1 |
(82.4–100) | (54.1–80.9) | (36.7–71.2) | (90.0–100) | (65.7–86.3) | |
≤1 cm | |||||
CE-MRI | 71.4 | 88.5 | 62.5 | 92.0 | 84.9 |
(47.8–88.7) | (79.2–94.6) | (40.6–81.2) | (83.4–97.0) | (76.2–91.3) | |
CE-MRI with DWI | 76.2 | 88.5 | 64.0 | 93.2 | 85.9 |
(52.8–91.8) | (79.2–94.6) | (42.5–82.0) | (84.9–97.8) | (77.4–92.1) | |
>1cm | |||||
CE-MRI | 100 | 10.5 | 66.7 | 100 | 67.9 |
(89.7–100) | (1.3–33.1) | (52.1–79.2) | (15.8–100) | (53.7–80.1) | |
CE-MRI with DWI | 100 | 21.1 | 69.4 | 100 | 71.7 |
(89.7–100) | (6.1–45.6) | (54.6–81.8) | (39.8–100) | (57.7–83.2) |
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Mun, H.S.; Kang, B.J.; Kim, S.H.; Park, G.E. Enhanced Detection of Residual Breast Cancer Post-Excisional Biopsy: Comparative Analysis of Contrast-Enhanced MRI with and Without Diffusion-Weighted Imaging. Tomography 2025, 11, 10. https://doi.org/10.3390/tomography11010010
Mun HS, Kang BJ, Kim SH, Park GE. Enhanced Detection of Residual Breast Cancer Post-Excisional Biopsy: Comparative Analysis of Contrast-Enhanced MRI with and Without Diffusion-Weighted Imaging. Tomography. 2025; 11(1):10. https://doi.org/10.3390/tomography11010010
Chicago/Turabian StyleMun, Han Song, Bong Joo Kang, Sung Hun Kim, and Ga Eun Park. 2025. "Enhanced Detection of Residual Breast Cancer Post-Excisional Biopsy: Comparative Analysis of Contrast-Enhanced MRI with and Without Diffusion-Weighted Imaging" Tomography 11, no. 1: 10. https://doi.org/10.3390/tomography11010010
APA StyleMun, H. S., Kang, B. J., Kim, S. H., & Park, G. E. (2025). Enhanced Detection of Residual Breast Cancer Post-Excisional Biopsy: Comparative Analysis of Contrast-Enhanced MRI with and Without Diffusion-Weighted Imaging. Tomography, 11(1), 10. https://doi.org/10.3390/tomography11010010