Browse > Article
http://dx.doi.org/10.3348/kjr.2016.17.1.59

Features of Undiagnosed Breast Cancers at Screening Breast MR Imaging and Potential Utility of Computer-Aided Evaluation  

Seo, Mirinae (Department of Radiology, Seoul National University Hospital)
Cho, Nariya (Department of Radiology, Seoul National University Hospital)
Bae, Min Sun (Department of Radiology, Seoul National University Hospital)
Koo, Hye Ryoung (Department of Radiology, Seoul National University Hospital)
Kim, Won Hwa (Department of Radiology, Seoul National University Hospital)
Lee, Su Hyun (Department of Radiology, Seoul National University Hospital)
Chu, Ajung (Department of Radiology, Seoul National University Hospital)
Publication Information
Korean Journal of Radiology / v.17, no.1, 2016 , pp. 59-68 More about this Journal
Abstract
Objective: To retrospectively evaluate the features of undiagnosed breast cancers on prior screening breast magnetic resonance (MR) images in patients who were subsequently diagnosed with breast cancer, as well as the potential utility of MR-computer-aided evaluation (CAE). Materials and Methods: Between March 2004 and May 2013, of the 72 consecutive pairs of prior negative MR images and subsequent MR images with diagnosed cancers (median interval, 32.8 months; range, 5.4-104.6 months), 36 (50%) had visible findings (mean size, 1.0 cm; range, 0.3-5.2 cm). The visible findings were divided into either actionable or underthreshold groups by the blinded review by 5 radiologists. MR imaging features, reasons for missed cancer, and MR-CAE features according to actionability were evaluated. Results: Of the 36 visible findings on prior MR images, 33.3% (12 of 36) of the lesions were determined to be actionable and 66.7% (24 of 36) were underthreshold; 85.7% (6 of 7) of masses and 31.6% (6 of 19) of non-mass enhancements were classified as actionable lesions. Mimicking physiologic enhancements (27.8%, 10 of 36) and small lesion size (27.8%, 10 of 36) were the most common reasons for missed cancer. Actionable findings tended to show more washout or plateau kinetic patterns on MR-CAE than underthreshold findings, as the 100% of actionable findings and 46.7% of underthreshold findings showed washout or plateau (p = 0.008). Conclusion: MR-CAE has the potential for reducing the number of undiagnosed breast cancers on screening breast MR images, the majority of which are caused by mimicking physiologic enhancements or small lesion size.
Keywords
False negative breast cancer; Magnetic resonance imaging; Computer-aided evaluation;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Hambly NM, Liberman L, Dershaw DD, Brennan S, Morris EA. Background parenchymal enhancement on baseline screening breast MRI: impact on biopsy rate and short-interval followup. AJR Am J Roentgenol 2011;196:218-224   DOI
2 Lehman CD, Blume JD, DeMartini WB, Hylton NM, Herman B, Schnall MD. Accuracy and interpretation time of computeraided detection among novice and experienced breast MRI readers. AJR Am J Roentgenol 2013;200:W683-W689   DOI
3 Cho N, Kim SM, Park JS, Jang M, Kim SY, Chang JM, et al. Contralateral lesions detected by preoperative MRI in patients with recently diagnosed breast cancer: application of MR CAD in differentiation of benign and malignant lesions. Eur J Radiol 2012;81:1520-1526   DOI
4 Su MY, Cheung YC, Fruehauf JP, Yu H, Nalcioglu O, Mechetner E, et al. Correlation of dynamic contrast enhancement MRI parameters with microvessel density and VEGF for assessment of angiogenesis in breast cancer. J Magn Reson Imaging 2003;18:467-477   DOI
5 Lee SH, Cho N, Kim SJ, Cha JH, Cho KS, Ko ES, et al. Correlation between high resolution dynamic MR features and prognostic factors in breast cancer. Korean J Radiol 2008;9:10-18   DOI
6 Liu YH, Xu L, Liu LH, Liu XS, Hou ZY, Hou DL, et al. 3.0T MRCAD: Clinical Value in Diagnosis of Breast Tumor Compared with Conventional MRI. J Cancer 2014;5:585-589   DOI
7 Teifke A, Hlawatsch A, Beier T, Werner Vomweg T, Schadmand S, Schmidt M, et al. Undetected malignancies of the breast: dynamic contrast-enhanced MR imaging at 1.0 T. Radiology 2002;224:881-888   DOI
8 Soderstrom CE, Harms SE, Farrell RS Jr, Pruneda JM, Flamig DP. Detection with MR imaging of residual tumor in the breast soon after surgery. AJR Am J Roentgenol 1997;168:485-488   DOI
9 Belli P, Costantini M, Romani M, Marano P, Pastore G. Magnetic resonance imaging in breast cancer recurrence. Breast Cancer Res Treat 2002;73:223-235   DOI
10 Saslow D, Boetes C, Burke W, Harms S, Leach MO, Lehman CD, et al. American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin 2007;57:75-89   DOI
11 Kriege M, Brekelmans CT, Boetes C, Besnard PE, Zonderland HM, Obdeijn IM, et al. Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition. N Engl J Med 2004;351:427-437   DOI
12 Kuhl CK, Schrading S, Leutner CC, Morakkabati-Spitz N, Wardelmann E, Fimmers R, et al. Mammography, breast ultrasound, and magnetic resonance imaging for surveillance of women at high familial risk for breast cancer. J Clin Oncol 2005;23:8469-8476   DOI
13 Warner E, Plewes DB, Hill KA, Causer PA, Zubovits JT, Jong RA, et al. Surveillance of BRCA1 and BRCA2 mutation carriers with magnetic resonance imaging, ultrasound, mammography, and clinical breast examination. JAMA 2004;292:1317-1325   DOI
14 Sardanelli F, Podo F, D'Agnolo G, Verdecchia A, Santaquilani M, Musumeci R, et al. Multicenter comparative multimodality surveillance of women at genetic-familial high risk for breast cancer (HIBCRIT study): interim results. Radiology 2007;242:698-715   DOI
15 Leach MO, Boggis CR, Dixon AK, Easton DF, Eeles RA, Evans DG, et al. Screening with magnetic resonance imaging and mammography of a UK population at high familial risk of breast cancer: a prospective multicentre cohort study (MARIBS). Lancet 2005;365:1769-1778   DOI
16 Pages EB, Millet I, Hoa D, Doyon FC, Taourel P. Undiagnosed breast cancer at MR imaging: analysis of causes. Radiology 2012;264:40-50   DOI
17 Kuhl CK, Schrading S, Bieling HB, Wardelmann E, Leutner CC, Koenig R, et al. MRI for diagnosis of pure ductal carcinoma in situ: a prospective observational study. Lancet 2007;370:485-492   DOI
18 Baur A, Bahrs SD, Speck S, Wietek BM, Kramer B, Vogel U, et al. Breast MRI of pure ductal carcinoma in situ: sensitivity of diagnosis and influence of lesion characteristics. Eur J Radiol 2013;82:1731-1737   DOI
19 Obdeijn IM, Loo CE, Rijnsburger AJ, Wasser MN, Bergers E, Kok T, et al. Assessment of false-negative cases of breast MR imaging in women with a familial or genetic predisposition. Breast Cancer Res Treat 2010;119:399-407   DOI
20 Birdwell RL, Ikeda DM, O'Shaughnessy KF, Sickles EA. Mammographic characteristics of 115 missed cancers later detected with screening mammography and the potential utility of computer-aided detection. Radiology 2001;219:192-202   DOI
21 Ikeda DM, Birdwell RL, O'Shaughnessy KF, Sickles EA, Brenner RJ. Computer-aided detection output on 172 subtle findings on normal mammograms previously obtained in women with breast cancer detected at follow-up screening mammography. Radiology 2004;230:811-819   DOI
22 Williams TC, DeMartini WB, Partridge SC, Peacock S, Lehman CD. Breast MR imaging: computer-aided evaluation program for discriminating benign from malignant lesions. Radiology 2007;244:94-103   DOI
23 Wang LC, DeMartini WB, Partridge SC, Peacock S, Lehman CD. MRI-detected suspicious breast lesions: predictive values of kinetic features measured by computer-aided evaluation. AJR Am J Roentgenol 2009;193:826-831   DOI
24 DeMartini WB, Liu F, Peacock S, Eby PR, Gutierrez RL, Lehman CD. Background parenchymal enhancement on breast MRI: impact on diagnostic performance. AJR Am J Roentgenol 2012;198:W373-W380   DOI
25 Yamaguchi K, Schacht D, Newstead GM, Bradbury AR, Verp MS, Olopade OI, et al. Breast cancer detected on an incident (second or subsequent) round of screening MRI: MRI features of false-negative cases. AJR Am J Roentgenol 2013;201:1155-1163   DOI
26 Morris EA, Comstock CE, Lee CH. ACR BI-RADS$^{(R)}$ Magnetic Resonance Imaging. In: ACR BI-RADS$^{(R)}$ Atlas, Breast Imaging Reporting and Data System. Reston, VA: American College of Radiology, 2013
27 Mahoney MC, Gatsonis C, Hanna L, DeMartini WB, Lehman C. Positive predictive value of BI-RADS MR imaging. Radiology 2012;264:51-58   DOI