Differentiation between benign and malignant findings on MR-mammography: usefulness of morphological criteria

Eur Radiol. 2001;11(9):1645-50. doi: 10.1007/s003300100885.

Abstract

The purpose of this study was to evaluate the usefulness of morphological criteria in differentiating between benign and malignant lesions on MR-mammography. Fifty-three women (18-82 years) with 62 lesions scheduled for excisional biopsy underwent dynamic contrast-enhanced MR-mammography using fast 3D Gradient-Echo sequences in coronal orientation (axial orientation in seven patients). Histology revealed 44 malignant and 18 benign lesions. For each lesion, five radiologists evaluated four morphological features: lesion shape, irregularity of contour, homogeneity of contrast enhancement and presence of ring enhancement. For each feature a receiver operating characteristic (ROC) curve was generated with calculation of the area under the curve (AUC). Interobserver variability was evaluated by the kappa-coefficient. The most reliable morphological feature indicating malignancy was an irregular lesion contour with a sensitivity/specificity/AUC of 83%/76%/0.9 followed by inhomogeneous contrast enhancement (85%/42%/0.7) and the presence of ring enhancement (71%/53%/0.64). The average interobserver agreement for the different features ranged between 0.35 and 0.4. Morphological criteria are useful features in MR-mammography for differentiating between benign and malignant lesions. However, due to the relatively high interobserver variability, standardization of terminology is important.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Area Under Curve
  • Biopsy
  • Breast / pathology
  • Breast Diseases / diagnosis*
  • Breast Neoplasms / diagnosis*
  • Diagnosis, Differential
  • Female
  • Humans
  • Image Enhancement*
  • Image Processing, Computer-Assisted*
  • Imaging, Three-Dimensional*
  • Magnetic Resonance Imaging*
  • Mammography*
  • Middle Aged
  • Observer Variation
  • ROC Curve
  • Sensitivity and Specificity