Sensitivity and specificity of unenhanced MR mammography (DWI combined with T2-weighted TSE imaging, ueMRM) for the differentiation of mass lesions

Eur Radiol. 2010 May;20(5):1101-10. doi: 10.1007/s00330-009-1654-5. Epub 2009 Nov 20.


Objective: This study was performed to assess the sensitivity and specificity for malignant and benign mass lesions of a diagnostic approach combining DWI with T2-weighted images (unenhanced MR mammography, ueMRM) and compare the results with contrast-enhanced MR mammography (ceMRM).

Materials and methods: Consecutive patients undergoing histopathological verification of mass lesions after MR mammography without prior breast interventions (contrast-enhanced T1-weighted, T2-weighted and DWI sequences) were eligible for this retrospective investigation. Two blinded observers first rated ueMRM and then ceMRM according to the BIRADS scale. Lesion size, ADC values and T2-weighted TSE descriptors were assessed.

Results: This study examined 81 lesions (27 benign, 54 malignant). Sensitivity of ueMRM was 93% (observer 1) and 86% (observer 2), respectively. Sensitivity of ceMRM was 96.5% (observer 1) and 98.3% (observer 2). Specificity was 85.2% (ueMRM) and 92.6% (ceMRM) for both observers. The differences between both methods and observers were not significant (P > or = 0.09). Lesion size measurements did not differ significantly among all sequences analyzed. Tumor visibility was worse using ueMRM for both benign (P < 0.001) and malignant lesions (P = 0.004).

Conclusion: Sensitivity and specificity of ueMRM in mass lesions equal that of ceMRM. However, a reduced lesion visibility in ueMRM may lead to more false-negative findings.

Publication types

  • Comparative Study

MeSH terms

  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / pathology
  • Contrast Media
  • Diagnosis, Differential
  • Diffusion Magnetic Resonance Imaging / methods
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Middle Aged
  • ROC Curve
  • Retrospective Studies
  • Sensitivity and Specificity
  • Statistics, Nonparametric


  • Contrast Media