Enhanced Detection of Residual Breast Cancer Post-Excisional Biopsy: Comparative Analysis of Contrast-Enhanced MRI with and Without Diffusion-Weighted Imaging
Objectives: To evaluate the effectiveness of breast MRI, including diffusion-weighted imaging (DWI), in detecting residual lesions in patients with malignancy after excisional biopsy. Methods: From January 2018 to December 2023, 3T breast MRI was performed to assess lesion morphology, residual size,...
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2025-01-01
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| author | Han Song Mun Bong Joo Kang Sung Hun Kim Ga Eun Park |
| author_facet | Han Song Mun Bong Joo Kang Sung Hun Kim Ga Eun Park |
| author_sort | Han Song Mun |
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| description | Objectives: To evaluate the effectiveness of breast MRI, including diffusion-weighted imaging (DWI), in detecting residual lesions in patients with malignancy after excisional biopsy. Methods: From January 2018 to December 2023, 3T breast MRI was performed to assess lesion morphology, residual size, and enhancement kinetics. The apparent diffusion coefficient (ADC) values were measured, and the diagnostic outcomes of CE-MRI, CE-MRI with DWI, mammography (MG), and ultrasound (US) were compared with clinical and histopathological data. Results: A total of 152 lesions were analyzed, with 36.2% showing residual malignancy. Both CE-MRI and CE-MRI with DWI effectively identified residual lesions, with significant differences in morphology, size, kinetic patterns, and ADC values (all <i>p</i> < 0.001). CE-MRI with DWI showed a sensitivity of 90.9% and an NPV of 93.6%, compared with 89.1% sensitivity and 92.2% NPV for CE-MRI alone. Sensitivities for MG and US were 57.1% and 38.7%, with NPVs of 64.7% and 59.6%, respectively. Diagnostic accuracy was highest for CE-MRI with DWI (80.9%), followed by CE-MRI (79.0%), MG (60.3%), and US (59.7%). The AUC for CE-MRI with DWI (0.831) was slightly higher than CE-MRI alone (0.811), though not significant (<i>p</i> = 0.095). AUCs for MG and US were lower at 0.623 and 0.563, with no significant difference between MG and US (<i>p</i> = 0.234). Conclusions: CE-MRI with DWI and CE-MRI alone were comparable and demonstrated excellent performance in discriminating between women with and without residual disease. Integrating CE-MRI with DWI could become a standard protocol for patients with suspected residual malignancy after excisional biopsy. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
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| series | Tomography |
| spelling | doaj-art-803e1f35adf74645adaa5a09dc6dd0832025-01-24T13:50:52ZengMDPI AGTomography2379-13812379-139X2025-01-011111010.3390/tomography11010010Enhanced Detection of Residual Breast Cancer Post-Excisional Biopsy: Comparative Analysis of Contrast-Enhanced MRI with and Without Diffusion-Weighted ImagingHan Song Mun0Bong Joo Kang1Sung Hun Kim2Ga Eun Park3Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaObjectives: To evaluate the effectiveness of breast MRI, including diffusion-weighted imaging (DWI), in detecting residual lesions in patients with malignancy after excisional biopsy. Methods: From January 2018 to December 2023, 3T breast MRI was performed to assess lesion morphology, residual size, and enhancement kinetics. The apparent diffusion coefficient (ADC) values were measured, and the diagnostic outcomes of CE-MRI, CE-MRI with DWI, mammography (MG), and ultrasound (US) were compared with clinical and histopathological data. Results: A total of 152 lesions were analyzed, with 36.2% showing residual malignancy. Both CE-MRI and CE-MRI with DWI effectively identified residual lesions, with significant differences in morphology, size, kinetic patterns, and ADC values (all <i>p</i> < 0.001). CE-MRI with DWI showed a sensitivity of 90.9% and an NPV of 93.6%, compared with 89.1% sensitivity and 92.2% NPV for CE-MRI alone. Sensitivities for MG and US were 57.1% and 38.7%, with NPVs of 64.7% and 59.6%, respectively. Diagnostic accuracy was highest for CE-MRI with DWI (80.9%), followed by CE-MRI (79.0%), MG (60.3%), and US (59.7%). The AUC for CE-MRI with DWI (0.831) was slightly higher than CE-MRI alone (0.811), though not significant (<i>p</i> = 0.095). AUCs for MG and US were lower at 0.623 and 0.563, with no significant difference between MG and US (<i>p</i> = 0.234). Conclusions: CE-MRI with DWI and CE-MRI alone were comparable and demonstrated excellent performance in discriminating between women with and without residual disease. Integrating CE-MRI with DWI could become a standard protocol for patients with suspected residual malignancy after excisional biopsy.https://www.mdpi.com/2379-139X/11/1/10breast cancerexcisional biopsyMRIresidual diseasebreast imaging |
| spellingShingle | Han Song Mun Bong Joo Kang Sung Hun Kim Ga Eun Park Enhanced Detection of Residual Breast Cancer Post-Excisional Biopsy: Comparative Analysis of Contrast-Enhanced MRI with and Without Diffusion-Weighted Imaging Tomography breast cancer excisional biopsy MRI residual disease breast imaging |
| title | Enhanced Detection of Residual Breast Cancer Post-Excisional Biopsy: Comparative Analysis of Contrast-Enhanced MRI with and Without Diffusion-Weighted Imaging |
| title_full | Enhanced Detection of Residual Breast Cancer Post-Excisional Biopsy: Comparative Analysis of Contrast-Enhanced MRI with and Without Diffusion-Weighted Imaging |
| title_fullStr | Enhanced Detection of Residual Breast Cancer Post-Excisional Biopsy: Comparative Analysis of Contrast-Enhanced MRI with and Without Diffusion-Weighted Imaging |
| title_full_unstemmed | Enhanced Detection of Residual Breast Cancer Post-Excisional Biopsy: Comparative Analysis of Contrast-Enhanced MRI with and Without Diffusion-Weighted Imaging |
| title_short | Enhanced Detection of Residual Breast Cancer Post-Excisional Biopsy: Comparative Analysis of Contrast-Enhanced MRI with and Without Diffusion-Weighted Imaging |
| title_sort | enhanced detection of residual breast cancer post excisional biopsy comparative analysis of contrast enhanced mri with and without diffusion weighted imaging |
| topic | breast cancer excisional biopsy MRI residual disease breast imaging |
| url | https://www.mdpi.com/2379-139X/11/1/10 |
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