Meme kanseri tahmininde kısaltılmış meme MRG ve diffüzyon ağırlıklı MRG'nin beraber kullanımının tanısal değeri

Year 2023, Volume: 48 Issue: 1, 153 - 160, 31.03.2023

Şehnaz Tezcan , Ülkü Bekar , Funda Ulu Öztürk

https://doi.org/10.17826/cumj.1185951

Abstract

Amaç: Bu çalışmanın amacı meme kanserini benign meme hastalıklarından ayırma da kullanılan kısaltılmış protocol (AP) manyetik rezonanas görünütleme (MRG), AP ile difüzyon ağırlıklı görüntülemenin (DWI) kombine kullanımı ve tam dinamik protokolün (FDP) tanısal performansını karşılaştırmaktır.
Gereç ve Yöntem: Toplam çalışma populasyonu Ocak 2016 ile Aralık 2021 tarihleri arasında mamografi veya ultrasonografide şüpheli bulguların değerlendirilmesi amacıyla meme MRG (1,5 Tesla) çekilen 68 hastadan oluşmaktadır. Tüm lezyonlar 2 radyolog tarafından AP, AP+DWI ve FDP ile değerlendirildi. Okuyucu duyarlılığı, özgüllüğü ve doğruluğu “Ki kare” testi ile analiz edildi. Her iki okuyucunun Meme Görüntüleme Raporlama ve Veri Sistemi (BI-RADS)’ne göre oluşturduğu kategoriler arasındaki gözlemciler arası uyum (IOA), “Kappa istatistiği” kullanılarak değerlendirildi.
Bulgular: 72 lezyonu olan 68 hasta (31 maligniteli ve 41 benign patolojili) analiz edildi. Okuyucu 1 için AP ve AP+DWI için duyarlılık/özgüllük oranları sırasıyla %67.7/%90.2 ve %80.6/%87.8 iken okuyucu 2 için bu oranlar sırasıyla %67.7/%92.6 ve %70.9/%90.2’idi. FDP için duyarlılık/özgüllük oranları, okuyucu 1 için %83.7/%85.3 iken okuyucu 2 için %80.6/90.2’idi. BI-RADS kategori değerlendirmesindeki IOA, iki okuyucu arasında tüm modellerde neredeyse mükemmel uyum kategorisindeydi (kappa değeri AP, AP+DWI ve FDP'de sırasıyla 0.907, 0.825 ve 0.858’idi).
Sonuç: FDP, tümör biyolojisinin karakterizasyonunda AP ve AP+DWI'den daha iyi tanısal etkinlik göstermektedir. AP'ye DWI’nin eklenmesi, malignitenin öngörülmesinde MRG'nin tanısal performansını arttırmaktadır.

Keywords

diffüzyon ağırlıklı görüntüleme, kısaltılmış meme MRG, meme kanseri

Diagnostic value of combined use of abbreviated breast MRI and diffusion-weighted MRI in the prediction of breast cancer

Abstract

Purpose: The aim of this study was to compare the diagnostic performances of abbreviated protocol (AP) magnetic resonance imaging (MRI), AP combined with diffusion-weighted imaging (DWI), and full dynamic protocol (FDP) in the differentiation of breast cancers from benign breast diseases.
Materials and Methods: The total study population consisted of 68 patients who underwent breast MRI (1.5 Tesla) between January 2016 and December 2021 for the evaluation of suspicious findings on mammography or ultrasonography. All lesions were evaluated by 2 radiologists using AP, AP+DWI, and FDP. The reader sensitivity, specificity, and accuracy were analyzed using the “Chi-squared” test. The inter-observer agreement (IOA) between the Breast Imaging Reporting and Data System (BI-RADS) category assessments of the two readers was evaluated by using the “Kappa statistics”.
Results: Sixty-eight patients with 72 lesions (31 malignant and 41 benign) were analyzed. The sensitivity/specificity for AP and AP+DWI for reader 1 was 67.7/90.2% and 80.6/87.8%, respectively, and for reader 2 was 67.7/92.6% and 70.9/90.2%, respectively. The sensitivity/specificity for FDP for reader 1 was 83.7/85.3% and for reader 2 was 80.6/90.2%. The IOA in the BI-RADS category assessment was almost perfect in all models between two readers (the kappa value was 0.907, 0.825, and 0.858 in AP, AP+DWI, and FDP, respectively).
Conclusion: FDP showed greater diagnostic efficiency in the characterization of tumor biology as compared to AP and AP +DWI. Combining AP with DWI improved the diagnostic performance of MRI for the determination of malignancy.

Keywords

Diffusion-Weighted Imaging, Abbreviated Protocol, Breast Cancer

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