title: Diagnostic value of MR elastography in addition to contrast-enhanced MR imaging of the breast-initial clinical results.
abstract: OBJECTIVE
  The purpose of the study was to assess the additional value of magnetic resonance (MR) elastography (MRE) to contrast-enhanced (ce) MR imaging (MRI) for breast lesion characterisation.
  
  
  METHODS
  Fifty-seven suspected breast lesions in 57 patients (mean age 52.4 years) were examined by ce MRI and MRE. All lesions were classified into BI-RADS categories. Viscoelastic parameters, e.g. alpha0 as an indicator of tissue stiffness, were calculated. Histology of the lesions was correlated with BI-RADS and viscoelastic properties. The positive predictive value (PPV) for malignancy, and the sensitivity and specificity of ce MRI were calculated. Receiver-operating characteristics (ROC) curves were separately calculated for both ce MRI and viscoelastic properties and conjoined to analyse the accuracy of diagnostic performance.
  
  
  RESULTS
  The lesions (mean size 27.6 mm) were malignant in 64.9% (n = 37) of cases. The PPV for malignancy was significantly (p < 0.0001) dependent on BI-RADS classification. The sensitivity of ce MRI for breast cancer detection was 97.3% (36/37), whereas specificity was 55% (11/20). If ce MRI was combined with alpha0, the diagnostic accuracy could be significantly increased (p < 0.05; AUC(ce MRI) = 0.93, AUC(combined) = 0.96).
  
  
  CONCLUSIONS
  In this study, the combination of MRE and ce MRI could increase the diagnostic performance of breast MRI. Further investigations of larger cohorts and smaller lesions (in particular those only visible on MRI) are necessary to validate these results.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany. katja.siegmann@gmx.de
authors.forename: Katja C
authors.initials: KC
authors.lastname: Siegmann
authors.forename: Tanja
authors.initials: T
authors.lastname: Xydeas
authors.forename: Ralph
authors.initials: R
authors.lastname: Sinkus
authors.forename: Bernhard
authors.initials: B
authors.lastname: Kraemer
authors.forename: Ulrich
authors.initials: U
authors.lastname: Vogel
authors.forename: Claus D
authors.initials: CD
authors.lastname: Claussen
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis*; D003287:Contrast Media; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA