title: Detection of non-palpable breast cancer in asymptomatic women by using unenhanced diffusion-weighted and T2-weighted MR imaging: comparison with mammography and dynamic contrast-enhanced MR imaging.
abstract: OBJECTIVE
  To compare the detectability of non-palpable breast cancer in asymptomatic women by using mammography (MMG), dynamic contrast-enhanced MR imaging (DCE-MRI) and unenhanced MR imaging with combined diffusion-weighted and T2-weighted images (DWI+T2WI).
  
  
  METHODS
  Forty-two lesions in 42 patients with non-palpable breast cancer in asymptomatic women were enrolled. For the reading test, we prepared a control including 13 normal and 8 benign cases. Each imaging set included biplane MMG, DCE-MRI and DWI+T2WI. Five readers were asked to rate the images on a scale of 0 to 100 for the likelihood of the presence of cancer and the BI-RADS category. Confidence level results were used to construct receiver operating characteristic analysis. Sensitivity and specificity were calculated for each technique.
  
  
  RESULTS
  DWI+T2WI showed higher observer performances (area under the curve, AUC, 0.73) and sensitivity (50%) for the detection of non-palpable breast cancer than MMG alone (AUC 0.64; sensitivity 40%) but lower than those of DCE-MRI (AUC 0.93; sensitivity 86%). A combination of MMG and DWI+T2WI exhibited higher sensitivity (69%) compared with that of MMG alone (40%).
  
  
  CONCLUSIONS
  DWI+T2WI could be useful in screening breast cancer for patients who cannot receive contrast medium and could be used as a new screening technique for breast cancer.
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. yabuuchi@shs.kyushu-u.ac.jp
authors.forename: Hidetake
authors.initials: H
authors.lastname: Yabuuchi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Matsuo
authors.forename: Shunya
authors.initials: S
authors.lastname: Sunami
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kamitani
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kawanami
authors.forename: Taro
authors.initials: T
authors.lastname: Setoguchi
authors.forename: Shuji
authors.initials: S
authors.lastname: Sakai
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Hatakenaka
authors.forename: Makoto
authors.initials: M
authors.lastname: Kubo
authors.forename: Eriko
authors.initials: E
authors.lastname: Tokunaga
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media