Abdominopelvic MRI for lesion characterization after prior imaging: factors associated with likelihood of added value.
OBJECTIVE
The purpose of this article is to evaluate factors associated with the likelihood that abdominopelvic MRI examinations performed for characterization of lesions identified on other imaging modalities will provide information that adds value to patient management.


METHODS
One thousand one hundred thirty-two lesions in 863 patients undergoing MRI for further characterization after detection by an alternative imaging modality were identified. Reports of the MRI examinations and of previous studies were reviewed to classify cases in terms of patient-, examination-, and lesion-related factors. MRI reports were also classified in terms of measures reflecting inclusion of content with the potential to add value to patient management. Data were analyzed using logistic regression for correlated data.


RESULTS
MRI provided a definitive diagnosis in 79.2% (897/1132), upgraded the severity of the favored diagnosis in 5.3% (60/1132), downgraded the severity of the favored diagnosis in 34.5% (390/1132), and showed an absence of the suspected lesion in 12.1% (137/1132) of cases. Provision of a definitive diagnosis (most common in liver, kidney, gallbladder, bowel, myometrium, and adrenal gland) was significantly associated with the organ containing the lesion (p < 0.001). A change in severity of the favored diagnosis (most common after CT or PET/CT) and the absence of the suspected lesion (most common after PET/CT) were significantly associated with the prior imaging modality (p ≤ 0.001). Among the lesions that were upgraded in severity, 76.7% subsequently underwent intervention or change in medical management.


CONCLUSIONS
Abdominopelvic MRI examinations performed for further lesion characterization may affect clinical management in a high fraction of cases, the likelihood of which is influenced by factors related to the given examination.
1 Both authors: Department of Radiology, Center for Biomedical Imaging, 660 First Ave, 3rd Fl, NYU Langone Medical Center, New York, NY 10016.
Andrew B
AB
Rosenkrantz
Laura
L
Heacock
D000005:Abdomen; D000368:Aged; D019468:Disease Management; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010388:Pelvis; D012189:Retrospective Studies