Probability of malignancy for lesions detected on breast MRI: a predictive model incorporating BI-RADS imaging features and patient characteristics
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Wendy B. DeMartini & Brenda F. Kurland & Robert L. Gutierrez & C. Craig Blackmore & Sue Peacock & Constance D. Lehman
- چاپ و سال / کشور: 2011
Description
Objectives To predict the probability of malignancy for MRI-detected breast lesions with a multivariate model incorporating patient and lesion characteristics. Methods Retrospective review of 2565 breast MR examinations from 1/03–11/06. BI-RADS 3, 4 and 5 lesions initially detected on MRI for new cancer or high-risk screening were included and outcomes determined by imaging, biopsy or tumor registry linkage. Variables were indication for MRI, age, lesion size, BI-RADS lesion type and kinetics. Associations with malignancy were assessed using generalized estimating equations and lesion probabilities of malignancy were calculated. Results 855 lesions (155 malignant, 700 benign) were included. Strongest associations with malignancy were for kinetics (washout versus persistent; OR 4.2, 95% CI 2.5– 7.1) and clinical indication (new cancer versus high-risk screening; OR 3.0, 95% CI 1.7–5.1). Also significant were age >=50 years, size >=10 mm and lesion-type mass. The most predictive model (AUC 0.70) incorporated indication, size and kinetics. The highest probability of malignancy (41.1%) was for lesions on MRI for new cancer, >=10 mm with washout. The lowest (1.2%) was for lesions on highrisk screening, <10 mm with persistent kinetics. Conclusions A multivariate model shows promise as a decision support tool in predicting malignancy for MRIdetected breast lesions.
Eur Radiol (2011) 21:1609–1617 DOI 10.1007/s00330-011-2094-6 Received: 17 September 2010 / Revised: 15 December 2010 / Accepted: 24 January 2011 / Published online: 27 February 2011
