MRI Criteria for Predicting Invasive Lesions in Biopsy-Proven Ductal Carcinoma in Situ
이지영, 박고운, 고은영, 한부경, 고은숙, 최지수, 남미영, 조수연,
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이지영 ( Lee Ji-Yeong )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiology
박고운 ( Park Ko-Woon )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiology
고은영 ( Ko Eun-Young )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiology
한부경 ( Han Boo-Kyung )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiology
고은숙 ( Ko Eun-Sook )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiology
최지수 ( Choi Ji-Soo )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiology
남미영 ( Nam Mee-Young )
Ewha Womans University Seoul Hospital Department of Radiology
조수연 ( Cho Soo-Youn )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Pathology
Abstract
Purpose: To evaluate the criteria for predicting invasive lesions with preoperative breast MRI in ductal carcinoma in situ (DCIS) histopathologically diagnosed with biopsy.
Materials and Methods: We retrospectively analyzed the preoperative MRI findings of 80 percutaneous biopsy-proven DCIS. The morphological type, enhancement distribution and kinetics, and extent of the lesions were analyzed. We compared the results of pure DCIS and DCIS with invasive lesions. We evaluated the MRI criteria for predicting DCIS with invasive lesions and assessed its diagnostic performance.
Results: Of the 80 DCIS lesions analyzed, 27 contained co-existing invasive lesions and 49 were pure DCIS. No residual lesions after biopsy were seen in 4 cases. DCIS with invasive lesions showed washout kinetics more frequently and to a larger extent than did pure DCIS (p = 0.030 and p = 0.048, respectively). Using enhancement kinetics and the lesion cut-off value of 4 cm yielded the highest diagnostic performance, with 92.6% sensitivity and 93.8% negative predictive value for predicting invasive lesions.
Conclusion: Washout kinetics and the lesion extent of at least 4 cm are useful criteria for the prediction of co-existing invasive lesions in patients with DCIS diagnosed with biopsy.
키워드
Breast; Carcinoma, Intraductal; Magnetic Resonance Imaging
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