The value of "constant sharpness" as a diagnostic sign in MR-Mammography

Clemens G. Kaiser, Pascal Baltzer, Anna K. Kaiser, Julia Krammer, Michael Uder, Werner A. Kaiser, Matthias Dietzel
2016 European Journal of Radiology Open  
Purpose: To examine "constant lesion sharpness" as a morphological diagnostic sign in the differential diagnosis between benign and malignant lesions. Material and methods: This prospective study had institutional review board approval and was HIPAA compliant. In total 1014 consecutive patients were examined (mean age 55 years ± 13 years) and evaluated in our University hospital towards the morphological shape of the lesion borders. The "Constant sharpness Sign" was defined as a lesion
more » ... continuously sharp for the duration of the dynamic scan. Inclusion criteria were unclear findings (e.g. BIRADS III/IV), Preoperative staging (BRIDAS IV/V), and referred patients from local clinic of gynecology. Exclusion criteria were MRM-examination ≤1 year before, status after surgery and/or biopsy, chemotherapy and/or radiation therapy. Reference Standard was histological verification. Images were diagnosed by two experienced radiologists in consensus, blinded to the standard of reference. Results: 1014 patients with 1084 lesions (436 benign, 648 malignant lesions) were included into the study. 41.5% of benign lesions and 6.8% (181/436) of malignant lesions displayed a constant sharpness as an accompanying morphological sign (P < 0.001). This resulted in a sensitivity of 41.5%, specificity of 93.2%, a positive likelihood ratio of 6.1%, a negative likelihood ratio of 0.63 and an odd's ratio of 9,7%. Summary and conclusion: The constant sharpness sign seems to be an accurate predictor of benign breast lesions, which may help to increase the accuracy of MRM as a morphological sign.
doi:10.1016/j.ejro.2016.08.004 pmid:27622201 pmcid:PMC5009188 fatcat:l6pp44wznbfclc4xrikmcujkom