Motion artifacts, lesion type, and parenchymal enhancement in breast MRI: what does really influence diagnostic accuracy?. (January 2019)

• Record Type: Journal Article
• Authors: Clauser, Paola; Dietzel, Matthias; Weber, Michael; Kaiser, Clemens G; Baltzer, Pascal AT
• Is Part Of: Acta radiologica. Volume 60:Number 1(2019)
• Page Start: 19
• Page End: 27
• Publication Date: 2019-01
• Subjects: Breast -- magnetic resonance imaging -- artifacts -- sensitivity -- specificity -- cross-sectional studies; Radiology, Medical -- Periodicals; Radiography, Medical -- Periodicals; Radiotherapy -- Periodicals; 616.0757
• DOI: 10.1177/0284185118770918
• Languages: English
• ISSNs: 0284-1851

Abstract

Background: Motion artifacts can reduce image quality of breast magnetic resonance imaging (MRI). There is a lack of data regarding their effect on diagnostic estimates. Purpose: To evaluate factors that potentially influence readers' diagnostic estimates in breast MRI: motion artifacts; amount of fibroglandular tissue; background parenchymal enhancement; lesion size; and lesion type. Material and Methods: This Institutional Review Board-approved, retrospective, cross-sectional, single-center study included 320 patients (mean age = 55.1 years) with 334 histologically verified breast lesions (139 benign, 195 malignant) who underwent breast MRI. Two expert breast radiologists evaluated the images considering: motion artifacts (1 = minimal to 4 = marked); fibroglandular tissue (BI-RADS FGT); background parenchymal enhancement (BI-RADS BPE); lesion size; lesion type; and BI-RADS score. Univariate (Chi-square) and multivariate (Generalized Estimation Equations [GEE]) statistics were used to identify factors influencing sensitivity, specificity, and accuracy. Results: Lesions were: 230 mass (68.9%) and 59 non-mass (17.7%), no foci. Forty-five lesions (13.5%) did not enhance in MRI but were suspicious or unclear in conventional imaging. Sensitivity, specificity, and accuracy were 93.8%, 83.4%, and 89.8% for Reader 1 and 95.4%, 87.8%, and 91.9% for Reader 2. Lower sensitivity was observed in case of increased motion artifacts ( P = 0.007), non-mass lesions ( P < 0.001), and small lesions ≤ 10 mm ( P < 0.021). No further factors (e.g. BPE, FGT) significantly influenced diagnostic estimates. At multivariate analysis, lesion type and size were retained as independent factors influencing the diagnostic performance ( P < 0.033). Conclusion: Motion artifacts can impair lesion characterization with breast MRI, but lesion type and small size have the strongest influence on diagnostic estimates.