The value of "constant sharpness" as a diagnostic sign in MR-Mammography. (2016)

• Record Type: Journal Article
• Authors: Kaiser, Clemens G.; Baltzer, Pascal; Kaiser, Anna K.; Krammer, Julia; Uder, Michael; Kaiser, Werner A.; Dietzel, Matthias
• Is Part Of: European journal of radiology open. Volume 3(2016)
• Page Start: 236
• Page End: 238
• Publication Date: 2016
• Subjects: Constant sharpness -- Morphology -- MR-Mammography -- Breast-MR; Medical radiology -- Periodicals; 616.075705
• DOI: 10.1016/j.ejro.2016.08.004
• Languages: English
• ISSNs: 2352-0477

Abstract

Abstract: 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 remaining 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.