A Multicentric Comparison of Apparent Diffusion Coefficient Mapping and the Kaiser Score in the Assessment of Breast Lesions

Objective Materials and Methods In this multicentric study, individual patient data from 3 different centers were analyzed. Consecutive patients receiving standardized multiparametric breast magnetic resonance imaging for standard nonscreening indications were included. At each center, 2 experienced radiologists with more than 5 years of experience retrospectively interpreted the examinations in consensus and applied the KS to every histologically verified lesion. The corresponding mean ADC of each lesion was measured using a Wielema type 4 region of interest. According to established methods, the KS and ADC were combined, yielding the KS+ score. Diagnostic accuracy was evaluated by the area under the receiver operating characteristics curve (AUROC) and compared between the KS, ADC, and KS+ (DeLong test). Likewise, the potential to help avoid unnecessary biopsies was compared between the KS, ADC, and KS+ based on established high sensitivity thresholds (McNemar test). Results A total of 450 lesions in 414 patients (mean age, 51.5 years; interquartile range, 42–60.8 years) were included, with 219 lesions being malignant (48.7%; 95% confidence interval [CI], 44%–53.4%). The performance of the KS (AUROC, 0.915; CI, 0.886–0.939) was significantly better than that of the ADC (AUROC, 0.848; CI, 0.811–0.880; P 4 for KS and ≤1.4 × 10−3 mm2/s for ADC). However, the rate of potentially avoidable biopsies was higher when using the KS (specificity: 65.4% for K...
Source: Investigative Radiology - Category: Radiology Tags: Original Articles Source Type: research