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- Title
Probability of malignancy for lesions detected on breast MRI: a predictive model incorporating BI-RADS imaging features and patient characteristics.
- Authors
Demartini WB; Kurland BF; Gutierrez RL; Blackmore CC; Peacock S; Lehman CD; Demartini, Wendy B; Kurland, Brenda F; Gutierrez, Robert L; Blackmore, C Craig; Peacock, Sue; Lehman, Constance D
- Abstract
<bold>Objectives: </bold>To predict the probability of malignancy for MRI-detected breast lesions with a multivariate model incorporating patient and lesion characteristics.<bold>Methods: </bold>Retrospective review of 2565 breast MR examinations from 1/03-11/06. BI-RADS 3, 4 and 5 lesions initially detected on MRI for new cancer or high-risk screening were included and outcomes determined by imaging, biopsy or tumor registry linkage. Variables were indication for MRI, age, lesion size, BI-RADS lesion type and kinetics. Associations with malignancy were assessed using generalized estimating equations and lesion probabilities of malignancy were calculated.<bold>Results: </bold>855 lesions (155 malignant, 700 benign) were included. Strongest associations with malignancy were for kinetics (washout versus persistent; OR 4.2, 95% CI 2.5-7.1) and clinical indication (new cancer versus high-risk screening; OR 3.0, 95% CI 1.7-5.1). Also significant were age > = 50 years, size > = 10 mm and lesion-type mass. The most predictive model (AUC 0.70) incorporated indication, size and kinetics. The highest probability of malignancy (41.1%) was for lesions on MRI for new cancer, > = 10 mm with washout. The lowest (1.2%) was for lesions on high-risk screening, <10 mm with persistent kinetics.<bold>Conclusions: </bold>A multivariate model shows promise as a decision support tool in predicting malignancy for MRI-detected breast lesions.
- Subjects
BREAST tumor diagnosis; DIAGNOSTIC imaging; MAGNETIC resonance imaging; COMPUTERS in medicine; PROBABILITY theory; RESEARCH funding; LOGISTIC regression analysis; PREDICTIVE tests; CONTRAST media; RETROSPECTIVE studies; RECEIVER operating characteristic curves
- Publication
European Radiology, 2011, Vol 21, Issue 8, p1609
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-011-2094-6