Accuracy of Unenhanced Breast MRI Compared to Dynamic Contrast Enhanced MRI in Detection and Characterization of Breast Masses

Abstract

Background: Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females worldwide. Obtaining an accurate diagnosis is of considerable importance as it informs the choice of treatment and the prognostic outcomes of the disease. Magnetic resonance imaging (MRI) has a higher sensitivity for the diagnosis of breast cancer than mammography and ultrasound. Objective: We aimed to assess the diagnostic efficacy and efficiency of unenhanced MRI sequences for detection and characterization of breast lesions. Accordingly, we evaluated the breast unenhanced- MRI (UE-MRI) protocol as a reliable alternative for dynamic contrast-enhanced MRI (DCE-MRI). Patients and Methods: 90 female patients underwent MR examination with a diagnostic protocol including UE-MRI sequences (T1WI, T2WI, short TI inversion recovery (STIR) and diffusion weighted imaging (DWI)) and CE-MRI. UE-MRI results were compared with DCE-MRI and the gold standard results having the latter as the reference standard. Results: UE-MRI results obtained sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of 90%, 80%, 90%, 80%, and 86.7% respectively. On the other hand, those for the DCE-MRI were 95%, 90%, 95%, 90%, and 93.3% respectively. It was revealed that there was no significant difference between the two methods. Conclusion: UE-MRI could be considered as a reliable diagnostic tool and an effective substitute for DCE-MRI when contrast administration is not feasible or contraindicated.