The Potential Of Fast Non-contrast MRI To Screen Women With Dense Breasts:A Retrospective Analysis

Objective To explore the potential of diffusion weighted imaging(DWI)and combined diffusion weighted imaging and turbo inversion recovery magnitude MRI(DWI+TIRM)as a screening tool for women with dense breasts.Methods Firstly,mammography and DWI were used to evaluate 169 breast lesions in 159 women with dense breasts.Two experienced radiologists scored for presence or absence of breast lesions and breast cancers.Lesion visibility as well as accuracy,sensitivity and specificity of cancer detection were analyzed and compared between mammography and DWI.Then 176 breast lesions from 166 women with dense breasts were retrospectively evaluated.Two experienced radiologists scored for presence or absence of breast lesions and breast cancers.The lesion visibility,area under the curve(AUC),sensitivity and specificity of cancer detection by mammography(MG),DWI+TIRM,and combined magnetic resonance imaging(c MRI)were evaluated and compared using mammography plus clinical MRI as the gold standard for lesion detection and pathology as the gold standard for cancer detection.Results DWI detected 157 lesions while mammography detected 116.In total,113 lesions were detected by both modalities,44 by DWI alone,3 by mammography alone,and 9 by neither.Lesion visibility of DWI(92.9%)was superior to mammography(68.6%,p < 0.001).DWI missed one malignant lesion compared to nine by mammography.DWI also showed better accuracy(AUC 0.914)and sensitivity(85.71%)for breast cancer detection than mammography(AUC 0.789,sensitivity 47.25%).The specificity of mammography(98.7%)was higher than DWI(83.3%).Lesion visibility of DWI+TIRM(96.6%)was significantly superior to MG(67.6%)in women with dense breasts(p<0.001).No significant difference was noted when compared with clinical MRI.DWI+TIRM showed higher accuracy(AUC = 0.935)and sensitivity(93.68%)for breast cancer detection than MG(AUC = 0.783,sensitivity = 46.32%),but was comparable to clinical MRI(AUC = 0.944,sensitivity = 93.68%).The specificity of DWI+TIRM(83.95%)was lower than MG(98.77%),but higher than clinical MRI(77.78%).Conclusion Lesion visibility as well as accuracy and sensitivity of DWI+TIRM were significantly superior to MG in women with dense breasts.These findings suggest that the combination of DWI+TIRM has the potential to be a potent breast cancer screening tool for women with dense breasts.