Diagnostic performance of abbreviated non-contrast MRI for liver metastases in patients with newly diagnosed breast cancer

Abstract

Purpose

To compare the diagnostic performance of non-contrast abbreviated liver MRI (abMRI) and standard MRI (sMRI) with gadoxetic acid enhancement in the detection of liver metastasis during the initial workup for patients with breast cancer.

Methods

Of 7621 patients diagnosed with breast cancer who underwent abdominopelvic CT for their initial staging, 222 underwent sMRI between January 2016 and June 2019 to evaluate and/or characterize CT-indeterminate liver lesions. The abMRI protocol included diffusion-weighted images, apparent diffusion coefficient maps, and T2-weighted fat-suppression images, while the reference standard was histopathology or composite imaging follow-up. Two radiologists utilized a five-point scale to determine the probability of malignancy for each lesion. The per-patient diagnostic parameters were compared using generalized estimating equation and chi-square test.

Results

A total of 222 female patients (age, 49.8 ± 10.4 years) including 17 with metastases (7.7 %) were included in the present analysis. When defining scores ≥4 as metastasis, there were no significant differences in the per-patient sensitivities (82.4 % vs. 82.4 %; p > 0.99), specificities (97.6 % vs. 98.1 %; p = 0.61), positive predictive values (73.7 % vs. 77.8 %; p = 0.63), negative predictive values (98.5 % vs. 98.5 %; p = 0.99), or accuracies (96.4 % vs. 96.9 %; p = 0.99) between the abMRI and sMRI groups, respectively. Additionally, there were no significant differences in the subgroups of patients with subcentimetre and stage II or higher disease.

Conclusion

During the patients' initial workup, the diagnostic performance of non-contrast abMRI was comparable to that of sMRI with gadoxetic acid for CT-indeterminate liver lesions.