Diagnostic performance of abbreviated breast MRI in differentiating intraductal papilloma from ductal secretion

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-06-01 DOI:10.1016/j.ejrad.2025.112211

Gülbanu Güner, Ahmet Harun Turgan, Sevde Nur Emir

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引用次数: 0

Abstract

Objective

To evaluate the diagnostic efficacy of abbreviated breast magnetic resonance imaging (AB-MRI) in aiding the differentiation of intraductal papilloma (IDP) from ductal secretion, as compared to full diagnostic breast magnetic resonance imaging (FDB-MRI).

Materials and methods

This retrospective study included patients who underwent breast MRI between June 2016 and January 2024 due to inconclusive ultrasonographic findings suggestive of IDP or ductal secretions, A total of 62 patients were analyzed with histopathological results used as the reference standard.

Two radiologists independently reviewed the AB-MRI protocols in a blinded manner. These protocols included fat-suppressed precontrast T1, first postcontrast T1, and subtracted images derived from the FDB-MRI. After a one-week interval, the same radiologists evaluated the FDB-MRI examinations in a separate session, blinded to the AB-MRI results. Diagnostic performance metrics including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Interobserver agreement for AB-MRI, as well as agreement between AB-MRI and FDB-MRI interpretations, were analyzed using Cohen’s kappa test.

Results

The mean age of the 62 patients was 46.05 ± 11.59 years, Histopathological results identified 48 IDPs, 6 cases of adenosis and fibrosis, and 8 cases of ductal secretions.

The FDB-MRI demonstrated high sensitivity (87.5 %) and PPV (85.7 %) for IDP detection but limited specificity (50 %) and NPV (53.85 %). The comparison between FDB-MRI and pathology did not reveal a statistically significant difference (p > 0.05). The diagnostic performance of AB-MRI was observer-dependent; for Observer 1, sensitivity and specificity were 75.0 % and 57.1 %, respectively, with no significant difference compared to pathology (p = 0.0525) or FDB-MRI (p = 0.124). For Observer 2, sensitivity and specificity were 66.67 % and 57.14 %, also not significantly different from pathology (p = 0.1945) or FDB-MRI (p = 0.347). Interobserver agreement was high (Cohen’s Kappa = 0.79)

Conclusion

The AB-MRI protocol demonstrated moderate-to-high diagnostic performance and high interobserver agreement as a time-efficient alternative. While the FDB-MRI remains superior in sensitivity and diagnostic accuracy, AB-MRI offers a reasonable alternative in clinical scenarios where shorter imaging time is prioritized, such as in the differentiation of IDPs from ductal secretions.

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乳腺短程MRI对导管内乳头状瘤与导管分泌物鉴别的诊断价值

目的评价缩短乳腺磁共振成像（AB-MRI）与全诊断乳腺磁共振成像（FDB-MRI）鉴别导管内乳头状瘤（IDP）和导管分泌物的诊断价值。材料与方法回顾性研究纳入2016年6月至2024年1月期间因超声检查不确定提示IDP或导管分泌物而行乳腺MRI检查的患者，共62例患者以组织病理学结果为参考标准进行分析。两名放射科医生以盲法独立审查了AB-MRI方案。这些方案包括脂肪抑制的对比前T1，首先是对比后T1，以及来自FDB-MRI的减影图像。间隔一周后，同样的放射科医生在一个单独的会议中评估FDB-MRI检查，对AB-MRI结果不知情。计算诊断性能指标，包括敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。使用Cohen 's kappa检验分析AB-MRI的观察者间一致性，以及AB-MRI和FDB-MRI解释之间的一致性。结果62例患者平均年龄46.05±11.59岁，组织病理学检查发现IDPs 48例，腺病及纤维化6例，导管分泌物8例。FDB-MRI对IDP的检测灵敏度（87.5%）和PPV（85.7%）较高，但特异性（50%）和NPV（53.85%）较低。FDB-MRI与病理比较无统计学差异(p >；0.05)。AB-MRI的诊断表现依赖于观察者；观察者1的敏感性和特异性分别为75.0%和57.1%，与病理（p = 0.0525）或FDB-MRI （p = 0.124）相比无显著差异。观察者2的敏感性和特异性分别为66.67%和57.14%，与病理（p = 0.1945）或FDB-MRI （p = 0.347）差异无统计学意义。观察者间一致性高（Cohen’s Kappa = 0.79）结论AB-MRI方案具有中高的诊断性能，作为一种高效的替代方案，观察者间一致性高。虽然FDB-MRI在敏感性和诊断准确性方面仍具有优势，但AB-MRI在优先考虑较短成像时间的临床情况下提供了合理的替代方案，例如在区分IDPs和导管分泌物方面。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.