Characterization of indeterminate soft tissue masses referred for biopsy: What is the added value of contrast imaging at 3.0 tesla?

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Abstract

Purpose: To assess the added value of contrast-enhanced (CE) MR sequences (static CE-MR sequences, dynamic CE-MR sequences) to noncontrast enhanced MR sequences (non-CE-MR sequences) including T1, fluid-sensitive, and diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) mapping for characterizing "indeterminate" soft tissue masses (STMs) as benign or malignant. Materials and Methods: Thirty-nine patients with indeterminate STMs (27 benign, 12 malignant) underwent 3 Tesla MRI with conventional non-CE-MR sequences (T1-weighted, fluid-sensitive), DWI (b-values 50, 400, 800, ADC mapping), dynamic CE-MR sequences (7-s time resolution), and static CE-MR sequences. Two readers independently reviewed imaging in four sessions (conventional non-CE-MR sequences alone, conventional+DWI/ADC, conventional+DWI/ADC+static CE-MR sequences, conventional+DWI/ADC+static CE-MR sequences dynamic CE-MR sequences). Readers recorded the potential of malignancy at each session; reader diagnostic performance (receiver operating characteristics analysis) and inter-observer variability (weighted kappa [k]) were determined. Results: Diagnostic performance for distinguishing benign and malignant STMs was highest with the addition of dynamic CE-MR sequences (reader 1, area under the curve [AUC] 0.91; reader 2, AUC 0.88). The diagnostic performance of static CE-MR sequences (reader 1, AUC 0.86; reader 2, AUC 0.84) was not superior to non-CE-MR sequences with DWI (reader 1, AUC 0.88; reader 2, AUC 0.8). Interobserver agreement was: k = 0.82 (static CE-MRI), k = 0.79 (dynamic CE-MRI), k = 0.53 (non-CE-MR sequences without DWI), and k = 0.63 (with DWI). Conclusion: Non-CE-MR sequences offer similar diagnostic performance to imaging with the addition of static CE-MR sequences, but their interobserver reliability is lower. The addition of dynamic CE-MR sequences offers the higher diagnostic performance for distinguishing benign and malignant indeterminate STMs.

Original languageEnglish (US)
JournalJournal of Magnetic Resonance Imaging
DOIs
StateAccepted/In press - 2016

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Biopsy
Area Under Curve
Observer Variation
ROC Curve
Neoplasms

Keywords

  • DWI
  • MRI-contrast enhanced imaging
  • Soft tissue tumors

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{43cb97f44b184d43b11f1b3a24a4b7e3,
title = "Characterization of indeterminate soft tissue masses referred for biopsy: What is the added value of contrast imaging at 3.0 tesla?",
abstract = "Purpose: To assess the added value of contrast-enhanced (CE) MR sequences (static CE-MR sequences, dynamic CE-MR sequences) to noncontrast enhanced MR sequences (non-CE-MR sequences) including T1, fluid-sensitive, and diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) mapping for characterizing {"}indeterminate{"} soft tissue masses (STMs) as benign or malignant. Materials and Methods: Thirty-nine patients with indeterminate STMs (27 benign, 12 malignant) underwent 3 Tesla MRI with conventional non-CE-MR sequences (T1-weighted, fluid-sensitive), DWI (b-values 50, 400, 800, ADC mapping), dynamic CE-MR sequences (7-s time resolution), and static CE-MR sequences. Two readers independently reviewed imaging in four sessions (conventional non-CE-MR sequences alone, conventional+DWI/ADC, conventional+DWI/ADC+static CE-MR sequences, conventional+DWI/ADC+static CE-MR sequences dynamic CE-MR sequences). Readers recorded the potential of malignancy at each session; reader diagnostic performance (receiver operating characteristics analysis) and inter-observer variability (weighted kappa [k]) were determined. Results: Diagnostic performance for distinguishing benign and malignant STMs was highest with the addition of dynamic CE-MR sequences (reader 1, area under the curve [AUC] 0.91; reader 2, AUC 0.88). The diagnostic performance of static CE-MR sequences (reader 1, AUC 0.86; reader 2, AUC 0.84) was not superior to non-CE-MR sequences with DWI (reader 1, AUC 0.88; reader 2, AUC 0.8). Interobserver agreement was: k = 0.82 (static CE-MRI), k = 0.79 (dynamic CE-MRI), k = 0.53 (non-CE-MR sequences without DWI), and k = 0.63 (with DWI). Conclusion: Non-CE-MR sequences offer similar diagnostic performance to imaging with the addition of static CE-MR sequences, but their interobserver reliability is lower. The addition of dynamic CE-MR sequences offers the higher diagnostic performance for distinguishing benign and malignant indeterminate STMs.",
keywords = "DWI, MRI-contrast enhanced imaging, Soft tissue tumors",
author = "{Del Grande}, Filippo and Shivani Ahlawat and Ty Subhangwong and Fayad, {Laura M}",
year = "2016",
doi = "10.1002/jmri.25361",
language = "English (US)",
journal = "Journal of Magnetic Resonance Imaging",
issn = "1053-1807",
publisher = "John Wiley and Sons Inc.",

}

TY - JOUR

T1 - Characterization of indeterminate soft tissue masses referred for biopsy

T2 - What is the added value of contrast imaging at 3.0 tesla?

AU - Del Grande, Filippo

AU - Ahlawat, Shivani

AU - Subhangwong, Ty

AU - Fayad, Laura M

PY - 2016

Y1 - 2016

N2 - Purpose: To assess the added value of contrast-enhanced (CE) MR sequences (static CE-MR sequences, dynamic CE-MR sequences) to noncontrast enhanced MR sequences (non-CE-MR sequences) including T1, fluid-sensitive, and diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) mapping for characterizing "indeterminate" soft tissue masses (STMs) as benign or malignant. Materials and Methods: Thirty-nine patients with indeterminate STMs (27 benign, 12 malignant) underwent 3 Tesla MRI with conventional non-CE-MR sequences (T1-weighted, fluid-sensitive), DWI (b-values 50, 400, 800, ADC mapping), dynamic CE-MR sequences (7-s time resolution), and static CE-MR sequences. Two readers independently reviewed imaging in four sessions (conventional non-CE-MR sequences alone, conventional+DWI/ADC, conventional+DWI/ADC+static CE-MR sequences, conventional+DWI/ADC+static CE-MR sequences dynamic CE-MR sequences). Readers recorded the potential of malignancy at each session; reader diagnostic performance (receiver operating characteristics analysis) and inter-observer variability (weighted kappa [k]) were determined. Results: Diagnostic performance for distinguishing benign and malignant STMs was highest with the addition of dynamic CE-MR sequences (reader 1, area under the curve [AUC] 0.91; reader 2, AUC 0.88). The diagnostic performance of static CE-MR sequences (reader 1, AUC 0.86; reader 2, AUC 0.84) was not superior to non-CE-MR sequences with DWI (reader 1, AUC 0.88; reader 2, AUC 0.8). Interobserver agreement was: k = 0.82 (static CE-MRI), k = 0.79 (dynamic CE-MRI), k = 0.53 (non-CE-MR sequences without DWI), and k = 0.63 (with DWI). Conclusion: Non-CE-MR sequences offer similar diagnostic performance to imaging with the addition of static CE-MR sequences, but their interobserver reliability is lower. The addition of dynamic CE-MR sequences offers the higher diagnostic performance for distinguishing benign and malignant indeterminate STMs.

AB - Purpose: To assess the added value of contrast-enhanced (CE) MR sequences (static CE-MR sequences, dynamic CE-MR sequences) to noncontrast enhanced MR sequences (non-CE-MR sequences) including T1, fluid-sensitive, and diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) mapping for characterizing "indeterminate" soft tissue masses (STMs) as benign or malignant. Materials and Methods: Thirty-nine patients with indeterminate STMs (27 benign, 12 malignant) underwent 3 Tesla MRI with conventional non-CE-MR sequences (T1-weighted, fluid-sensitive), DWI (b-values 50, 400, 800, ADC mapping), dynamic CE-MR sequences (7-s time resolution), and static CE-MR sequences. Two readers independently reviewed imaging in four sessions (conventional non-CE-MR sequences alone, conventional+DWI/ADC, conventional+DWI/ADC+static CE-MR sequences, conventional+DWI/ADC+static CE-MR sequences dynamic CE-MR sequences). Readers recorded the potential of malignancy at each session; reader diagnostic performance (receiver operating characteristics analysis) and inter-observer variability (weighted kappa [k]) were determined. Results: Diagnostic performance for distinguishing benign and malignant STMs was highest with the addition of dynamic CE-MR sequences (reader 1, area under the curve [AUC] 0.91; reader 2, AUC 0.88). The diagnostic performance of static CE-MR sequences (reader 1, AUC 0.86; reader 2, AUC 0.84) was not superior to non-CE-MR sequences with DWI (reader 1, AUC 0.88; reader 2, AUC 0.8). Interobserver agreement was: k = 0.82 (static CE-MRI), k = 0.79 (dynamic CE-MRI), k = 0.53 (non-CE-MR sequences without DWI), and k = 0.63 (with DWI). Conclusion: Non-CE-MR sequences offer similar diagnostic performance to imaging with the addition of static CE-MR sequences, but their interobserver reliability is lower. The addition of dynamic CE-MR sequences offers the higher diagnostic performance for distinguishing benign and malignant indeterminate STMs.

KW - DWI

KW - MRI-contrast enhanced imaging

KW - Soft tissue tumors

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U2 - 10.1002/jmri.25361

DO - 10.1002/jmri.25361

M3 - Article

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AN - SCOPUS:84992093049

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JF - Journal of Magnetic Resonance Imaging

SN - 1053-1807

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