Monitoring of Breast Lesions after Breast Conservative Therapy: Does A Combination of Dynamic and Functional MRI Techniques Can Add Value in Early Detection of Recurrent Malignancy? | ||
| The Medical Journal of Cairo University | ||
| Article 107, Volume 87, December, December 2019, Pages 4883-4893 PDF (1.08 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/mjcu.2019.85231 | ||
| Authors | ||
| MOHAMAD F. SHERIF, M.D.; NAGLA L. DABEES, M.D.; SAMAR G. YONES, M.D.; OM YOSEF A. KHEDR, M.D. | ||
| The Departments of Diagnostic Radiology* and Oncology & Nuclear Medicine**, Faculty of Medicine, Tanta University and The Department of Medicine, Faculty of Medicine, Al-Menshawy Hospital***, Tanta | ||
| Abstract | ||
| Abstract Background: To assess efficacy of combined dynamic and functional MRI techniques in early detection of recurrent malignancy after breast conservative therapy and differentiating it from other post-operative lesions. Aim of Study: To assess efficacy of combined dynamic and functional MRI techniques in early detection of recurrent malignancy after breast conservative therapy and differentiating it from other post-operative lesions. Patients and Methods: Thirty female patients who under-went breast conservative therapy were involved in this pro-spective study. Patients were examined by sono-mammography that aroused suspicious of breast lesions followed by DCE-MRI & DWI-MRI to exclude recurrence. DWI was performed using b-values of 50, 400, 800s/mm2. All patients were subjected to histopathological confirmation which was the gold standard in this study. Results: Eight patients had pathologically proven recur-rence and 22 patients showed spectrum of post-operative changes. DCE- MRI diagnosis (considering lesion morphology, enhancement pattern) overestimated 2 lesions were scored BIRADS 4 and proved pathologically as fat necrosis. When adding the data elicited by the DWI to the DCE-MRI assessment, the statistical analysis presented 100% sensitivity, 95.4% specificity, 88.9% PPV, 100% NPV and 96.6% accuracy. Conclusion: Combination of functional & dynamic MRI techniques added high significant value in follow-up of breast lesion occurred after BCT as it can avoid biopsy in positive patients, to send negative patients to follow-up and reserving biopsy in the cases with a clinico-radiological mismatch. Breast MRI should be the imaging modality of choice in detection of the tumoral recurrence, and differentiating it from other post-operative lesions. | ||
| Keywords | ||
| Breast Conservative Therapy; Dynamic and Functional MRI Techniques; Early Detection of Recurrent Malignancy | ||
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