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Current Medical Imaging


ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Research Article

Papillary Lesions of the Breast: Addition of DWI and TIRM Sequences to Routine Breast MRI Could Help in Differentiation Benign from Malignant

Author(s): Mehmet Ali Gültekin, Fatma Çelik Yabul, Hafize Otçu Temur, Lutfullah Sari*, Temel Fatih Yilmaz, Hüseyin Toprak and Seyma Yildiz

Volume 18, Issue 9, 2022

Published on: 06 April, 2022

Article ID: e180222201272 Pages: 8

DOI: 10.2174/1573405618666220218101931

Price: $65


Aim: We aimed to investigate the magnetic resonance imaging (MRI) features of benign, atypical, or malignant papillary breast lesions and to assess the additional value of diffusion-weighted imaging (DWI) and turbo inversion recovery magnitude (TIRM) sequences to routine breast MRI.

Background: Differentiation between benign and malignant papillary breast lesions is essential for patient management. However, morphologic features and enhancement patterns of malignant papillary lesions may overlap with those of benign papilloma.

Methods: Seventy-two papillary breast lesions (50 benign, 22 atypical or malignant) were included in the current study, retrospectively. We divided the patients into two groups: benign papillary breast lesions and atypical or malignant papillary breast lesions. Morphologic, dynamic, turbo inversion recovery magnitude (TIRM) values and diffusion features of the papillary lesions were compared between two groups.

Results: Benign papillary lesions were smaller in size (p=0.006 and p=0.005, for radiologists 1 and 2 respectively), closer to the areola (p=0.045 and 0.049 for radiologist 1 and 2 respectively), and had higher ADC values (p=0.001 for two radiologists) than the atypical or malignant group. ROC curves showed diagnostic accuracy for ADC (AUC=0.770 and 0.762, p & amp; lt; 0.0001 for two radiologists), and showed a cut-off value of ≤ 957 x 10-6 mm2/s (radiologist 1) and ≤ 910 x 10-6 mm2/s (radiologist 2).

Conclusion: MRI is a useful method for differentiation between benign and malignant papillary breast lesions. Centrally located, lesser in size, and higher ADC values should be considered benign, whereas peripherally located, larger in size, and lower ADC values should be considered malignant.

Keywords: Breast MRI, diffusion weighted imaging, papillary breast lesions, TIRM sequences, benign breast lesion, mammography.

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