Screening breast MRI: higher parenchymal enhancement impairs diagnostic performance

  • Sippo DA & al.
  • Acad Radiol
  • 18 Jul 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • High background parenchymal enhancement (BPE) on screening breast MRI is associated with higher abnormal interpretation rate.
  • BPE, an inherent property of breast tissue, is indicative of the physiologic enhancement of normal fibroglandular tissue.

Why this matters

  • Higher BPE interferes with identification of suspicious lesions, and thus impairs diagnostic performance of screening breast MRI.

Study design

  • Retrospective analysis of 4686 screening breast MRIs from 2446 women.
  • BPE was divided into 2 categories by radiologist rating: minimal or mild (85%) and moderate or marked (15%).
  • Performance measures (e.g., abnormal interpretation rate; AIR) were compared, with adjustment for these confounders: age, screening indication, mammographic density, available prior MRI, and examination year.
  • Funding: None disclosed.

Key results

  • The higher (vs lower) BPE group was associated with higher AIR (13% vs 7%; adjusted OR, 1.37; 95% CI, 1.03-1.82).
  • Higher (vs lower) BPE was not associated with cancer detection rate, positive predictive value, sensitivity, and specificity (all P's>.05).

Limitations

  • Retrospective observational study.
  • Single center, with single radiologist performing ratings.