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Quantitative evaluation of Kaiser score in diagnosing breast dynamic contrast-enhanced magnetic resonance imaging for patients with high-grade background parenchymal enhancement
BACKGROUND: High-grade background parenchymal enhancement (BPE), including moderate and marked, poses a considerable challenge for the diagnosis of breast disease due to its tendency to increase the rate of false positives and false negatives. The purpose of our study was to explore whether the Kais...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10585520/ https://www.ncbi.nlm.nih.gov/pubmed/37869283 http://dx.doi.org/10.21037/qims-23-113 |
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author | Wang, Hui Gao, Ling Chen, Xu Wang, Shou-Ju |
author_facet | Wang, Hui Gao, Ling Chen, Xu Wang, Shou-Ju |
author_sort | Wang, Hui |
collection | PubMed |
description | BACKGROUND: High-grade background parenchymal enhancement (BPE), including moderate and marked, poses a considerable challenge for the diagnosis of breast disease due to its tendency to increase the rate of false positives and false negatives. The purpose of our study was to explore whether the Kaiser score can be used for more accurate assessment of benign and malignant lesions in high-grade BPE compared with the Breast Imaging Reporting and Data System (BI-RADS). METHODS: A retrospective review was conducted on consecutive breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) scans from 2 medical centers. Included were patients who underwent DCE-MRI demonstrating high-grade BPE and who had a pathology-confirmed diagnosis. Excluded were patients who had received neoadjuvant chemotherapy or who had undergone biopsy prior to MRI examination. Two physicians with more than 7 years of experience specializing in breast imaging diagnosis jointly reviewed breast magnetic resonance (MR) images. The Kaiser score was used to determine the sensitivity, specificity, and positive predictive value (PPV), and negative predictive value (NPV) of the BI-RADS from different BPE groups and different enhancement types. The performance of the Kaiser score and BI-RADS were compared according to diagnostic accuracy. RESULTS: A total of 126 cases of high-grade BPE from 2 medical centers were included in this study. The Kaiser score had a higher specificity and PPV than did the BI-RADS (87.5% vs. 46.3%) as well as a higher PPV (94.3% vs. 79.8%). The value of diagnostic accuracy and 95% confidence interval (CI) for the Kaiser score (accuracy 0.928; 95% CI: 0.883–0.973) was larger than that for BI-RADS (accuracy 0.810; 95% CI: 0.741–0.879). Moreover, the Kaiser score had a significantly higher value of diagnostic accuracy for both mass and non-mass enhancement, especially mass lesions (Kaiser score: accuracy 0.947, 95% CI: 0.902–0.992; BI-RADS: accuracy 0.821, 95% CI: 0.782–0.860), with a P value of 0.006. CONCLUSIONS: The Kaiser score is a useful diagnostic tool for the evaluation of high-grade BPE lesions, with a higher specificity, PPV, and diagnostic accuracy as compared to the BI-RADS. |
format | Online Article Text |
id | pubmed-10585520 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-105855202023-10-20 Quantitative evaluation of Kaiser score in diagnosing breast dynamic contrast-enhanced magnetic resonance imaging for patients with high-grade background parenchymal enhancement Wang, Hui Gao, Ling Chen, Xu Wang, Shou-Ju Quant Imaging Med Surg Original Article BACKGROUND: High-grade background parenchymal enhancement (BPE), including moderate and marked, poses a considerable challenge for the diagnosis of breast disease due to its tendency to increase the rate of false positives and false negatives. The purpose of our study was to explore whether the Kaiser score can be used for more accurate assessment of benign and malignant lesions in high-grade BPE compared with the Breast Imaging Reporting and Data System (BI-RADS). METHODS: A retrospective review was conducted on consecutive breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) scans from 2 medical centers. Included were patients who underwent DCE-MRI demonstrating high-grade BPE and who had a pathology-confirmed diagnosis. Excluded were patients who had received neoadjuvant chemotherapy or who had undergone biopsy prior to MRI examination. Two physicians with more than 7 years of experience specializing in breast imaging diagnosis jointly reviewed breast magnetic resonance (MR) images. The Kaiser score was used to determine the sensitivity, specificity, and positive predictive value (PPV), and negative predictive value (NPV) of the BI-RADS from different BPE groups and different enhancement types. The performance of the Kaiser score and BI-RADS were compared according to diagnostic accuracy. RESULTS: A total of 126 cases of high-grade BPE from 2 medical centers were included in this study. The Kaiser score had a higher specificity and PPV than did the BI-RADS (87.5% vs. 46.3%) as well as a higher PPV (94.3% vs. 79.8%). The value of diagnostic accuracy and 95% confidence interval (CI) for the Kaiser score (accuracy 0.928; 95% CI: 0.883–0.973) was larger than that for BI-RADS (accuracy 0.810; 95% CI: 0.741–0.879). Moreover, the Kaiser score had a significantly higher value of diagnostic accuracy for both mass and non-mass enhancement, especially mass lesions (Kaiser score: accuracy 0.947, 95% CI: 0.902–0.992; BI-RADS: accuracy 0.821, 95% CI: 0.782–0.860), with a P value of 0.006. CONCLUSIONS: The Kaiser score is a useful diagnostic tool for the evaluation of high-grade BPE lesions, with a higher specificity, PPV, and diagnostic accuracy as compared to the BI-RADS. AME Publishing Company 2023-08-17 2023-10-01 /pmc/articles/PMC10585520/ /pubmed/37869283 http://dx.doi.org/10.21037/qims-23-113 Text en 2023 Quantitative Imaging in Medicine and Surgery. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article Wang, Hui Gao, Ling Chen, Xu Wang, Shou-Ju Quantitative evaluation of Kaiser score in diagnosing breast dynamic contrast-enhanced magnetic resonance imaging for patients with high-grade background parenchymal enhancement |
title | Quantitative evaluation of Kaiser score in diagnosing breast dynamic contrast-enhanced magnetic resonance imaging for patients with high-grade background parenchymal enhancement |
title_full | Quantitative evaluation of Kaiser score in diagnosing breast dynamic contrast-enhanced magnetic resonance imaging for patients with high-grade background parenchymal enhancement |
title_fullStr | Quantitative evaluation of Kaiser score in diagnosing breast dynamic contrast-enhanced magnetic resonance imaging for patients with high-grade background parenchymal enhancement |
title_full_unstemmed | Quantitative evaluation of Kaiser score in diagnosing breast dynamic contrast-enhanced magnetic resonance imaging for patients with high-grade background parenchymal enhancement |
title_short | Quantitative evaluation of Kaiser score in diagnosing breast dynamic contrast-enhanced magnetic resonance imaging for patients with high-grade background parenchymal enhancement |
title_sort | quantitative evaluation of kaiser score in diagnosing breast dynamic contrast-enhanced magnetic resonance imaging for patients with high-grade background parenchymal enhancement |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10585520/ https://www.ncbi.nlm.nih.gov/pubmed/37869283 http://dx.doi.org/10.21037/qims-23-113 |
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