What are the magnetic resonance mammography (breast MRI) criteria for diagnoses of benign lesions and malignancies?

Updated: Feb 25, 2019
  • Author: Preeti Gupta, MD, FRCR; Chief Editor: Eugene C Lin, MD  more...
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Answer

Answer

The following summary tables show the diagnostic criteria that permit characterization of an enhancing lesion as either malignant or benign. The data have been collated from a variety of publications and represent pooled approximations of published results.

Table 2. Breast MRI Criteria for Malignant Processes (Open Table in a new window)

Criterion

Statistic

Value, %

Peak enhancement < 60-90 s after the injection

Sensitivity

>90

Peak enhancement >50% above baseline

Sensitivity

>90

Peak enhancement >80% above baseline

Sensitivity

70-80

Washout after peak with falling enhancement over 5 min

Specificity

>90

Peripheral washout of enhancing mass*

Specificity

100

Spiculated borders

PPV

˜90

Irregular borders

PPV

˜80

Note–Values are from various authors and the architectural interpretation model developed by Nunes et al in 1997. PPV indicates positive predictive value.

*Sherif [56]

†Nunes [41]

Table 3. Breast MRI Criteria for Benign Processes (Open Table in a new window)

Criterion

Statistic

Value, %

Minimal enhancement

Specificity

>95

Mild regional enhancement

NPV

92

No enhancing lesion

NPV

99

Smooth borders

NPV

93

Lobulated enhancing nonseptate mass with low T2 intensity

NPV

100

Lobulated mass with minimal enhancement

NPV

100

Lobulated mass with non-enhancing internal septations

NPV

98

Note–Values are from various authors and the architectural interpretation model developed by Nunes et al in 1997. NPV indicates negative predictive value.


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