Diagnostic value of dynamic contrast-enhanced magnetic resonance imaging and ultrasonography for differentiating between breast benign and malignant lesions: a comparative study

This study aims to evaluate the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and ultrasonography (US) for differentiating breast benign and malignant lesions. The study included a total of 105 patients with breast lesions who received DCE-MRI and US examinations in the First Affiliated Hospital of Hebei North University from September 2013 to December 2015. More than two experienced radiologists who were double-blinded before surgery assessed the images from DCE-MRI and US jointly. In accordance with the Breast Imaging Reporting and Data System (BI-RADS), lesions were evaluated in order to differentiate between breast benign and malignant lesions. A Receiver operating characteristic (ROC) curve was used to assess the diagnostic value of DCE-MRI, US and DCE-MRI + US in differentiating between breast benign and malignant lesions. A total of 125 breast lesions were detected in 105 patients. The pathological diagnosis results criteria showed that there were 52 (41.6%) benign lesions and 73 (58.4%) malignant lesions. According to the ROC results, there were misdiagnoses by US; category 4 in BI-RADS scoring was considered as the optimal threshold to differentiate between benign lesions from malignant lesions. The area under the curve (AUC) of US, DCE-MRI and the combination of DCE-MRI and US (DCE-MRI + US) was 0.849 (95% CI = 0.781 similar to 0.918; P < 0.001), 0.915 (95% CI = 0.862 similar to 0.968; P < 0.001) and 0.938 (95% CI = 0.893 similar to 0.983; P < 0.001), respectively; the accuracy rate of DCE-MRI for diagnosing malignant lesions was higher than that of US (94.4% vs. 76.7%, P = 0.043); and sensitivity was highest in DCE-MRI + US, followed by DCE-MRI and US individually (97.3%, 90.4%, and 76.7%). Our study suggests that a combination of DCE-MRI and US is more efficient for the diagnosis and differentiation of breast lesions than DCE-MRI or US individually.