%0 Journal Article
%T Motion artifacts, lesion type, and parenchymal enhancement in breast MRI: what does really influence diagnostic accuracy?
%A Clemens G Kaiser
%A Matthias Dietzel
%A Michael Weber
%A Paola Clauser
%A Pascal AT Baltzer
%J Acta Radiologica
%@ 1600-0455
%D 2019
%R 10.1177/0284185118770918
%X Motion artifacts can reduce image quality of breast magnetic resonance imaging (MRI). There is a lack of data regarding their effect on diagnostic estimates. To evaluate factors that potentially influence readers¡¯ diagnostic estimates in breast MRI: motion artifacts; amount of fibroglandular tissue; background parenchymal enhancement; lesion size; and lesion type. This Institutional Review Board-approved, retrospective, cross-sectional, single-center study included 320 patients (mean age£¿=£¿55.1 years) with 334 histologically verified breast lesions (139 benign, 195 malignant) who underwent breast MRI. Two expert breast radiologists evaluated the images considering: motion artifacts (1£¿=£¿minimal to 4£¿=£¿marked); fibroglandular tissue (BI-RADS FGT); background parenchymal enhancement (BI-RADS BPE); lesion size; lesion type; and BI-RADS score. Univariate (Chi-square) and multivariate (Generalized Estimation Equations [GEE]) statistics were used to identify factors influencing sensitivity, specificity, and accuracy. Lesions were: 230 mass (68.9%) and 59 non-mass (17.7%), no foci. Forty-five lesions (13.5%) did not enhance in MRI but were suspicious or unclear in conventional imaging. Sensitivity, specificity, and accuracy were 93.8%, 83.4%, and 89.8% for Reader 1 and 95.4%, 87.8%, and 91.9% for Reader 2. Lower sensitivity was observed in case of increased motion artifacts (P£¿=£¿0.007), non-mass lesions (P£¿<£¿0.001), and small lesions£¿¡Ü£¿10£¿mm (P£¿<£¿0.021). No further factors (e.g. BPE, FGT) significantly influenced diagnostic estimates. At multivariate analysis, lesion type and size were retained as independent factors influencing the diagnostic performance (P£¿<£¿0.033). Motion artifacts can impair lesion characterization with breast MRI, but lesion type and small size have the strongest influence on diagnostic estimates
%K Breast
%K magnetic resonance imaging
%K artifacts
%K sensitivity
%K specificity
%K cross-sectional studies
%U https://journals.sagepub.com/doi/full/10.1177/0284185118770918