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Rim sign in breast lesions on diffusion‐weighted magnetic resonance imaging: Diagnostic accuracy and clinical usefulness
Author(s) -
Kang Bong Joo,
Lipson Jafi Alyssa,
Planey Katie RoseMary,
Zackrisson Sophia,
Ikeda Debra M.,
Kao Jennifer,
Pal Sunita,
Moran Catherine J.,
Daniel Bruce Lewis
Publication year - 2015
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.24617
Subject(s) - magnetic resonance imaging , diffusion mri , medicine , radiology , effective diffusion coefficient , breast mri , sign (mathematics) , nuclear medicine , breast cancer , mammography , cancer , mathematical analysis , mathematics
Purpose To investigate the diagnostic accuracy and clinical usefulness of the rim sign in breast lesions observed in diffusion‐weighted magnetic resonance imaging (DWI). Materials and Methods The magnetic resonance imaging (MRI) findings of 98 pathologically confirmed lesions (62 malignant and 36 benign) in 84 patients were included. Five breast radiologists were asked to independently review the breast MRI results, to grade the degree of high peripheral signal, the “rim sign,” in the DWI, and to confirm the mean apparent diffusion coefficient (ADC mean ) values. We analyzed the diagnostic accuracy and compared the consensus (when ≥4 of 5 independent reviewers agreed) results of the rim sign with the ADC mean values. Additionally, we evaluated the correlation between the dynamic contrast‐enhanced (DCE)‐MRI morphologic appearance and DWI rim sign. Results According to the consensus results, the rim sign in DWI was observed on 59.7% of malignant lesions and 19.4% of benign lesions. The sensitivity, specificity, and area under the curve (AUC) value for the rim sign in DWI were 59.7%, 80.6%, and 0.701, respectively. The sensitivity, specificity, and AUC value for the ADC mean value (criteria ≤1.46 × 10 −3 mm 2 /sec) were 82.3%, 63.9%, and 0.731, respectively. Based on consensus, no correlation was observed between the DCE‐MRI and DWI rim signs. Conclusion In DWI, a high‐signal rim is a valuable morphological feature for improving specificity in DWI. J. Magn. Reson. Imaging 2015;41:616–623. © 2014 Wiley Periodicals, Inc.