Subcategory classifications of Breast Imaging and Data System (BI-RADS) category 4 lesions on MRI.

Abstract:

PURPOSE:Category 4 in BI-RADS for magnetic resonance imaging (MRI) has a wide range of probabilities of malignancy, extending from > 2 to < 95%. We classified category 4 lesions into three subcategories and analyzed the positive predictive value (PPV) of malignancy in a tertiary hospital. MATERIALS AND METHODS:This retrospective study included 346 breast MRIs with 434 category 2-5 lesions. All enhancing lesions were classified as category 2 (0% probability of malignancy), 3 (> 0%, ≤ 2%), 4 (> 2%, < 95%) and 5 (≥ 95%); category 4 lesions were further subcategorized into 4A (> 2%, ≤ 10%), 4B (> 10%, ≤ 50%) and 4C (> 50%, < 95%) at the time of diagnosis. Radiological and pathological reports were retrospectively analyzed, and the PPVs were calculated. RESULTS:We included 149 malignant and 285 benign lesions. The PPVs of subcategories 4A, 4B and 4C were 1.8%, 11.8% and 67.5%, respectively. The PPVs were higher for lesions coexisting with category 5 or 6 lesions compared with those for isolated lesions. CONCLUSION:Category 4 lesions can be classified into three subcategories depending on the likelihood of malignancy. Lesions coexisting with category 5 or 6 lesions are more likely to be malignant.

journal_name

Jpn J Radiol

authors

Honda M,Kataoka M,Kawaguchi K,Iima M,Miyake KK,Kishimoto AO,Ota R,Ohashi A,Toi M,Nakamoto Y

doi

10.1007/s11604-020-01029-w

subject

Has Abstract

pub_date

2021-01-01 00:00:00

pages

56-65

issue

1

eissn

1867-1071

issn

1867-108X

pii

10.1007/s11604-020-01029-w

journal_volume

39

pub_type

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