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MRI features of intraductal papilloma of the breast: sheep in wolf's clothing?

Abstract

Background: Intraductal papillomas often present as small, smooth masses, dilated ducts or microcalcifications at mammography and as smooth, hypoechoic masses at sonography. At magnetic resonance imaging (MRI), intraductal papillomas often present as small smooth masses, however, often with strong enhancement with type 2 or 3 time intensity curves. The result of the MR analysis is therefore not infrequently inconclusive in order to characterize the mass as benign or malignant. Purpose: To characterize the appearance of intraductal papillomas of the breast at MRI, and determine whether the application of diagnostic rules described in literature could contribute to correctly classifying the lesions as benign. Material and Methods: Twenty patients with histologically proven intraductal papillomas were included. Two radiologists independently reviewed the MR images of the breast. The BI-RADS nomenclature was used to describe morphology and contrast-enhancement kinetics. Interobserver agreement in the interpretation of the MR images by the two investigators was performed. Kappa coefficient was calculated as index for the level of agreement. Subsequently, three sets of diagnostic rules, including the Goettinger score described by Fischer and the interpretation flowcharts according to Kinkel and to Tozaki were applied to characterize whether a biopsy should be recommended or not. Results: All papillomas presented  More>>
Authors:
Kurz, Kathinka D; Roy, Sumit; [1]  Saleh, Andreas; [2]  Diallo-Danebrock, Raihana; [3]  Skaane, Per [4] 
  1. Dept. of Radiology, Stavanger Univ. Hospital, Stavanger (Norway)
  2. Inst. of Diagnostic Radiology, Duesseldorf Univ. Hospital, Duesseldorf (Germany)
  3. Inst. of Pathology, Duesseldorf Univ. Hospital, Duesseldorf (Germany)
  4. Dept. of Radiology, Ullevaal Univ. Hospital, Univ. of Oslo, Oslo (Norway)
Publication Date:
Apr 15, 2011
Product Type:
Journal Article
Resource Relation:
Journal Name: Acta Radiologica (online); Journal Volume: 52; Journal Issue: 3; Other Information: 40 refs., 5 figs., 3 tabs.; 10.1258/AR.2011.100434
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; MAMMARY GLANDS; NMR IMAGING; NEOPLASMS
OSTI ID:
1011580
Country of Origin:
Sweden
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 1600-0455; TRN: SE1108068
Availability:
Available from DOI: http://dx.doi.org/10.1258/ar.2011.100434
Submitting Site:
SWDN
Size:
page(s) 264-272
Announcement Date:
Apr 25, 2011

Citation Formats

Kurz, Kathinka D, Roy, Sumit, Saleh, Andreas, Diallo-Danebrock, Raihana, and Skaane, Per. MRI features of intraductal papilloma of the breast: sheep in wolf's clothing?. Sweden: N. p., 2011. Web. doi:10.1258/AR.2011.100434.
Kurz, Kathinka D, Roy, Sumit, Saleh, Andreas, Diallo-Danebrock, Raihana, & Skaane, Per. MRI features of intraductal papilloma of the breast: sheep in wolf's clothing?. Sweden. doi:10.1258/AR.2011.100434.
Kurz, Kathinka D, Roy, Sumit, Saleh, Andreas, Diallo-Danebrock, Raihana, and Skaane, Per. 2011. "MRI features of intraductal papilloma of the breast: sheep in wolf's clothing?" Sweden. doi:10.1258/AR.2011.100434. https://www.osti.gov/servlets/purl/10.1258/AR.2011.100434.
@misc{etde_1011580,
title = {MRI features of intraductal papilloma of the breast: sheep in wolf's clothing?}
author = {Kurz, Kathinka D, Roy, Sumit, Saleh, Andreas, Diallo-Danebrock, Raihana, and Skaane, Per}
abstractNote = {Background: Intraductal papillomas often present as small, smooth masses, dilated ducts or microcalcifications at mammography and as smooth, hypoechoic masses at sonography. At magnetic resonance imaging (MRI), intraductal papillomas often present as small smooth masses, however, often with strong enhancement with type 2 or 3 time intensity curves. The result of the MR analysis is therefore not infrequently inconclusive in order to characterize the mass as benign or malignant. Purpose: To characterize the appearance of intraductal papillomas of the breast at MRI, and determine whether the application of diagnostic rules described in literature could contribute to correctly classifying the lesions as benign. Material and Methods: Twenty patients with histologically proven intraductal papillomas were included. Two radiologists independently reviewed the MR images of the breast. The BI-RADS nomenclature was used to describe morphology and contrast-enhancement kinetics. Interobserver agreement in the interpretation of the MR images by the two investigators was performed. Kappa coefficient was calculated as index for the level of agreement. Subsequently, three sets of diagnostic rules, including the Goettinger score described by Fischer and the interpretation flowcharts according to Kinkel and to Tozaki were applied to characterize whether a biopsy should be recommended or not. Results: All papillomas presented as masses on dynamic contrast-enhanced MRI. Only five papillomas showed a round, oval, or lobulated shape combined with smooth margins and continuous rise of the time intensity curve. Using the Goettinger score, biopsy would be recommended in 16 patients. Based on the interpretation flowcharts of Kinkel and of Tozaki, an additional 13 and 10 papillomas, respectively, were correctly classified as benign. Dilated ducts were visible in 10 patients. The interobserver agreement was good or excellent for all included variables. Conclusion: Including systematic analysis of breast MRI to the diagnostic protocol and interpreting the images according to predetermined diagnostic rules, most solitary intraductal papillomas of the breast may be correctly characterized as benign}
doi = {10.1258/AR.2011.100434}
journal = {Acta Radiologica (online)}
issue = {3}
volume = {52}
place = {Sweden}
year = {2011}
month = {Apr}
}