DIAGNOSTIC ACCURACY OF DYNAMIC CONTRAST ENHANCED MRI BREAST FOR CHARACTERIZATION OF RECURRENT LESION IN POST-OPERATIVE PATIENTS KEEPING HISTOPATHOLOGY AS A GOLD STANDARD

Abstract

Objectives: To evaluate the diagnostic accuracy of dynamic contrast-enhanced MRI (DCE-MRI) in characterizing recurrent lesions in post-operative breast cancer patients, using histopathology as the gold standard.

Materials and Methods: This cross-sectional study, approved by the CMH Rawalpindi ethical board, enrolled patients who met the inclusion criteria and provided informed consent. DCE-MRI scans were performed using a high-resolution MRI scanner with a breast coil and gadolinium-based contrast. Lesions were evaluated based on temporal enhancement patterns, including wash-in, peak enhancement, and washout, by two blinded radiologists. Histopathological confirmation was obtained through biopsy or surgical excision. Data were collected using a pre-designed questionnaire and analyzed with SPSS version 25, with histopathology keeping as the gold standard for evaluating DCE-MRI's diagnostic accuracy.

Results: The study included 90 participants with a mean age of 41.52 ± 8.84 years. Age distribution showed 10.0% were 18-30 years, 30.0% were 31-40 years, 41.1% were 41-50 years, and 18.9% were over 50 years. Tumor types were 80.0% benign and 20.0% malignant. DCE-MRI's diagnostic performance for recurrent breast lesions showed a sensitivity of 97.2%, specificity of 72.2%, PPV of 93.3%, NPV of 86.7%, and an overall accuracy of 92.2%.

Conclusion: It was concluded that DCE-MRI is a highly effective tool for characterizing recurrent breast lesions in post-operative patients, with a sensitivity of 97.2% and overall accuracy of 92.2%. It aids in distinguishing benign from malignant lesions, highlighting its role as a non-invasive imaging modality that complements histopathology for early detection and management of recurrent breast cancer.