• Katja Pinker, Wolfgang Bogner, Pascal Baltzer, Stephan Gruber, Hubert Bickel, Benedikt Brueck, Siegfried Trattnig, Michael Weber, Peter Dubsky, Zsuzsanna Bago-Horvath, Rupert Bartsch, and Thomas H Helbich.
• From the Departments of *Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, †Biomedical Imaging and Image-guided Therapy, MR Centre of Excellence, ‡Surgery, §Pathology, and ∥Internal Medicine, Division of Oncology, Medical University of Vienna, Vienna, Austria.
• Invest Radiol. 2014 Jun 1; 49 (6): 421-30.

IntroductionThe purpose of this study was to compare the diagnostic accuracy of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) as a single parameter to multiparametric (MP) MRI with 2 (DCE MRI and diffusion-weighted imaging [DWI]) and 3 (DCE MRI, DWI, and 3-dimensional proton magnetic resonance spectroscopic imaging [3D H-MRSI]) parameters in breast cancer diagnosis.Materials And MethodsThis prospective study was approved by the institutional review board. Written informed consent was obtained in all patients. One hundred thirteen female patients (mean age, 52 years; range, 22-86 years) with an imaging abnormality (Breast Imaging Reporting and Data System 0, 4-5) were included in this study. Multiparametric MRI of the breast at 3 T with DCE MRI, DWI, and 3D H-MRSI was performed. The likelihood of malignancy was assessed for DCE MRI and MP MRI with 2 (DCE MRI and DWI) and 3 (DCE MRI, DWI, and 3D H-MRSI) parameters separately. Histopathology was used as the standard of reference. Appropriate statistical tests were used to assess sensitivity, specificity, and diagnostic accuracy for each assessment combination.ResultsThere were 74 malignant and 39 benign breast lesions. Multiparametric MRI with 3 MRI parameters yielded significantly higher areas under the curve (0.936) in comparison with DCE MRI alone (0.814) (P<0.001). Multiparametric MRI with just 2 parameters at 3 T did not yield higher areas under the curve (0.808) than did DCE MRI alone (0.814). Multiparametric MRI with 3 parameters resulted in elimination of false-negative lesions and significantly reduced the false-positives ones (P=0.002).ConclusionsMultiparametric MRI with 3 parameters increases the diagnostic accuracy of breast cancer in comparison with DCE-MRI alone and MP MRI with 2 parameters.

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