Diagnostic Accuracy of Dynamic Contrast-Enhanced MRI for Breast Lesions Using Histopathology as the Gold Standard

Abstract

OBJECTIVES

This study aimed to determine the diagnostic accuracy of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for differentiating benign and malignant breast lesions, using histopathology as the reference standard.

METHODOLOGY

This cross-sectional diagnostic-accuracy study was conducted at DHQ Hospital, Gujranwala, Pakistan, from November 2023 to April 2024. Ninety-six patients with clinically suspected breast lesions were enrolled by non-probability consecutive sampling. DCE-MRI was performed before histopathological examination by biopsy or surgical excision. Sensitivity, specificity, predictive values, overall accuracy, and the association between MRI and histopathological diagnosis were analyzed using SPSS version 26.

RESULTS
The mean age of participants was 45.52 ± 12.73 years, and histopathology confirmed malignancy in 54/96 (56.3%) lesions. DCE-MRI showed a sensitivity of 90.7%, specificity of 83.3%, positive predictive value of 87.5%, negative predictive value of 87.5%, and overall accuracy of 87.5%. MRI diagnosis was strongly associated with histopathology (χ² = 53.33, p < 0.001; Cramer's V = 0.745).

CONCLUSION

DCE-MRI demonstrated high diagnostic accuracy for differentiating benign and malignant breast lesions and may serve as a valuable adjunct in the evaluation of suspicious lesions.