Meta-analysis: Architectural distortion and breast MRI

Area of Science:

• Radiology
• Breast Imaging
• Diagnostic Accuracy

Background:

• Digital breast tomosynthesis (DBT) has increased architectural distortion (AD) detection, posing clinical management challenges.
• Architectural distortion (AD) management is a clinical dilemma, with limited data on Breast Contrast-Enhanced MRI (CE-BMR) utility.
• CE-BMR is a valuable problem-solving tool for mammographic abnormalities.

Purpose of the Study:

• To systematically review and meta-analyze the literature to estimate the benefit of CE-BMR for mammographically detected architectural distortion.
• To evaluate the diagnostic performance of CE-BMR in cases of architectural distortion.

Main Methods:

• Systematic literature search of MEDLINE and EMBASE databases (2020) following PRISMA guidelines.
• Meta-analysis of four included studies.
• Chi-square test of independence used to assess the association between CE-BMR results and participant condition (malignant vs. non-malignant).

Main Results:

• The meta-analysis included four studies.
• The negative predictive value (NPV) of CE-BMR for architectural distortion ranged from 98.3% to 100%.
• A significant association was found between CE-BMR results and the participant's condition (X(1,175)² = 84.051, p = 0.0001).

Conclusions:

• The high NPV of CE-BMR suggests its utility in managing architectural distortion.
• A negative CE-BMR result may allow for deferral of biopsy in favor of short-interval imaging follow-up.
• CE-BMR demonstrates significant value in differentiating malignant from non-malignant causes of architectural distortion.