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Meta-analysis: Radial Scar and Breast MRI
Romuald Ferre1, Matthew F Covington2, Cherie M Kuzmiak3
1TADH, Ontario, Canada.
Academic Radiology
|May 7, 2024
Summary
Digital breast tomosynthesis increases radial scar detection, posing a clinical dilemma. Contrast-enhanced MRI (CE-BMR) shows high negative predictive value, potentially avoiding biopsies for radial scars.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Digital breast tomosynthesis (DBT) has increased the detection of radial scars (RS).
- Managing RS findings presents a clinical challenge.
- Contrast-enhanced MRI (CE-BMR) is a valuable tool for evaluating mammographic abnormalities, but data on its use for RS are limited.
Purpose of the Study:
- To systematically review and meta-analyze the literature to determine the benefit of CE-BMR in evaluating mammographically detected radial scars.
- To assess the diagnostic performance of CE-BMR for radial scar characterization.
Main Methods:
- A systematic literature search of MEDLINE and EMBASE databases was conducted in 2022.
- The review followed PRISMA guidelines.
- The primary endpoint was the correlation between CE-BMR findings and the definitive outcome of RS (pure RS versus RS associated with atypia or malignancy).
Main Results:
- Three studies met the inclusion criteria for the meta-analysis.
- The negative predictive value (NPV) of CE-BMR for radial scars was 100% across all included studies.
Conclusions:
- The high NPV of CE-BMR suggests its utility in managing radial scars.
- A negative CE-BMR finding may allow for deferral of biopsy, opting for short-interval imaging follow-up instead.
- CE-BMR can be a problem-solving tool for radial scars detected on mammography.
