バイオプシーの前の乳房の磁気共鳴画像検査
David A Bluemke1, Constantine A Gatsonis, Mei Hsiu Chen
1Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Md, USA. dbluemke@jhmi.edu
JAMA
|December 9, 2004
まとめ
乳房MRIは,がんの検出に高い感度を示していますが,特異性は中等です. 陽性予測値はマンモグラフィーを上回るものの,断定的な診断には組織採取が必要である.
科学分野:
- 放射線学 放射線学
- 腫瘍学 腫瘍学
- メディカルイマージング (医学イメージング)
背景:
- 乳腺磁気共鳴画像 (MRI) は,がんの検出に高い感度を提供します.
- マンモグラフィで特定された疑わしい乳房病変の評価のためにその使用が増加しています.
研究 の 目的:
- マンモグラフィーと組み合わせた乳房MRIの精度を評価するために.
- 疑わしいマモグラフィー検査または臨床検査結果のある患者の診断性能を決定する.
主な方法:
- 14の大学病院の821人の患者を対象とした将来的なマルチセンター研究.
- バイオプシーの前にMRI検査を行い,MRIの結果を盲目的に解釈した.
- 主要な成果指標には,受信機の動作特性曲線 (AUC) 下の面積,感度,および特異性が含まれていました.
主要な成果:
- 乳房のMRIはAUCを0.88で,感度88.1%と特異性67.7%を達成した.
- 性能は,異なる乳腺密度,腫瘍組織学,および更年期状態において一貫していました.
- MRIの陽性予測値 (72.4%) は,マンモグラフィ (52.8%) よりも著しく高かった.
結論:
- 乳房MRIは,患者の特徴や腫瘍の特徴に関係なく,高い感度だが,中程度の特異性しか示さない.
- マンモグラフィと比較して優れたポジティブな予測値にもかかわらず,MRIは生検の必要性を排除しません.
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