Can presence of metallic markers influence diagnostic precision of breast MRI?
Switzerland: There is no statistical difference between the diagnostic performance of preoperative breast MRI after neoadjuvant chemotherapy (NAC) for predicting pathological complete response (pCR) in the presence or absence of metallic marker, a recent study has found. Also, there was no difference between the brands of the two markers that were studied.
The researchers stated, "diagnostic performance for pCR detection to NAC was same irrespective of the presence of a marker. Also, the type of metallic marker did not affect the readers' diagnostic performance for pCR detection." Regardless of the marker presence, the inter-reader agreement was high, they wrote in their study published in the European Journal of Radiology.
The study was conducted by Hugot Matthias, Geneva University Hospital, Division of Radiology, Geneva, Switzerland, and colleagues with the objective to determine if the presence of metallic markers (markers) affects the diagnostic accuracy of preoperative breast MRI for predicting pathological complete response to neoadjuvant chemotherapy in patients with breast cancer in a single-center, retrospective, observational study.
For this purpose, the researchers included all consecutive patients that underwent preoperative breast MRI after NAC completion. They recorded the presence or absence of markers, the type of markers, the size, and the type of artifact on each MRI sequence. All MRI examinations were evaluated for the presence or absence of a complete response by two radiologists blinded to histopathological results and to each other's findings.
Pathology was the standard of reference. Chi-squared tests or equivalents were used to compare the diagnostic performance of MRI for the prediction of pCR in the presence or absence of markers and also between the two most represented marker brands (O'Twist and UltraClip).
The study revealed the following:
· The study included ninety-three patients (mean age 48 ± 11 years).
· Nineteen of them had no markers and 74 had 108 markers.
· Sensitivity and specificity of MRI for the prediction of pCR were 0.73 and 0,81 for patients with and 0.67 and 0.90 for patients without markers.
· There was no statistical difference in the performance of MRI for the two different types of markers studied.
"The findings suggest that neither the presence of metallic markers between the ones represented nor their specific type between the two most represented influences preoperative breast MRI's diagnostic performance for pCR detection after NAC completion," the researchers wrote.
"In order to systematically examine the effect of different types of markers in different types of MRI sets and protocols, further prospective studies should be undertaken," they concluded.
Reference:
Matthias H, Clémence B, Electra S, Thanh L, Poletti Pierre-Alexandre P, Alexandre B, Delattre BMA, Diomidis B. Diagnostic precision of breast MRI in prediction of pathological complete response: Is it influenced by the presence of metallic markers? Eur J Radiol. 2022 Jul 29;154:110453. doi: 10.1016/j.ejrad.2022.110453. Epub ahead of print. PMID: 35926356.
