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@ARTICLE{Bickelhaupt:128310,
      author       = {S. Bickelhaupt$^*$ and D. Paech$^*$ and F. Laun$^*$ and F.
                      Steudle$^*$ and T. A. Kuder$^*$ and A. Mlynarska$^*$ and M.
                      Bach$^*$ and W. Lederer and S. Teiner and S. Schneider and
                      M. Ladd$^*$ and H. Daniel and A. Stieber and A.
                      Kopp-Schneider$^*$ and S. Delorme$^*$ and H.-P.
                      Schlemmer$^*$},
      title        = {{M}aximum intensity breast diffusion {MRI} for {BI}-{RADS}
                      4 lesions detected on {X}-ray mammography.},
      journal      = {Clinical radiology},
      volume       = {72},
      number       = {10},
      issn         = {0009-9260},
      address      = {Amsterdam},
      publisher    = {Elsevier Science},
      reportid     = {DKFZ-2017-04327},
      pages        = {900.e1 - 900.e8},
      year         = {2017},
      abstract     = {To investigate an abbreviated, contrast-agent free
                      diffusion-weighted (DW) breast magnetic resonance imaging
                      (MRI) protocol that provides a single image for the
                      radiologist to read in order to non-invasively examine
                      Breast Imaging-Reporting and Data System (BI-RADS) 4 lesions
                      detected using breast cancer screening X-ray
                      mammography.This retrospective evaluation within a
                      institutional review board-approved, prospective study
                      included 115 women (mean 57 years, range 50-69 years) with
                      BI-RADS 4 findings on X-ray mammography and indication for
                      biopsy over a period of 15 months. Full diagnostic breast
                      MRI (FDP) was performed prior to biopsy (1.5 T). Maximum
                      intensity breast diffusion (MIBD) images were generated from
                      DW images (b = 1,500 mm/s(2), 3 mm section thickness) of
                      the breast. MIBD and T2-weighted (T2W) images were read by
                      two radiologists and compared to the diagnostic accuracy of
                      an expert reading of the FDP with histopathology as the
                      reference standard. The acquisition time of MIBD and T2W MRI
                      was about 7 minutes.MIBD MRI provided a diagnostic accuracy
                      of $87.93\%$ $(95\%$ confidence interval [CI]:
                      $80.58-93.24\%)$ for R1 and $89.66\%$ $(95\%$ CI:
                      $82.63-94.54\%)$ for R2. Expert reading of the FDP revealed
                      a similar accuracy of $86.2\%$ $(95\%$ CI: $78.67-91.43\%).$
                      The positive predictive value (PPV) could be increased from
                      $36.2\%$ $(95\%$ CI: 28.02-45.28; X-ray mammography alone)
                      to a mean PPV of $80.89\%$ (R1 $79.17\%,$ R2 $82.16\%)$
                      using MIBD MRI. Mean reading time was 30 seconds $(25\%/75$
                      percentile 24.5-41.25).MIBD MRI might be of supplemental
                      value if added to the work-up of BI-RADS 4 X-ray mammography
                      screening findings. MIBD MRI might help reduce the
                      false-positive rate prior to biopsy for reference lesions at
                      only limited expense of measurement and reading time.},
      cin          = {E010 / E020 / C060},
      ddc          = {610},
      cid          = {I:(DE-He78)E010-20160331 / I:(DE-He78)E020-20160331 /
                      I:(DE-He78)C060-20160331},
      pnm          = {315 - Imaging and radiooncology (POF3-315)},
      pid          = {G:(DE-HGF)POF3-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:28687167},
      doi          = {10.1016/j.crad.2017.05.017},
      url          = {https://inrepo02.dkfz.de/record/128310},
}