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• Clinical Article •
Value of a clinical-multiparametric MRI diagnostic model based on Kaiser score in the differential diagnosis of benign and malignant breast lesions
GAO Wenxia  SHENG Meihong  XIAO Jianyun  NI Jian  YAN Xuncheng  SUN Rong 

Cite this article as: GAO W X, SHENG M H, XIAO J Y, et al. Value of a clinical-multiparametric MRI diagnostic model based on Kaiser score in the differential diagnosis of benign and malignant breast lesions[J]. Chin J Magn Reson Imaging, 2024, 15(8): 117-123. DOI:10.12015/issn.1674-8034.2024.08.018.


[Abstract] Objective To establish a clinical-multiparameter breast MRI diagnostic model based on Kaiser score (KS) and explore its value in the diagnosis and differentiation of benign and malignant breast lesions.Materials and Methods Clinical and preoperative MRI data of 389 patients with 403 lesions confirmed by pathology were retrospectively analyzed between January 2019 and December 2022, collected MRI, clinical and pathological data of breast lesions, including 100 cases in benign group and 303 cases in malignant group. Based on MRI image features, apparent diffusion coefficient (ADC) value and related clinical indicators in KS, comparing the differences between the indicators of benign and malignant breast lesions by univariate analysis, multivariate logistic regression analysis established clinical-multiparameter MRI imaging diagnosis model. The receiver operating characteristic (ROC) cruve was plotted to evaluate the diagnostic performance. DeLong test was used to compare the diagnostic efficacy of clinical-multiparameter MRI imaging diagnosis model with the KS.Results Root features, time-signal intensity curves (TIC) type, margin, internal enhancement, edema, ADC value, age, gynecological tumor history, menopausal status between benign and malignant breast lesions with a statistical difference (P<0.001). Multivariate logistic regression analysis showed positive root sign, TIC type Ⅲ, rough margins, old age, and history of gynecological tumors [odds ratio (OR)=7.889, 7.707, 4.398, 1.122, 0.239, P<0.05] was an independent predictor of malignant breast lesions. A clinical-multiparametric MRI imaging diagnostic model was established based on KS correlation characteristics, age, and gynecological tumor history. The ROC curves of KS and clinically-multi-parameter MRI diagnostic models were mapped using benign and malignant breast as criteria. Sensitivity was 97.4% and 91.1%, specificity was 69.3% and 84.2%, respectively. Area under the curve (AUC) values were 0.912 and 0.950. The AUC difference was statistically significant (P=0.006). There were significant differences between the positive and negative ALN metastasis groups in breast cancer root sign (χ2=6.477, P=0.011), peritumoral edema (χ2=12.241, P<0.001), and ADC value (Z=10.988, P=0.015). Multivariate logistic regression analysis showed that peritumoral brain edema (OR=2.807, P=0.006) increased the risk of axillary lymph node (ALN) metastasis, and the presence of peritumoral edema increased the risk of ALN metastasis 2.807 times higher than in patients without this feature.Conclusions KS has high diagnostic value for breast lesions, the clinical-multiparametric MRI diagnostic model based on KS is subservient to improve the diagnostic efficacy of benign and malignant breast lesions, and the presence of peritumoral edema in the primary breast MRI can be used as an independent predictor of ALN metastasis in breast cancer.
[Keywords] breast cancer；magnetic resonance imaging；Kaiser score；lymph node metastasis；clinical factors

GAO Wenxia1   SHENG Meihong2*   XIAO Jianyun1   NI Jian1   YAN Xuncheng1   SUN Rong1  

1 Department of Radiology, Ru Gao People's Hospital, Rugao 226500, China

2 Department of Radiology, the Second Affiliated Hospital of Nantong University (the First People's Hospital of Nantong), Nantong 226001, China

Corresponding author: SHENG M H, E-mail: smh4127@163.com

Conflicts of interest   None.

Received  2024-03-20
Accepted  2024-08-05
DOI: 10.12015/issn.1674-8034.2024.08.018
Cite this article as: GAO W X, SHENG M H, XIAO J Y, et al. Value of a clinical-multiparametric MRI diagnostic model based on Kaiser score in the differential diagnosis of benign and malignant breast lesions[J]. Chin J Magn Reson Imaging, 2024, 15(8): 117-123. DOI:10.12015/issn.1674-8034.2024.08.018.

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