The use of breast MRI as a problem-solving tool in BI-RADS 0 cases has been controversial, according to Dr. Claudio Spick, from the Medical University of Vienna, and colleagues. To address the controversy, Spick's group analyzed data from 687 women who underwent high-resolution, 3D, dynamic contrast-enhanced breast MRI between January 2012 and December 2012; 111 women were categorized as BI-RADS 0. The team organized the breast MR findings by clinical presentation, conventional imaging findings, and breast density.
Of the 111 BI-RADS 0 findings, 30 were masses, 57 were architectural distortions, five were microcalcifications, 17 were ultrasound-only findings, and two were palpable findings without imaging correlates, Spick and colleagues wrote. There were 15 true-positive, 85 true-negative, 11 false-positive, and zero false-negative breast MRI findings; these results represented sensitivity, specificity, positive predictive value, and negative predictive value rates of 100%, 88.5%, 57.7%, and 100%, respectively.
"Due to its high negative predictive value, breast MRI is suitable as a problem-solving tool for conventional BI-RADS 0 findings," Spick's team concluded.