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Role of Breast Mri Bi-Rads Descriptors in Discrimination of Non-Mass Enhancement Lesion: A Systematic Review & Meta-Analysis Publisher Pubmed



Arian A1 ; Teymouri Athar MM2 ; Nouri S3 ; Ghorani H4 ; Khalaj F4 ; Hejazian SS5 ; Shaghaghi S6 ; Beheshti R7, 8
Authors
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Authors Affiliations
  1. 1. Advanced Diagnostic and Interventional Radiology (ADIR), Cancer Research Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran
  2. 2. School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  3. 3. of Radiology, Arak University of Medical Sciences, Arak, Iran
  4. 4. Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Science, Tehran, Iran
  5. 5. Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
  6. 6. Medical Image Processing Group (MIPG), Radiology Department, University of Pennsylvania, Philadelphia, PA, United States
  7. 7. Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
  8. 8. Research Center for Evidence-Based Medicine, Iranian EBM Center: A Joanna Briggs Institute Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran

Source: European Journal of Radiology Published:2025


Abstract

Objectives: To evaluate the association of BI-RADS 5th edition distribution and type of enhancement descriptors with the malignancy of non-mass enhancement (NME) lesions. Methods: Medline via PubMed, Scopus, Web of Science, ProQuest, and Embase databases were systematically searched from January 2013 to July 2022 for original studies, written in English, reporting the positive predictive value (PPV) of individual BI-RADS 5th edition descriptors (distribution and type of enhancement) of NME lesions. Risk of bias and quality of included studies were assessed by QUADAS 2 appraisal tool. Odds ratio (OR) of pathologically confirmed malignant results in each distribution and internal enhancement were pooled in a meta-analysis. Results: Eight studies for a total of 1095 lesions were included. The pooled OR of malignancy for linear, focal, segmental, regional, multiple region, and diffuse distributions are 0.70 (95%CI: 0.44–1.14), 0.37 (95% CI: 0.26–0.54), 2.42 (95% CI: 1.62–3.62), 0.56 (95% CI: 0.11–2.79), 2.80 (95% CI: 0.96–8.21), and 3.35 (95% CI: 0.59–19.04), respectively. The pooled OR of malignancy for homogenous, heterogeneous, clustered ring enhancement, and clumped enhancement are 0.39 (95% CI: 0.23–0.67), 0.59 (95% CI: 0.40–0.85), 2.92 (95% CI: 1.86–4.57), and 1.49 (95% CI: 0.96–2.32), respectively. Conclusion: Based on a meta-analysis of 8 studies and more than one thousand non-mass enhancing lesions, diffuse, multiple regions and clustered ring descriptors of enhancement have the highest pooled OR for malignancy. © 2025 Elsevier B.V.
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