Highlights
- •It is possible to classify the silicone implant fibrous capsules by MRI.
- •The results assume that the changes in the fibrous capsules are chronic-evolutionary.
- •The proposed classification has good interobserver agreement.
- •The fibrous capsule graduation by MRI directly impacts patient management and follow-up.
Abstract
Objective
To propose a new classification system for evaluating fibrous capsules around silicone
implants using magnetic resonance.
Methods
We retrospectively evaluated 90 consecutive patients who underwent breast MRI scans
at a single center from February to March 2022. All patients with silicone implants
and contrast dynamic sequences were included. Two radiologists classified the fibrous
capsules according to the proposed classification in four grades. Interobserver variability
was calculated for the final score. For comparison purposes, the inter-rater agreement
of background parenchymal enhancement and the amount of fibroglandular tissue were
also calculated.
Results
Reader 1 classified 2 (2.2) fibrous capsules as grade 1, 7 (7.8) as grade 2, 18 (20.0)
as grade 3, and 63 (70.0) as grade 4, whereas reader 2 classified 1 (1.1), 9 (10.0),
24 (26.7), and 56 (62.2) fibrous capsules, respectively, for each grade. The interobserver
agreement for fibrous capsule classification was moderate (ĸ = 0.65). The inter-rater
agreement of background parenchymal enhancement and amount of fibroglandular tissue
were fair: ĸ = 0.50 and ĸ = 0.44, respectively.
Conclusion
Our study proposes classifying FC by MRI in patients with SI to standardize the description
and classification of the findings with good interobserver agreement.
Abbreviations:
SI (Silicone implants), MRI (Magnetic resonance imaging), FDA (Food and Drug Administration), BI-RADS (Breast imaging-reporting and data system), SIGBIC (Silicone-induced granuloma of breast implant capsules), FC (Fibrous capsules), PD (Proton density), BIA-ALCL (Breast implant-associated anaplastic large cell lymphoma)Keywords
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Article info
Publication history
Published online: August 15, 2022
Accepted:
August 9,
2022
Received in revised form:
August 8,
2022
Received:
May 9,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
