Discrimination of benign and malignant breast lesions by using shutter-speed dynamic contrast-enhanced MR imaging 1 Journal Article
| Authors: | Huang, W.; Tudorica, L. A.; Li, X.; Thakur, S. B.; Chen, Y.; Morris, E. A.; Tagge, I. J.; Korenblit, M. E.; Rooney, W. D.; Koutcher, J. A.; Springer, C. S. Jr |
| Article Title: | Discrimination of benign and malignant breast lesions by using shutter-speed dynamic contrast-enhanced MR imaging 1 |
| Abstract: | Purpose: To assess the accuracy of the shutter-speed approach compared with standard approach dynamic contrast material-enhanced magnetic resonance (MR) imaging pharmacokinetic analysis for breast cancer diagnosis. Materials and Methods: This study was approved by the institutional review board and was HIPAA compliant. Informed consent was obtained from 89 high-risk women (age range, 28-83 years) who had 92 suspicious lesions with negative findings at mammography (but visible at MR imaging). Each underwent a research dynamic contrast-enhanced MR imaging examination just prior to a clinical MR imaging-guided interventional procedure. Tumor region of interest (ROI) averaged and (for some) pixel-by-pixel dynamic contrastenhanced time-course data, together with mean arterial input function, were subjected to serial standard and shutter-speed approach analyses to extract pharmacokinetic parameters, including rate constant for passive contrast reagent transfer between plasma and interstitium (Ktrans) and interstitial space volume fraction, or ve. Pathologic findings were used as reference standards. Diagnostic accuracy was assessed with receiver operating characteristic analyses. Results: The pathologic analyses revealed 20 malignant and 72 benign lesions. Positive predictive value of the institutional clinical breast MR imaging protocol was 22%. At 100% sensitivity, ROI-averaged shutter-speed approach K transhad significantly(P = .008) higher diagnostic specificity than standard approach Ktrans:86.1% versus 77.8%. The difference in the ROI-averaged Ktrans parameter value, or ΔKtrans (≡ Ktrans [shutter-speed approach] - Ktrans [standard approach]), had even higher specificity (88.9%). Combined use of ROI analysis and pixel-by-pixel mapping of ΔKtrans achieved 98.6% specificity at 100% sensitivity. Conclusion: The use of the shutter-speed dynamic contrast-enhanced MR imaging method has the potential to improve breast cancer diagnostic accuracy and reduce putatively unnecessary biopsy procedures that yield benign pathologic findings. © RSNA, 2011. |
| Keywords: | adult; controlled study; aged; aged, 80 and over; middle aged; major clinical study; nuclear magnetic resonance imaging; magnetic resonance imaging; cancer diagnosis; diagnostic accuracy; sensitivity and specificity; breast cancer; image analysis; diagnosis, differential; clinical protocol; diagnostic imaging; breast neoplasms; mammography; image enhancement; contrast enhancement; intermethod comparison; contrast media; invasive carcinoma; benign tumor; gadolinium dtpa; false positive result; intraductal carcinoma; predictive value; roc curve; optical resolution; breast diseases; receiver operating characteristic; breast fibroadenoma; breast hyperplasia; diagnostic test accuracy study; fibrocystic breast disease |
| Journal Title: | Radiology |
| Volume: | 261 |
| Issue: | 2 |
| ISSN: | 0033-8419 |
| Publisher: | Radiological Society of North America, Inc. |
| Date Published: | 2011-11-01 |
| Start Page: | 394 |
| End Page: | 403 |
| Language: | English |
| DOI: | 10.1148/radiol.11102413 |
| PROVIDER: | scopus |
| PMCID: | PMC3198224 |
| PUBMED: | 21828189 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 9 December 2011" - "CODEN: RADLA" - "Source: Scopus" |
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