Differentiation between subcentimeter carcinomas and benign lesions using kinetic parameters derived from ultrafast dynamic contrast-enhanced breast MRI Journal Article


Authors: Onishi, N.; Sadinski, M.; Gibbs, P.; Gallagher, K. M.; Hughes, M. C.; Ko, E. S.; Dashevsky, B. Z.; Shanbhag, D. D.; Fung, M. M.; Hunt, T. M.; Martinez, D. F.; Shukla-Dave, A.; Morris, E. A.; Sutton, E. J.
Article Title: Differentiation between subcentimeter carcinomas and benign lesions using kinetic parameters derived from ultrafast dynamic contrast-enhanced breast MRI
Abstract: Objectives: This study aims to evaluate ultrafast DCE-MRI-derived kinetic parameters that reflect contrast agent inflow effects in differentiating between subcentimeter BI-RADS 4–5 breast carcinomas and benign lesions. Methods: We retrospectively reviewed consecutive 3-T MRI performed from February to October 2017, during which ultrafast DCE-MRI was performed as part of a hybrid clinical protocol with conventional DCE-MRI. In total, 301 female patients with 369 biopsy-proven breast lesions were included. Ultrafast DCE-MRI was acquired continuously over approximately 60 s (temporal resolution, 2.7–7.1 s/phase) starting simultaneously with the start of contrast injection. Four ultrafast DCE-MRI-derived kinetic parameters (maximum slope [MS], contrast enhancement ratio [CER], bolus arrival time [BAT], and initial area under gadolinium contrast agent concentration [IAUGC]) and one conventional DCE-MRI-derived kinetic parameter (signal enhancement ratio [SER]) were calculated for each lesion. Wilcoxon rank sum test or Fisher’s exact test was performed to compare kinetic parameters, volume, diameter, age, and BI-RADS morphological descriptors between subcentimeter carcinomas and benign lesions. Univariate/multivariate logistic regression analyses were performed to determine predictive parameters for subcentimeter carcinomas. Results: In total, 125 lesions (26 carcinomas and 99 benign lesions) were identified as BI-RADS 4–5 subcentimeter lesions. Subcentimeter carcinomas demonstrated significantly larger MS and SER and shorter BAT than benign lesions (p = 0.0117, 0.0046, and 0.0102, respectively). MS, BAT, and age were determined as significantly predictive for subcentimeter carcinoma (p = 0.0208, 0.0023, and < 0.0001, respectively). Conclusions: Ultrafast DCE-MRI-derived kinetic parameters may be useful in differentiating subcentimeter BI-RADS 4 and 5 carcinomas from benign lesions. Key Points: • Ultrafast DCE-MRI can generate kinetic parameters, effectively differentiating breast carcinomas from benign lesions. • Subcentimeter carcinomas demonstrated significantly larger maximum slope and shorter bolus arrival time than benign lesions. • Maximum slope and bolus arrival time contribute to better management of suspicious subcentimeter breast lesions. © 2019, European Society of Radiology.
Keywords: human tissue; treatment response; major clinical study; cancer patient; magnetic resonance imaging; breast; clinical assessment; differential diagnosis; cancer screening; clinical protocol; retrospective study; kinetics; contrast enhancement; breast carcinoma; invasive carcinoma; dynamic contrast-enhanced magnetic resonance imaging; intraductal carcinoma; breast lesion; lobular carcinoma in situ; kinetic parameters; atypical ductal hyperplasia; lobular carcinoma; cancer; human; female; priority journal; article; lesion volume; subcentimeter carcinoma; subcentimeter lesion
Journal Title: European Radiology
Volume: 30
Issue: 2
ISSN: 0938-7994
Publisher: Springer  
Date Published: 2020-02-01
Start Page: 756
End Page: 766
Language: English
DOI: 10.1007/s00330-019-06392-5
PUBMED: 31468162
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 3 February 2020 -- Source: Scopus
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MSK Authors
  1. Mary Catherine Hughes
    7 Hughes
  2. Elizabeth A Morris
    296 Morris
  3. Amita Dave
    93 Dave
  4. Elizabeth Jane Sutton
    36 Sutton
  5. Eun Sook Ko
    3 Ko
  6. Peter Gibbs
    8 Gibbs
  7. Theodore J Hunt
    2 Hunt