Harmonization of quantitative parenchymal enhancement in T(1)-weighted breast MRI Journal Article


Authors: van der Velden, B. H. M.; van Rijssel, M. J.; Lena, B.; Philippens, M. E. P.; Loo, C. E.; Ragusi, M. A. A.; Elias, S. G.; Sutton, E. J.; Morris, E. A.; Bartels, L. W.; Gilhuijs, K. G. A.
Article Title: Harmonization of quantitative parenchymal enhancement in T(1)-weighted breast MRI
Abstract: Background: Differences in imaging parameters influence computer-extracted parenchymal enhancement measures from breast MRI. Purpose: To investigate the effect of differences in dynamic contrast-enhanced MRI acquisition parameter settings on quantitative parenchymal enhancement of the breast, and to evaluate harmonization of contrast-enhancement values with respect to flip angle and repetition time. Study Type: Retrospective. Phantom/Populations: We modeled parenchymal enhancement using simulations, a phantom, and two cohorts (N = 398 and N = 302) from independent cancer centers. Sequence Field/Strength: 1.5T dynamic contrast-enhanced T1-weighted spoiled gradient echo MRI. Vendors: Philips, Siemens, General Electric Medical Systems. Assessment: We assessed harmonization of parenchymal enhancement in simulations and phantom by varying the MR parameters that influence the amount of T1-weighting: flip angle (8°–25°) and repetition time (4–12 msec). We calculated the median and interquartile range (IQR) of the enhancement values before and after harmonization. In vivo, we assessed overlap of quantitative parenchymal enhancement in the cohorts before and after harmonization using kernel density estimations. Cohort 1 was scanned with flip angle 20° and repetition time 8 msec; cohort 2 with flip angle 10° and repetition time 6 msec. Statistical Tests: Paired Wilcoxon signed-rank-test of bootstrapped kernel density estimations. Results: Before harmonization, simulated enhancement values had a median (IQR) of 0.46 (0.34–0.49). After harmonization, the IQR was reduced: median (IQR): 0.44 (0.44–0.45). In the phantom, the IQR also decreased, median (IQR): 0.96 (0.59–1.22) before harmonization, 0.96 (0.91–1.02) after harmonization. Harmonization yielded significantly (P < 0.001) better overlap in parenchymal enhancement between the cohorts: median (IQR) was 0.46 (0.37–0.58) for cohort 1 vs. 0.37 (0.30–0.44) for cohort 2 before harmonization (57% overlap); and 0.35 (0.28–0.43) vs.0.37 (0.30–0.44) after harmonization (85% overlap). Data Conclusion: The proposed practical harmonization method enables an accurate comparison between patients scanned with differences in imaging parameters. Level of Evidence: 3. Technical Efficacy Stage: 4. © 2020 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.
Journal Title: Journal of Magnetic Resonance Imaging
Volume: 52
Issue: 5
ISSN: 1053-1807
Publisher: Wiley Blackwell  
Date Published: 2020-11-01
Start Page: 1374
End Page: 1382
Language: English
DOI: 10.1002/jmri.27244
PUBMED: 32491246
PROVIDER: scopus
PMCID: PMC7687185
DOI/URL:
Notes: Article -- Export Date: 1 December 2020 -- Source: Scopus
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  1. Elizabeth A Morris
    336 Morris
  2. Elizabeth Jane Sutton
    69 Sutton