Discrimination of Benign and Malignant Breast Lesions by Using Shutter-Speed Dynamic Contrast-enhanced MR Imaging
- 1 November 2011
- journal article
- research article
- Published by Radiological Society of North America (RSNA) in Radiology
- Vol. 261 (2), 394-403
- https://doi.org/10.1148/radiol.11102413
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 contrast-enhanced 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 Ktrans had 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 ∆Ktrans (≡ Ktrans [shutter-speed approach] − Ktrans [standard approach]), had even higher specificity (88.9%). Combined use of ROI analysis and pixel-by-pixel mapping of ∆Ktrans 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 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11102413/-/DC1Keywords
This publication has 40 references indexed in Scilit:
- Tracer kinetic analysis of dynamic contrast‐enhanced MRI and CT bladder cancer data: A preliminary comparison to assess the magnitude of water exchange effectsMagnetic Resonance in Medicine, 2010
- Kinetic Curves of Malignant Lesions Are Not Consistent Across MRI Systems: Need for Improved Standardization of Breast Dynamic Contrast-Enhanced MRI AcquisitionAmerican Journal of Roentgenology, 2009
- The magnetic resonance shutter speed discriminates vascular properties of malignant and benign breast tumors in vivoProceedings of the National Academy of Sciences of the United States of America, 2008
- Dynamic NMR effects in breast cancer dynamic-contrast-enhanced MRIProceedings of the National Academy of Sciences of the United States of America, 2008
- First‐pass dynamic contrast‐enhanced MRI with extravasating contrast reagent: evidence for human myocardial capillary recruitment in adenosine‐induced hyperemiaNMR in Biomedicine, 2008
- Feasibility of using limited‐population‐based arterial input function for pharmacokinetic modeling of osteosarcoma dynamic contrast‐enhanced MRI dataMagnetic Resonance in Medicine, 2008
- MRI Evaluation of the Contralateral Breast in Women with Recently Diagnosed Breast CancerNew England Journal of Medicine, 2007
- Magnetic resonance imaging in breast cancerEuropean Journal of Surgical Oncology, 2006
- Experimentally‐derived functional form for a population‐averaged high‐temporal‐resolution arterial input function for dynamic contrast‐enhanced MRIMagnetic Resonance in Medicine, 2006
- A unified magnetic resonance imaging pharmacokinetic theory: Intravascular and extracellular contrast reagentsMagnetic Resonance in Medicine, 2005