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- Title
Pharmacokinetic mapping for lesion classification in dynamic breast MRI.
- Authors
Schabel, Matthias C.; Morrell, Glen R.; Oh, Karen Y.; Walczak, Cheryl A.; Barlow, R. Brad; Neumayer, Leigh A.
- Abstract
Purpose: To prospectively investigate whether a rapid dynamic MRI protocol, in conjunction with pharmacokinetic modeling, could provide diagnostically useful information for discriminating biopsy-proven benign lesions from malignancies. Materials and Methods: Patients referred to breast biopsy based on suspicious screening findings were eligible. After anatomic imaging, patients were scanned using a dynamic protocol with complete bilateral breast coverage. Maps of pharmacokinetic parameters representing transfer constant ( K trans), efflux rate constant ( k ep), blood plasma volume fraction ( v p), and extracellular extravascular volume fraction ( v e) were averaged over lesions and used, with biopsy results, to generate receiver operating characteristic curves for linear classifiers using one, two, or three parameters. Results: Biopsy and imaging results were obtained from 93 lesions in 74 of 78 study patients. Classification based on K trans and k ep gave the greatest accuracy, with an area under the receiver operating characteristic curve of 0.915, sensitivity of 91%, and specificity of 85%, compared with values of 88% and 68%, respectively, obtained in a recent study of clinical breast MRI in a similar patient population. Conclusion: Pharmacokinetic classification of breast lesions is practical on modern MRI hardware and provides significant accuracy for identification of malignancies. Sensitivity of a two-parameter linear classifier is comparable to that reported in a recent multicenter study of clinical breast MRI, while specificity is significantly higher. J. Magn. Reson. Imaging 2010;31:1371-1378. © 2010 Wiley-Liss, Inc.
- Publication
Journal of Magnetic Resonance Imaging, 2010, Vol 31, Issue 6, p1371
- ISSN
1053-1807
- Publication type
Article
- DOI
10.1002/jmri.22179