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- Title
Differentiation between subcentimeter carcinomas and benign lesions using kinetic parameters derived from ultrafast dynamic contrast-enhanced breast MRI.
- Authors
Onishi, Natsuko; Sadinski, Meredith; Gibbs, Peter; Gallagher, Katherine M.; Hughes, Mary C.; Ko, Eun Sook; Dashevsky, Brittany Z.; Shanbhag, Dattesh D.; Fung, Maggie M.; Hunt, Theodore M.; Martinez, Danny F.; Shukla-Dave, Amita; Morris, Elizabeth A.; Sutton, Elizabeth J.
- Abstract
<bold>Objectives: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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).<bold>Conclusions: </bold>Ultrafast DCE-MRI-derived kinetic parameters may be useful in differentiating subcentimeter BI-RADS 4 and 5 carcinomas from benign lesions.<bold>Key Points: </bold>• 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.
- Subjects
CONTRAST-enhanced magnetic resonance imaging; FISHER exact test; LOGISTIC regression analysis; CARCINOMA; MEDICAL protocols; FIBROADENOMAS; MAGNETIC resonance imaging; CONTRAST media; RETROSPECTIVE studies; DIFFERENTIAL diagnosis; DIAGNOSTIC imaging; BREAST; RESEARCH funding; BREAST tumors
- Publication
European Radiology, 2020, Vol 30, Issue 2, p756
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-019-06392-5