Document Detail


Discrimination of benign and malignant breast lesions by using shutter-speed dynamic contrast-enhanced MR imaging.
MedLine Citation:
PMID:  21828189     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 (K(trans)) and interstitial space volume fraction, or v(e). 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 K(trans) had significantly (P = .008) higher diagnostic specificity than standard approach K(trans): 86.1% versus 77.8%. The difference in the ROI-averaged K(trans) parameter value, or ΔK(trans) (≡ K(trans) [shutter-speed approach] - K(trans) [standard approach]), had even higher specificity (88.9%). Combined use of ROI analysis and pixel-by-pixel mapping of ΔK(trans) 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. Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11102413/-/DC1.
Authors:
Wei Huang; Luminita A Tudorica; Xin Li; Sunitha B Thakur; Yiyi Chen; Elizabeth A Morris; Ian J Tagge; Maayan E Korenblit; William D Rooney; Jason A Koutcher; Charles S Springer
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-08-09
Journal Detail:
Title:  Radiology     Volume:  261     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-20     Completed Date:  2011-12-07     Revised Date:  2012-01-18    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  394-403     Citation Subset:  AIM; IM    
Copyright Information:
RSNA, 2011
Affiliation:
W. M. Keck Foundation High-Field MRI Laboratory-Advanced Imaging Research Center, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA. huangwe@ohsu.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Breast Diseases / pathology*
Breast Neoplasms / pathology
Contrast Media / diagnostic use,  pharmacokinetics
Diagnosis, Differential
Female
Gadolinium DTPA / diagnostic use,  pharmacokinetics
Humans
Image Enhancement / methods
Magnetic Resonance Imaging / methods*
Mammography
Middle Aged
ROC Curve
Sensitivity and Specificity
Grant Support
ID/Acronym/Agency:
R01 CA120861/CA/NCI NIH HHS; R01 EB000422/EB/NIBIB NIH HHS; R01 NS040801/NS/NINDS NIH HHS; R01 NS040801-09/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Contrast Media; 80529-93-7/Gadolinium DTPA

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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