Purpose:To develop and apply a semiautomatic method of segmenting fibroglandular tissue to quantify magnetic resonance (MR) imaging contrast material-enhancement kinetics of breast background parenchyma (BP) and lesions throughout the phases of the menstrual cycle in women with benign and malignant lesions. Materials and Methods:The institutional review board approved this retrospective HIPAA-compliant study, and informed consent was waived. From December 2008 to August 2011, 58 premenopausal women who had undergone contrast materialenhanced MR imaging and MR imaging-guided biopsy were identified. The longest time from the start of the last known period was 34 days. One lesion per patient (37 benign and 21 malignant) was analyzed. The patient groups were stratified according to the week of the menstrual cycle when MR imaging was performed. A method based on principal component analysis (PCA) was applied for quantitative analysis of signal enhancement in the BP and lesions by using the percentage of slope and percentage of enhancement. Linear regression and the Mann-Whitney U test were used to assess the association between the kinetic parameters and the week of the menstrual cycle. Results:In the women with benign lesions, percentages of slope and enhancement for both BP and lesions during week 2 were significantly (P , .05) lower than those in week 4. Percentage of enhancement in the lesion in week 2 was lower than that in week 3 (P , .05). The MR images of women with malignant lesions showed no significant difference between the weeks for any of the parameters. There was a strong positive correlation between lesion and BP percentage of slope (r = 0.72) and between lesion and BP percentage of enhancement (r = 0.67) in the benign group. There was also a significant (P = .03) difference in lesion percentage of slope between the benign and malignant groups at week 2. Conclusion:The PCA-based method can quantify contrast enhancement kinetics of BP semiautomatically, and kinetics of BP and lesions vary according to the week of the menstrual cycle in benign but not in malignant lesions.q RSNA, 2013

Purpose To develop a bilateral coil and optimized fat suppressed T1-weighted sequence for 7T breast MRI. Materials and Methods A dual-solenoid coil and 3D T1w gradient echo sequence with B1+ insensitive fat suppression (FS) were developed for 7T. T1w FS image quality was characterized through image uniformity and fat/water contrast measurements in 11 subjects. Signal-to-noise ratio (SNR) and flip angle maps were acquired to assess the coil performance. Bilateral contrast-enhanced and unilateral high resolution (0.6 mm isotropic, 6.5 min acquisition time) imaging highlighted the 7 T SNR advantage. Results Reliable and effective FS and high image quality was observed in all subjects at 7T, indicating that the custom coil and pulse sequence were insensitive to high-field obstacles such as variable tissue loading. 7T and 3T T1w FS image uniformity was similar (P=0.24), indicating adequate 7T B1+ uniformity. High 7T SNR and fat/water contrast enabled 0.6 mm isotropic imaging and visualization of a high level of fibroglandular tissue detail. Conclusion 7T T1w FS bilateral breast imaging is feasible with a custom RF coil and pulse sequence. Similar image uniformity was achieved at 7T and 3T, despite different RF field behavior and variable coil-tissue interaction due to anatomic differences that might be expected to alter magnetic field patterns.

Objectives To evaluate the image quality of T1-weighted fat-suppressed breast MRI at 7 T, and to compare 7-T and 3-T images. Methods Seventeen subjects were imaged using a 7-T bilateral transmit-receive coil and adiabatic inversion-based fat suppression (FS). Images were graded on a five-point scale and quantitatively assessed through signal-to-noise ratio (SNR), fibroglandular/fat contrast and signal uniformity measurements. Results Image scores at 7 T and 3 T were similar on standard-resolution images (1.1× 1.1×1.1−1.6 mm3), indicating that high-quality breast imaging with clinical parameters can be performed at 7 T. The 7-T SNR advantage was underscored on 0.6-mm isotropic images, where image quality was significantly greater than at 3 T (4.2 versus 3.1, P≤0.0001). Fibroglandular/fat contrast was more than two times higher at 7 T over 3 T, owing to effective adiabatic inversion-based FS and the inherent 7 T signal advantage. Signal uniformity was comparable at 7 T and 3 T (P<0.05). Similar 7-T image quality was observed in all subjects, indicating robustness against anatomical variation. Conclusion The 7-T bilateral transmit-receive coil and adiabatic inversion-based FS technique mitigate the impact of high-field heterogeneity to produce image quality that is as good as or better than at 3 T

PURPOSE To assess the diagnostic utility of contrast kinetic analysis for breast lesions and background parenchyma of women undergoing MRI-guided biopsies, for whom standard clinical analysis had failed to separate benign and malignant lesions. METHOD This study included 115 women who had indeterminate lesions based on routine diagnostic breast MRI exams and underwent an MRI(3T)-guided biopsy of one or more lesions suspicious for breast cancer. Breast DCE-MRI was performed using a radial stack-of-stars 3D spoiled gradient echo pulse sequence and modified k-space weighted image contrast (KWIC) image reconstruction. Contrast kinetic model analysis was conducted to characterize the contrast enhancement patterns measured in lesions and background parenchyma (BP). The transfer rate (Ktrans), interstitial volume fraction (ve), and vascular volume fraction (vp) estimated from the lesion and BP were used to separate malignant from benign lesions. RESULTS The patients with malignant lesions had significantly (p<0.05) higher median lesion-Ktrans (0.081 min−1), higher median BP-Ktrans (0.032 min−1), and BP-vp (0.020) than those without malignant lesions (0.056 min−1, 0.017 min−1 and 0.012, respectively). The area under the receiver operating characteristic curve (AUC) of the BP-Ktrans (0.687) was highest among the single parameters and higher than that of the lesion-Ktrans (0.664). The combined logistic regression model of lesion-Ktrans, lesion-ve, BP-Ktrans, BP-ve, and BP-vp had the highest AUC of 0.730. CONCLUSION Our results suggest that the contrast kinetic analysis of DCE-MRI data can be used to differentiate the malignant lesions from the benign and high-risk lesions among the indeterminate breast lesions recommended for MRI-guided biopsy exams.