Benign and malignant breast lesions: differentiation with echo-planar MR imaging.

Hulka, Carol A.; Smith, Benjamin L.; Sgroi, Dennis; Tan, L. K. A.; Edmister, Whitney B.; Semple, J. P.; Campbell, T; Kopans, Daniel B.; Brady, T J; Weisskoff, Robert M.

doi:10.1148/radiology.197.1.7568850

Cited by 184 publications

(132 citation statements)

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“…Previously, the presence of increased blood flow in breast tumors has also been demonstrated using positron emission tomography (13), temporally-resolved contrast-enhanced MRI (14)(15)(16)(17), and color Doppler ultrasonography (18). Furthermore, an ipsilateral association between cancer and increased breast vascularity has been demonstrated using conventional MRI (19,20).…”

Section: Discussionmentioning

confidence: 97%

3D vascular mapping of breast using contrast enhanced mri: association of unilateral increased vascularity with ipsilateral breast cancer

Örgüç

Başara²,

Coşkun³

et al. 2012

Diagn Interv Radiol

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Section: Discussionmentioning

confidence: 97%

3D vascular mapping of breast using contrast enhanced mri: association of unilateral increased vascularity with ipsilateral breast cancer

Örgüç

Başara²,

Coşkun³

et al. 2012

Diagn Interv Radiol

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“…Buckley et al (14) studied 40 malignant cancers and found a significant correlation between factor VIII vessel density and the early enhancement amplitude. Hulka et al (12) initially published a series of 22 lesions and found an overall positive, but not statistically significant, correlation between extraction-flow product and microvessel density. They further expanded their study to include 71 lesions and found an overall significant correlation between extraction-flow product and microvessel density, but the correlation was not significant in the subgroup of benign or malignant cancers (13).…”

Section: Discussionmentioning

confidence: 98%

“…We only included malignant cancers in this series. Benign lesions often had lower early enhancements and lower vascular density (12,13). If benign lesions were to be included, the spectrum would be widened and an improved correlation should be expected.…”

Section: Discussionmentioning

confidence: 99%

“…To further understand the pathophysiological basis for dynamic contrast enhancement properties in breast cancer, several investigators evaluated the association between MRI parameters and the angiogenic markers, such as quantitative microvessel density or vascular endothelial growth factor (VEGF) expression measured by immunohistochemistry (IHC) (12)(13)(14)(15)(16). Microvessel density is commonly used as a surrogate for angiogenesis and has been shown to be an independent prognostic factor associated with relapse-free and overall survival of breast cancer patients (17)(18)(19).…”

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confidence: 99%

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Correlation of dynamic contrast enhancement MRI parameters with microvessel density and VEGF for assessment of angiogenesis in breast cancer

Cheung

Fruehauf

et al. 2003

Magnetic Resonance Imaging

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Purpose:To investigate the association between parameters obtained from dynamic contrast enhanced MRI (DCE-MRI) of breast cancer using different analysis approaches, as well as their correlation with angiogenesis biomarkers (vascular endothelial growth factor and vessel density).Materials and Methods: DCE-MRI results were obtained from 105 patients with breast cancer (108 lesions). Three analysis methods were applied: 1) whole tumor analysis, 2) regional hot-spot analysis, and 3) intratumor pixel-by-pixel analysis. Early enhancement intensities and fitted pharmacokinetic parameters were studied. Paraffin blocks of 71 surgically resected specimens were analyzed by immunohistochemical staining to measure microvessel counts (with CD31) and vascular endothelial growth factor (VEGF) expression levels.Results: MRI parameters obtained from the three analysis methods showed significant correlations (P Ͻ 0.0001), but a substantial dispersion from the linear regression line was noted (r ϭ 0.72-0.97). The entire region of interest (ROI) vs. pixel population analyses had a significantly higher association compared to the entire ROI vs. hot-spot analyses. Cancer specimens with high VEGF expression had significantly higher CD31 microvessel densities than did specimens with low VEGF levels (P Ͻ 0.005). No significant association was found between MRI parameters obtained from the three analysis strategies and IHC based measurements of angiogenesis. Conclusion:A consistent analysis strategy was important in the DCE-MRI study. In this series, none of these strategies yielded results for MRI based quantitation of tumor vascularity that were associated with IHC based measurements. Therefore, different analyses could not account for the lack of association.

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“…Some investigators who have concentrated on T1-weighted, time-signal intensity characteristics of gadolinium enhancement report very high specificities (83%-97%) (6,7,(17)(18)(19), but others have seen no significant difference between benign and malignant abnormalities (2,5,20). Investigators who have tried to directly compare the use of contrast enhancement kinetics to the use of architectural features have found architectural features to be superior to quantitative kinetic indices alone (13,14).…”

Section: Discussionmentioning

confidence: 99%

Optimal post‐contrast timing of breast MR image acquisition for architectural feature analysis

Nunes

Englander

Charafeddine

et al. 2002

Magnetic Resonance Imaging

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Purpose: To define a post-contrast imaging time span during which diagnostic accuracy of breast magnetic resonance (MR) architectural feature analysis is maintained. Materials and Methods:Seventy-five patients with mammographically-visible or palpable findings underwent MR examination. Three sequential post-contrast, fat-saturated, three-dimensional gradient-echo imaging runs were acquired spanning 0 -90, 90 -180, and 180 -270 seconds after contrast injection. Five readers independently predicted the malignant potential of the MR abnormalities.Results: Receiver-operator characteristics (ROC) curves were our primary measure of diagnostic accuracy. The accuracy of four readers was unchanged over the three postcontrast runs. One reader was slightly more accurate using the second and third runs than using the first. Conclusion:For most readers, a single post-contrast run performed at any point during the first four minutes and 30 seconds following injection should yield an equivalent diagnostic accuracy. If any time period is less optimal, it is that of our first run, performed between 0 -90 seconds after contrast injection.

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Benign and malignant breast lesions: differentiation with echo-planar MR imaging.

Abstract: Echo-planar imaging appears promising for quantification of breast lesion enhancement. Microvessel data indicate that tumor angiogenesis affects enhancement.

Cited by 184 publications

References 0 publications

3D vascular mapping of breast using contrast enhanced mri: association of unilateral increased vascularity with ipsilateral breast cancer

3D vascular mapping of breast using contrast enhanced mri: association of unilateral increased vascularity with ipsilateral breast cancer

Correlation of dynamic contrast enhancement MRI parameters with microvessel density and VEGF for assessment of angiogenesis in breast cancer

Optimal post‐contrast timing of breast MR image acquisition for architectural feature analysis

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