Differentiation of benign from malignant breast masses by time-intensity evaluation of contrast enhanced MRI

Flickinger, Fred W.; Allison, J. B.; Sherry, Richard M.; Wright, J. C.

doi:10.1016/0730-725x(93)90002-u

Cited by 142 publications

(62 citation statements)

References 4 publications

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“…Many studies have used simplified measurements of change in signal intensity for their analyses. Such metrics characterize the shape of the signal-time course curve or describe the rate of increase in signal intensity (7,8), but show poor reproducibility and do not distinguish the effects of blood flow, blood volume, and contrast agent leakage (9). The application of T 1 -weighted DCE-MRI to early-phase clinical trials of angiogenesis inhibitors has driven developments in quantitative image analysis, particularly the modeling of variables that describe tumor microvascular structure and function (Fig.…”

Section: Applications Of Dce-mrimentioning

confidence: 99%

“…In the breast, it is common to calculate enhancement rates from regions of interest placed within suspicious lesions (10) with simple signal intensity metrics such as the proportion of maximal enhancement that occurs over a given time (e.g., 80%/min; ref. 8). Although malignant lesions tend to have higher enhancement rates, no fixed threshold provides a reliable distinction.…”

Section: Clinical Applications Of Dce-mrimentioning

confidence: 99%

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Imaging Tumor Vascular Heterogeneity and Angiogenesis using Dynamic Contrast-Enhanced Magnetic Resonance Imaging

Jackson

O’Connor

Parker

et al. 2007

Clinical Cancer Research

286

220

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This article reviews the application of dynamic contrast-enhanced magnetic resonance imaging in both clinical studies and early-phase trials of angiogenesis inhibitors. Emphasis is placed on how variation in image acquisition and analysis affects the meaning and use of derived variables. We then review the potential for future developments, with particular reference to the application of dynamic contrast-enhanced magnetic resonance imaging to evaluate the heterogeneity of tumor tissues.

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Section: Applications Of Dce-mrimentioning

confidence: 99%

Section: Clinical Applications Of Dce-mrimentioning

confidence: 99%

Imaging Tumor Vascular Heterogeneity and Angiogenesis using Dynamic Contrast-Enhanced Magnetic Resonance Imaging

Jackson

O’Connor

Parker

et al. 2007

Clinical Cancer Research

286

220

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“…The MR imaging studies of 93 women with 101 breast lesions met the following criteria for inclusion in this study: (a) MR imaging was performed by using a 3.0-T magnet, (b) both dynamic contrast-enhanced MR imaging (hereafter, dynamic imaging) and DW MR imaging sequences were performed, and (c) either the diagnosis was proved at pathologic analysis (96 lesions), or lesion stability was confi rmed at more than 2 years of follow-up (fi ve lesions). Of the 550 patients, 280 were excluded for not having a suspicious abnormality on dynamic images, 152 were excluded for having lesions without a suffi cient follow-up M agnetic resonance (MR) imaging of the breast is known for its inherently high sensitivity but only moderate specifi city for the characterization of breast lesions (1)(2)(3)(4)(5). Thus, efforts have been directed toward developing new pulse sequences and evaluation methods that improve lesion characterization.…”

Section: Patientsmentioning

confidence: 99%

Diffusion-weighted Imaging Improves the Diagnostic Accuracy of Conventional 3.0-T Breast MR Imaging

Jacobs²,

et al. 2010

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Purpose:To evaluate the incremental value of diffusion-weighted (DW) imaging and apparent diffusion coeffi cient (ADC) mapping in relation to conventional breast magnetic resonance (MR) imaging in the characterization of benign versus malignant breast lesions at 3.0 T. Materials and Methods:This retrospective HIPAA-compliant study was approved by the institutional review board, with the requirement for informed patient consent waived. Of 550 consecutive patients who underwent bilateral breast MR imaging over a 10-month period, 93 women with 101 lesions met the following study inclusion criteria: They had undergone three-dimensional (3D) high -spatial-resolution T1-weighted contrast material-enhanced MR imaging, dynamic contrastenhanced MR imaging, and DW imaging examinations at 3.0 T and either had received a pathologic analysis-proven diagnosis (96 lesions) or had lesion stability confi rmed at more than 2 years of follow-up (fi ve lesions). DW images were acquired with b values of 0 and 600 sec/mm 2 . Regions of interest were drawn on ADC maps of breast lesions and normal glandular tissue. Morphologic features (margin, enhancement pattern), dynamic contrastenhanced MR results (semiquantitative kinetic curve data), absolute ADCs, and glandular tissue-normalized ADCs were included in multivariate models to predict a diagnosis of benign versus malignant lesion. Results:Forty-one (44%) of the 93 patients were premenopausal, and 52 (56%) were postmenopausal. Thirty-three (32.7%) of the 101 lesions were benign, and 68 (67.3%) were malignant. Normalized ADCs were signifi cantly different between the benign (mean ADC, 1.1 3 10 2 3 mm 2 /sec 6 0.4 [standard deviation]) and malignant (mean ADC, 0.55 3 10 2 3 mm 2 /sec 6 0.16) lesions ( P , .001). Adding normalized ADCs to the 3D T1-weighted and dynamic contrast-enhanced MR data improved the diagnostic performance of MR imaging: The area under the receiver operating characteristic curve improved from 0 .89 to 0.98, and the false-positive rate decreased from 36% (nine of 25 lesions) to 24% (six of 25 lesions). Conclusion:DW imaging with glandular tissue-normalized ADC assessment improves the characterization of breast lesions beyond the characterization achieved with conventional 3D T1-weighted and dynamic contrast-enhanced MR imaging at 3.0 T.q RSNA, 2010

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“…Differentiation between benign and malignant lesions is still problematic in some cases; however, application of the dynamic turbo, fast low-angle shot (TurboFLASH; Siemens, Erlan gen, Germany) technique in the breast, which has recently been re ported, appears to be promising (4)(5)(6). With regard to the performance of MR imaging in size determination, few data are available (7,8).…”

mentioning

confidence: 99%

Breast tumors: comparative accuracy of MR imaging relative to mammography and US for demonstrating extent.

Boetes¹,

Mus²,

Holland³

et al. 1995

Radiology

480

244

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B r e a s t T u m o rs: C o m p a ra tiv e A c c u ra c y o f MR Im a g in g R elativ e to M a m m o g ra p h y a n d US fo r D e m o n s tra tin g E x te n t1 A PURPOSE; To evaluate the compara tive accuracy of magnetic resonance (MR) imaging relative to mammogra phy and ultrasonography (US) for assessing the extent of breast tumors. MATERIALS A N D METHODS:His tologic results and preoperative im aging findings (mammography, US, MR imaging) were analyzed regard ing tumor size and multifocality of 61 tumors in 60 women undergoing mastectomy for carcinoma. RESULTS:In 10% of cases, the index tumor was not seen at mammogra phy. With US, 15% of the index tu mors were not recognized, while MR imaging missed 2% of the index tu mors. On mammographic and US images, tumor size was underesti mated significantly (P < .005), by 14% and 18%, respectively, while MR im aging showed no significant differ ence in size compared with that found in a pathologic evaluation. Mammography showed 31% of the additional invasive lesions, w hile US showed 38% and MR imaging showed 100%. CONCLUSION: MR imaging was the most accurate of the three preopera tive imaging modalities in assessing the size and number of malignant lesions in the breast.

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Differentiation of benign from malignant breast masses by time-intensity evaluation of contrast enhanced MRI

Cited by 142 publications

References 4 publications

Imaging Tumor Vascular Heterogeneity and Angiogenesis using Dynamic Contrast-Enhanced Magnetic Resonance Imaging

Imaging Tumor Vascular Heterogeneity and Angiogenesis using Dynamic Contrast-Enhanced Magnetic Resonance Imaging

Diffusion-weighted Imaging Improves the Diagnostic Accuracy of Conventional 3.0-T Breast MR Imaging

Breast tumors: comparative accuracy of MR imaging relative to mammography and US for demonstrating extent.

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