Dynamic image interpretation of MRI of the breast

Kuhl, Christiane K.; Schild, Hans H.

doi:10.1002/1522-2586(200012)12:6<965::aid-jmri23>3.0.co;2-1

Cited by 194 publications

(138 citation statements)

References 71 publications

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“…Hot-spot analysis was applied to measure the characteristics from the regions showing the strongest early enhancement. This analysis was the most common approach in clinical practice for diagnosis of breast cancer (7). Among lesions that presented as distinct masses, a peripheral enhancement pattern was observed frequently, as is the case in Figure 1.…”

Section: Discussionmentioning

confidence: 99%

“…The early enhancement intensity (or the pharmacokinetic parameter Vb) may already include contributions from contrast agents in the extravascular space and may not reflect the true vascular volume or correlate with the number of vessels. The inconsistency between MRI enhancements and vascular density has also been addressed in detail by Kuhl et al (7).…”

Section: Discussionmentioning

confidence: 99%

“…Breast lesions may appear as masses with heterogeneous enhancement or as enhancing regions without distinct margins. In an attempt to overcome heterogeneity issues, various investigators have focused on using DCE-MRI kinetic enhancement patterns to differentiate between benign and malignant lesions (6,7). These differences have been attributed to the higher vascular volume and/or permeability associated with angiogenesis in malignant tissues.…”

mentioning

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

150

115

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

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

150

115

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“…High-resolution anatomic MRI and dynamic contrast-enhanced MR imaging (DCE) MR imaging have become an established clinical modality for detection and diagnosis of breast lesions (1). In March 2007, the American Cancer Society issued new guidelines recommending annual MRI screening for women who have a lifetime risk higher than 20% for developing breast cancer.…”

Section: Introductionmentioning

confidence: 99%

“…Combined application of DCE MR imaging and 1 H MRS has been used in diagnosing breast lesions in several studies (8,9). The addition of MRS yields a higher specificity relative to that using DCE MR imaging alone.…”

Section: Introductionmentioning

confidence: 99%

Quantitative correlation between 1H MRS and dynamic contrast-enhanced MRI of human breast cancer

Baek

Chen

et al. 2008

Magnetic Resonance Imaging

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Proton MR spectroscopy ( 1 H MRS) and dynamic contrast-enhanced (DCE) MR imaging provide functional information, including vascular volume, vascular permeability, and choline (Cho) metabolism. In this study, we applied these two imaging modalities to quantitatively characterize 36 malignant breast lesions in 32 patients and analyzed the correlation between them. The Cho concentration was quantified by single-voxel 1 H MRS using water as an internal reference. The measured Cho levels ranged from 0.32 to 10.47 mmol/kg, consistent with previously reported values. In 25 mass type lesions, the Cho concentration was significantly correlated with tumor size (r = 0.69, p < 0.0002). In addition, the Cho level was found to be significantly higher in lesions presenting as mass type lesions compared to non-mass type diffuse enhancements (p = 0.035). The enhancement kinetics from tissues covered within each MRS voxel were measured and analyzed with a 2-compartmental model to obtain pharmacokinetic parameters K trans and k ep . A significant correlation was found between the Cho level and pharmacokinetic parameter k ep (r = 0.62, p < 0.0001), indicating that tissues with a high Cho level have higher wash-out rates in DCE MR imaging. The results suggest a correlation between choline metabolism and angiogenesis activity, which might be explained by the association of Cho with cell replication and angiogenesis required to support tumor growth.

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Magnetic Resonance Imaging

Block¹,

Alexander²,

Fain³

et al. 2006

Encyclopedia of Medical Devices and Instrumentation

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Magnetic resonance imaging (MRI) moved out of the exclusive realm of academia and into widespread clinical practice in the 1980s. Relatively quickly, MRI became the modality of choice for several head, spine, and musculoskeletal imaging exams due to tis excellent soft tissue contrast. Although the plateau of MRI’s development and utilization has often been predicted, it continues to grow through being an amazingly adaptive technology. New mechanisms of generating image contrast have allowed the modality to go beyond the study of anatomical structure and deliver functional physiological informaion. A description of the nuclear magnetic resonance (NMR) phenomena, methods to spatially encode the NMR signal, image contrast mechanisms, and emerging appliactions are provided.

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Dynamic image interpretation of MRI of the breast

Cited by 194 publications

References 71 publications

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

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

Quantitative correlation between 1H MRS and dynamic contrast-enhanced MRI of human breast cancer

Magnetic Resonance Imaging

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