Dynamic MR Imaging Of The Breast. Analysis of kinetic and morphologic diagnostic criteria

Szabó, Botond K.; Aspelin, Peter; Wiberg, Maria Kristoffersen; Boné, B.

doi:10.1034/j.1600-0455.2003.00084.x

Cited by 95 publications

(89 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This suggests that the initial enhancement level, rather than kinetic curve morphologies, contributes most to predicting benign pathology. These findings are consistent with prior studies using qualitative (17,18) or quantitative (11,12,19–22) techniques that show lesions with initial enhancement above a certain threshold improves specificity of breast MRI. In retrospective studies of a three time-point model using the commercial product CADStream (11,19), lesions that did not meet an initial enhancement of 50%–100% were all benign, potentially excluding 25%–50% of all benign lesions without excluding malignant lesions.…”

Section: Discussionsupporting

confidence: 91%

Can Signal Enhancement Ratio (SER) Reduce the Number of Recommended Biopsies without Affecting Cancer Yield in Occult MRI-detected Lesions?

Arasu¹,

Chen²,

Newitt³

et al. 2011

Academic Radiology

View full text Add to dashboard Cite

Rationale and Objectives We retrospectively determined if signal enhancement ratio (SER), a quantitative measure of contrast kinetics using volumetric parameters, could reduce the number of biopsy recommendations without decreasing the number of cancers detected when applied to suspicious lesions seen on breast magnetic resonance imaging (MRI). Materials and Methods A retrospective review of Breast Imaging Reporting and Data System (BIRADS) 4 or 5 lesions seen on breast MRI in 2008 that were clinically and mammographically occult yielded a final sample size of 73 lesions in 65 patients. Images were processed with in-house software. Parameters used to predict benignity/malignancy included SER total tumor volume (lesion volume above a 70% initial enhancement level), SER partial tumor volume (volume with “washout” and “plateau” kinetics), SER washout tumor volume, peak SER, and peak percent enhancement. Thresholds were determined to retrospectively discriminate benign from malignant histopathology. Clinical impact was assessed through the reduction in the number of biopsies recommended (by eliminating benign lesions discriminated by SER). Results Based on the original radiologist interpretations, 73 occult lesions were called suspicious and biopsied with a predictive value of biopsies (PPV3) of 18/73 (25%). SER parameters were found to be significantly associated with histopathology (P < .05). Biopsy recommendations could be reduced using SER parameters of SER partial tumor volume (73 to 40), SER total tumor volume (73 to 45), and peak percent enhancement (73 to 55) without removing true positives. Conclusion The adjunctive use of SER parameters may reduce the number of recommended biopsies without reducing the number of cancers detected.

show abstract

Section: Discussionsupporting

confidence: 91%

Can Signal Enhancement Ratio (SER) Reduce the Number of Recommended Biopsies without Affecting Cancer Yield in Occult MRI-detected Lesions?

Arasu¹,

Chen²,

Newitt³

et al. 2011

Academic Radiology

View full text Add to dashboard Cite

show abstract

“…The plot of signal intensity vs. time for this ROI was assessed by the radiologist according to the BIRADS lexicon, which describes the initial rise (‘rapid’, ‘medium’, ‘slow’) and delayed phase (‘persistent’, ‘plateau’, ‘washout’) of the kinetic curve(9). In addition to this qualitative assessment of kinetics, several quantitative parameters were calculated: the initial and peak enhancement percentages ( E 1 and E peak ), the time to peak enhancement ( T peak ) in seconds (10), and the signal enhancement ratio ( SER ) a measure of contrast media washout relative to the first post contrast point (19). …”

Section: Methodsmentioning

confidence: 99%

The diverse pathology and kinetics of mass, nonmass, and focus enhancement on MR imaging of the breast

Jansen

Shimauchi

Zak

et al. 2011

Magnetic Resonance Imaging

View full text Add to dashboard Cite

Purpose To compare the pathology and kinetic characteristics of breast lesions with focus, mass and nonmass-like enhancement. Materials and Methods 852 MRI detected breast lesions in 697 patients were selected for an IRB approved review. Patients underwent dynamic contrast enhanced MRI using one pre and three to six post-contrast T1 weighted images. The ‘type’ of enhancement was classified as mass, non-mass or focus, and kinetic curves quantified by the initial enhancement percentage (E1), time to peak enhancement (Tpeak) and signal enhancement ratio (SER). These kinetic parameters were compared between malignant and benign lesions within each morphologic type. Results 552 lesions were classified as mass (396 malignant, 156 benign), 261 as nonmass (212 malignant,49 benign) and 39 as focus (9 malignant,30 benign). The most common pathology of malignant/benign lesions by morphology: for mass, invasive ductal carcinoma/fibroadenoma; for nonmass, ductal carcinoma in situ (DCIS)/fibrocystic change(FCC); for focus, DCIS/FCC. Benign mass lesions exhibited significantly lower E1, longer Tpeak and lower SER compared with malignant mass lesions (p < 0.0001). Benign nonmass lesions exhibited only a lower SER compared to malignant nonmass lesions (p<0.01). Conclusions By considering the diverse pathology and kinetic characteristics of different lesion morphologies, diagnostic accuracy may be improved.

show abstract

“…Several studies have shown a correlation between rim enhancement and rapid tumor growth, decreased tumor differentiation, and other poor prognostic features such as a higher histological grade, ER negativity, higher expression of Ki-67, and higher lymph node stage. [6,7,14,19] Among these poor prognostic features, lymph node status is associated with late recurrence, as is rim enhancement on DCE-MRI. [8] …”

Section: Discussionmentioning

confidence: 99%

“…For each curve, the initial enhancement percentage (E1), peak enhancement percentage ( E peak ), and time to peak enhancement (TTP) were measured as follows: [19] E 1 = 100×( S 1 – S 0 )/ S 0 , E peak = 100 × ( S peak – S 0 )/ S 0 , where E 1 is the initial percentage enhancement, E peak is the peak percentage enhancement, S 1 is the signal intensity in the ROI at the first contrast-enhanced point, S peak is the peak signal intensity, and S 0 is the unenhanced signal intensity in the ROI. Time to peak enhancement is the time in seconds between injection of contrast material and the peak of the signal intensity-time curve.…”

Section: Methodsmentioning

confidence: 99%

Dynamic contrast-enhanced breast magnetic resonance imaging for the prediction of early and late recurrences in breast cancer

Choi

et al. 2016

Medicine

View full text Add to dashboard Cite

The aim of the study was to evaluate dynamic contrast-enhanced breast magnetic resonance imaging (DCE-MRI) features for the prediction of early and late recurrences in patients with breast cancer.Of 1030 breast cancer patients who underwent surgery at our hospital from January 2007 to July 2011, 83 recurrent breast cancer patients were enrolled in this study. We compared MRI features (background parenchymal enhancement [BPE], internal enhancement, adjacent vessel sign, whole-breast vascularity, initial enhancement pattern, kinetic curve types, and quantitative kinetic parameters) and clinico-pathologic variables (age, stage, histologic grade, nuclear grade, existence of lymphovascular invasion and extensive intraductal carcinoma component, and immunohistochemical profiles) between patients with early (≤2.5 years after surgery) and late recurrence (>2.5 years after surgery). Cox proportional hazard regression analysis was performed to evaluate independent risk factors for early and late recurrence.On breast MRI, prominent ipsilateral whole-breast vascularity was independently associated with early recurrence (hazard ratio [HR], 2.86; 95% confidence intervals [CI], 1.39–5.88) and moderate or marked BPE (HR, 2.08; 95% CI, 1.04–4.18) and rim enhancement (HR, 2.14; 95% CI, 1.00–4.59) were independently associated with late recurrence. Clinico-pathologic variables independently associated with early recurrence included negative estrogen receptor (HR, 0.53; 95% CI, 0.29–0.96), whereas T2 stage (HR, 2.08; 95% CI, 1.04–4.16) and nuclear grade III (HR, 2.54; 95% CI, 1.29–4.98) were associated with late recurrence.In DCE-MRI, prominent ipsilateral whole-breast vascularity, moderate or marked BPE, and rim enhancement could be useful for predicting recurrence timing in patients with breast cancer.

show abstract

Dynamic MR Imaging Of The Breast. Analysis of kinetic and morphologic diagnostic criteria

Abstract: Time-to-peak enhancement and the descriptor of margins appear to be the most important diagnostic criteria for mass lesions in dynamic breast MR imaging.

Cited by 95 publications

References 32 publications

Can Signal Enhancement Ratio (SER) Reduce the Number of Recommended Biopsies without Affecting Cancer Yield in Occult MRI-detected Lesions?

Can Signal Enhancement Ratio (SER) Reduce the Number of Recommended Biopsies without Affecting Cancer Yield in Occult MRI-detected Lesions?

The diverse pathology and kinetics of mass, nonmass, and focus enhancement on MR imaging of the breast

Dynamic contrast-enhanced breast magnetic resonance imaging for the prediction of early and late recurrences in breast cancer

Contact Info

Product

Resources

About