Enhancement parameters on dynamic contrast enhanced breast MRI: do they correlate with prognostic factors and subtypes of breast cancers?

Evaluation of background parenchymal enhancement on breast MRI: a systematic review

“…Noteworthy, the study by Kim et al 32 was able to associate high values of BPE around the tumours on pre-operative MRI with an increased risk of ipsilateral breast tumour recurrence. Without the use a quantitative approach, this information would have been missed.…”

“…BPE was described as percentage enhancement rates or a relative percentage enhancement in 11 studies, 22,24,30,32,46,47,[53][54][55]58,59 with the use of both pre-and post-contrast images. There was a wide heterogeneity in the time selection of images obtained after contrast agent injection for relative percentage enhancement or percentage enhancement rate calculation.…”

“…57 Wu et al 60 used a validated fully automated method that allowed segmentation and quantitative measure of fibroglandular tissues and BPE. 60 Qualitative and quantitative background parenchymal enhancement assessment Among the 11 studies that assessed BPE in both qualitative and quantitative methods, 7,20,22,24,29,30,32,34,35,46,47 27% (3/11) studies were published in 2015 (January-October 2015) and 73% (8/11) studies were published during 2010-2014. Most of the studies were performed in the USA (3/11 studies) and the Korea (3/11 studies).…”

“…8,10,[12][13][14][15]21,23,26,28,[32][33][34][35][36]38,[40][41][42][43][48][49][50][51][52][53][54]57,59,61 In five studies, 11,17,19,29,44 the authors acknowledged that owing to the retrospective nature of the study, it was not possible to analyze the point of menstrual cycle, although, following institutional protocol, screening breast MRI of patients who were pre-menopausal was performed during the second week of the menstrual cycle. In a total of 14 studies, the authors stated the menstrual period.…”

“…The domain of "patient selection" for the qualitative and quantitative BPE evaluation was unclear in the studies of DeMartini et al, 11 Choi and Kim, 23 Jansen et al, 29 Kajihara et al, 30 Kang et al, 55 Kim JY et al 32 and Park et al 43 The domain "index test and reference standard" was described in detail in most of the studies that assessed BPE qualitatively and quantitatively. A risk of bias and concerns regarding applicability were judged in the study of Chen et al 50 and in the studies of Grimm et al 26 and Myers et al, 42 specifically for the low quality of MRI examinations where the BPE assessment was performed and a low detail of the qualitative assessment of BPE, respectively.…”