Evaluation of the Kinetic Properties of Background Parenchymal Enhancement throughout the Phases of the Menstrual Cycle

Abstract

Purpose:To develop and apply a semiautomatic method of segmenting fibroglandular tissue to quantify magnetic resonance (MR) imaging contrast material-enhancement kinetics of breast background parenchyma (BP) and lesions throughout the phases of the menstrual cycle in women with benign and malignant lesions. Materials and Methods:The institutional review board approved this retrospective HIPAA-compliant study, and informed consent was waived. From December 2008 to August 2011, 58 premenopausal women who had undergone contrast materialenhanced MR imaging and MR imaging-guided biopsy were identified. The longest time from the start of the last known period was 34 days. One lesion per patient (37 benign and 21 malignant) was analyzed. The patient groups were stratified according to the week of the menstrual cycle when MR imaging was performed. A method based on principal component analysis (PCA) was applied for quantitative analysis of signal enhancement in the BP and lesions by using the percentage of slope and percentage of enhancement. Linear regression and the Mann-Whitney U test were used to assess the association between the kinetic parameters and the week of the menstrual cycle. Results:In the women with benign lesions, percentages of slope and enhancement for both BP and lesions during week 2 were significantly (P , .05) lower than those in week 4. Percentage of enhancement in the lesion in week 2 was lower than that in week 3 (P , .05). The MR images of women with malignant lesions showed no significant difference between the weeks for any of the parameters. There was a strong positive correlation between lesion and BP percentage of slope (r = 0.72) and between lesion and BP percentage of enhancement (r = 0.67) in the benign group. There was also a significant (P = .03) difference in lesion percentage of slope between the benign and malignant groups at week 2. Conclusion:The PCA-based method can quantify contrast enhancement kinetics of BP semiautomatically, and kinetics of BP and lesions vary according to the week of the menstrual cycle in benign but not in malignant lesions.q RSNA, 2013

Ultrafast Bilateral DCE-MRI of the Breast with Conventional Fourier Sampling

“…younger women) (15–17). This is consistent with previous results with high temporal resolution imaging from Jansen et al (9), who sampled a limited number of slices with 7 second resolution and demonstrated that this approach detects significant differences between the early enhancement of DCIS and normal parenchyma, thus improving conspicuity of small diffuse cancers.…”

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

“…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).…”

“…In a total of 14 studies, the authors stated the menstrual period. 7,20,22,24,25,27,30,31,39,45,46,55,56,60 In 8 of these 14 studies, breast MRI were performed ideally in the second week of the menstrual cycle. 7,22,24,25,27,45,56,60 In three studies, 37,47,58 the patients were post-menopausal females.…”

The relationship of breast density in mammography and magnetic resonance imaging in high-risk women and women with breast cancer

“…Several studies have suggested that BPE represents physiological hormonal enhancement, reflecting hormone-related changes in breast composition and vascularity. Fluctuations in BPE have been demonstrated throughout the menstrual cycle, with the highest levels of enhancement in the second half of the menstrual cycle during the luteal phase when breast cell proliferation is at its highest [20]. BPE has also been demonstrated to reflect variations in estrogen-mediated vascular permeability, with increased BPE seen in women taking estrogen replacement therapy, and decreased BPE with anti-estrogen medications and in postmenopausal patients [23–30].…”