Improved diagnostic accuracy in dynamic contrast enhanced MRI of the breast by combined quantitative and qualitative analysis.

Liu, P F; Debatin, J. F.; Caduff, Rosmarie; Kacl, G. M.; Garzoli, Elisabeth; Krestin, Gabriël P.

doi:10.1259/bjr.71.845.9691895

Cited by 102 publications

(66 citation statements)

References 30 publications

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“…Contrast-enhanced magnetic resonance imaging (MRI) has been shown to have a high sensitivity (86% to 100%) for detecting breast cancer in high-risk asymptomatic and symptomatic women, although reports of specificity have been more variable (37% to 97%). [23][24][25][26][27] The American Cancer Society now recommends MRI screening in addition to mammograms for women who meet at least one of the following conditions 28 :…”

Section: Screening Strategies In High-risk Womenmentioning

confidence: 99%

Women at High Risk for Breast Cancer--What the Primary Care Provider Needs to Know

Afonso¹

2009

The Journal of the American Board of Family Medicine

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Until recently, the assessment made by the primary care provider regarding screening for breast cancer was generally limited to decisions about when to initiate mammography. Early diagnosis was stressed as the best protection against breast cancer morbidity. However, there have been recent developments in the ability to predict and modify breast cancer risk. It is therefore important for the primary care provider to be able to identify women at higher risk for breast cancer and be familiar with issues regarding screening and risk reduction. Recent data regarding the evaluation of breast cancer risk, newer screening strategies for high-risk women, and medical and surgical approaches to reduce breast cancer risk and are discussed in this article. Each year 170,000 women are diagnosed with breast cancer; screening for breast cancer is one of the topics that primary care providers should address with their patients. Screening for breast cancer has been extensively endorsed and most women in the United States more than 40 years old participate in screening activities.1,2 In the community mammography remains the main screening tool.3 However, there have been several important developments in the ability to predict and modify breast cancer risk. Recently, data have become available regarding the evaluation of risk, screening strategies for high-risk women, and medical and surgical approaches that can decrease breast cancer risk. Women who are concerned about their risk for breast cancer and should be counseled and managed appropriately; it is important for primary care providers to be familiar with these issues. Evaluation of Breast Cancer Risk Average RiskThe National Cancer Institute's Surveillance, Epidemiology, and End Results program estimates that, based on breast cancer statistics from 2001 through 2003, 12.7% of women born in the United States today will develop breast cancer sometime during their lifetime. This average risk of approximately 12% is often expressed as "1 in 8," whereas the chance that a woman will never have breast cancer is 87.3%, or "7 in 8" women. 4Identification of Women at Higher Risk for Breast Cancer Several approaches are available for identifying women with a higher than average risk of breast cancer. These include an assessment of family history with genetic testing consideration; a review of clinical history, including prior breast biopsies; and the evaluation of mammographic density. Family HistoryMany women will have a family history of breast cancer but, among the majority of these women, the risk does not increase substantially and is associated with, at the most, a doubling of the lifetime risk. Only 1% to 2% of breast cancer cases are caused by the inheritance of an autosomal dominant, high-penetrance gene, conferring up to an 85% lifetime risk of breast cancer. In some families, there is also a high risk of ovarian cancer. Features of the family history that suggest cancer may be caused by such a high-penetrance gene include: [5][6][7][8] • Two or more first-degree (parent, sib...

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Section: Screening Strategies In High-risk Womenmentioning

confidence: 99%

Women at High Risk for Breast Cancer--What the Primary Care Provider Needs to Know

Afonso¹

2009

The Journal of the American Board of Family Medicine

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“…THE QUALITY OF MAGNETIC RESONANCE (MR) images of breast has been enhanced by a number of technical improvements, including improved fat saturation (1,2), Dixon-based methods (3)(4)(5)(6)(7)(8)(9)(10)(11) for improved fat and water separation, and dynamic contrast-enhanced MR imaging (MRI) (12)(13)(14)(15)(16)(17). Despite these advances, the high sensitivity of MRI combined with limited specificity still leads to a large number of false positives (18 -25).…”

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confidence: 99%

The effect of varying spectral resolution on the quality of high spectral and spatial resolution magnetic resonance images of the breast

Medved

Zamora

et al. 2003

Magnetic Resonance Imaging

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Purpose:To evaluate the effect of varying spectral resolution on image quality of high spectral and spatial resolution (HiSS) images. Materials and Methods:Eight women with suspicious breast lesions and six healthy volunteers were scanned using echo-planar spectroscopic imaging (EPSI) at 1.5 Tesla with 0.75-to 1-mm in-plane resolution and 2.3-to 2.6-Hz spectral resolution. Time domain data were truncated to obtain proton spectra in each voxel with varying (2.6 -83.3 Hz) resolution. Images with intensity proportional to water signal peak heights were synthesized. Changes in water signal line shape following contrast injection were analyzed.Results: Fat suppression is optimized at ϳ10-Hz spectral resolution and is significantly improved by removal of wings of the fat resonance. This was accomplished by subtracting a Lorentzian fit to the fat resonance from the proton spectrum. The water resonance is often inhomogeneously broadened, and very high spectral resolution is necessary to resolve individual components. High spectral resolution is required for optimal contrast in anatomic features with very high T 2 * (e.g., within a lesion) and for detection of often subtle effects of contrast agents on water signal line shape. Conclusion:Despite a trade-off between the spectral resolution and signal-to-noise ratio, it is beneficial to acquire data at the highest spectral resolution currently attainable at 1.5 Tesla.

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“…For the detection of invasive carcinomas, previous studies reported sensitivities from 90% to almost 100% whereas specificity was between 75% and 85% [26][27][28]. In DCIS, detection rates of 70-80% were described [29][30][31].…”

Section: Discussionmentioning

confidence: 99%

Cluster analysis of signal-intensity time course in dynamic breast MRI: does unsupervised vector quantization help to evaluate small mammographic lesions?

Leinsinger¹,

Schlossbauer²,

Scherr³

et al. 2006

Eur Radiol

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We examined whether neural network clustering could support the characterization of diagnostically challenging breast lesions in dynamic magnetic resonance imaging (MRI). We examined 88 patients with 92 breast lesions (51 malignant, 41 benign). Lesions were detected by mammography and classified Breast Imaging and Reporting Data System (BIRADS) III (median diameter 14 mm). MRI was performed with a dynamic T1-weighted gradient echo sequence (one precontrast and five postcontrast series). Lesions with an initial contrast enhancement >or=50% were selected with semiautomatic segmentation. For conventional analysis, we calculated the mean initial signal increase and postinitial course of all voxels included in a lesion. Secondly, all voxels within the lesions were divided into four clusters using minimal-free-energy vector quantization (VQ). With conventional analysis, maximum accuracy in detecting breast cancer was 71%. With VQ, a maximum accuracy of 75% was observed. The slight improvement using VQ was mainly achieved by an increase of sensitivity, especially in invasive lobular carcinoma and ductal carcinoma in situ (DCIS). For lesion size, a high correlation between different observers was found (R(2) = 0.98). VQ slightly improved the discrimination between malignant and benign indeterminate lesions (BIRADS III) in comparison with a standard evaluation method.

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Improved diagnostic accuracy in dynamic contrast enhanced MRI of the breast by combined quantitative and qualitative analysis.

Cited by 102 publications

References 30 publications

Women at High Risk for Breast Cancer--What the Primary Care Provider Needs to Know

Women at High Risk for Breast Cancer--What the Primary Care Provider Needs to Know

The effect of varying spectral resolution on the quality of high spectral and spatial resolution magnetic resonance images of the breast

Cluster analysis of signal-intensity time course in dynamic breast MRI: does unsupervised vector quantization help to evaluate small mammographic lesions?

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