Pharmacokinetic Analysis of Dynamic Contrast-Enhanced Magnetic Resonance Imaging at 7T for Breast Cancer Diagnosis and Characterization

Abstract

The purpose of this study was to investigate whether ultra-high-field dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the breast at 7T using quantitative pharmacokinetic (PK) analysis can differentiate between benign and malignant breast tumors for improved breast cancer diagnosis and to predict molecular subtypes, histologic grade, and proliferation rate in breast cancer. In this prospective study, 37 patients with 43 lesions suspicious on mammography or ultrasound underwent bilateral DCE-MRI of the breast at 7T. PK parameters (KTrans, kep, Ve) were evaluated with two region of interest (ROI) approaches (2D whole-tumor ROI or 2D 10 mm standardized ROI) manually drawn by two readers (senior reader, R1, and R2) independently. Histopathology served as the reference standard. PK parameters differentiated benign and malignant lesions (n = 16, 27, respectively) with good accuracy (AUCs = 0.655–0.762). The addition of quantitative PK analysis to subjective BI-RADS classification improved breast cancer detection from 88.4% to 97.7% for R1 and 86.04% to 97.67% for R2. Different ROI approaches did not influence diagnostic accuracy for both readers. Except for KTrans for whole-tumor ROI for R2, none of the PK parameters were valuable to predict molecular subtypes, histologic grade, or proliferation rate in breast cancer. In conclusion, PK-enhanced BI-RADS is promising for the noninvasive differentiation of benign and malignant breast tumors.

Predictive Value of Preoperative Dynamic Contrast-Enhanced MRI Imaging Features in Breast Cancer Patients with Postoperative Recurrence Time

“…(1) The diagnosis results were confirmed by postoperative pathology. Conform to the diagnosis of postoperative recurrence of breast cancer in “China Anti-Cancer Association Guidelines and Specifications for Breast Cancer Diagnosis and Treatment” [ 3 ]; (2) preoperative breast DCE-MRI examination; (3) the patient had no distant metastasis at the time of diagnosis; (4) recurrence was confirmed after follow-up.…”

A Comprehensive Survey on Deep-Learning-Based Breast Cancer Diagnosis

“…Another imaging method called breast magnetic resonance imaging (MRI) is a costly procedure with minimal availability. These must be the cause of the lower adaptivity of MRI in research as very few studies utilized this imaging method [ 156 , 157 ]. Digital breast tomosynthesis and computed tomography imaging methods were used only in a few studies [ 67 , 124 ].…”

“…The feasibility of high-resolution dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) at 7T had not been investigated until a study was conducted in this context. The goal of this feasibility study was to see whether the PKs of ultra-high-field DCE-MRI of the breast at 7T could distinguish benign and malignant breast tumors [ 157 ]. Unfortunately, ultra-high-field DCE-MRI utilizing PK analysis of malignant breast tumors was unable to distinguish between different molecular subtypes, the histologic tumor grade, or the BrC proliferation rate.…”