Variation of Breast Vascular Maps on Dynamic Contrast-Enhanced MRI After Primary Chemotherapy of Locally Advanced Breast Cancer

A new algorithm for automatic vascular mapping of DCE-MRI of the breast: Clinical application of a potential new biomarker

“…The added diagnostic value of local and global breast vascularity has been recently investigated [9] and preliminary results have shown that breast vascular maps obtained by DCE-MRI can be considered as a new approach to evaluate the tumor response after NAC [10]. However, all studies in this realm highlight the requirement of further improvements for a higher reproducibility of vessel analysis.…”

“…During the past decade, this research issue has been approached in two ways: first, whole-breast vascularity, and second, local vascularity, that is, vessels adjacent to and feeding a lesion or lesions [9]. The evaluation of this information is already allowed, since the visualization of bilateral vascular maps is intrinsically integrated into a standard breast DCE-MRI study without an increase in acquisition time or the administration of additional contrast material [9,10]. However, vascularity is not usually considered by radiologists, mainly because evaluating and counting vessels using multiple views may be time consuming and a standardized quantification method of breast vessels does not exist [10].…”

“…The evaluation of this information is already allowed, since the visualization of bilateral vascular maps is intrinsically integrated into a standard breast DCE-MRI study without an increase in acquisition time or the administration of additional contrast material [9,10]. However, vascularity is not usually considered by radiologists, mainly because evaluating and counting vessels using multiple views may be time consuming and a standardized quantification method of breast vessels does not exist [10]. Several studies have tried to address the automatic detection and extraction of the breast vascularity to improve the work-flow of radiologists [1,11,12], but only one of them has been conceived to work on DCE-MRI [13].…”

“…Regarding the evaluation of the vascularity in the clinical practice, the unique quantitative approach existing has been introduced by Sardanelli et al [7] and it is based on the number of vessels per breast, with length of 30 mm or greater and maximal transverse diameter of 2 mm or greater. This method was used by a recent study [10] to assess the variation in whole-breast vascular maps on DCE-MRI after anthracycline-and taxane-based neoadjuvant chemotherapy (NAC) in patients with locally advanced breast cancer (LABC), showing a correlation between changes in breast vascular maps and pathologic tumor response. However, the authors highlight some limitations of the Sardanelli score system, as also recognized by other authors [14], such as difficulties in counting branching vessels, and time-consuming procedure to define if a vessel should or should not be counted.…”

“…However, the authors highlight some limitations of the Sardanelli score system, as also recognized by other authors [14], such as difficulties in counting branching vessels, and time-consuming procedure to define if a vessel should or should not be counted. The development of a highly reproducible method to extract vascular maps and to quantify vessels within the breast has been therefore encouraged [9,10]. In 2012, our group developed a novel fully automatic Hessian-matrix method able to overcome the limitations of Lin et al approach [15].…”