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Contrast-enhanced magnetic resonance imaging of the breast: the value of pharmacokinetic parameters derived from fast dynamic imaging during initial enhancement in classifying lesions.

ABSTRACT: The value of pharmacokinetic parameters derived from fast dynamic imaging during initial enhancement in characterizing breast lesions on magnetic resonance imaging (MRI) was evaluated. Sixty-eight malignant and 34 benign lesions were included. In the scanning protocol, high temporal resolution imaging was combined with high spatial resolution imaging. The high temporal resolution images were recorded every 4.1 s during initial enhancement (fast dynamic analysis). The high spatial resolution images were recorded at a temporal resolution of 86 s (slow dynamic analysis). In the fast dynamic evaluation pharmacokinetic parameters (K(trans), V(e) and k(ep)) were evaluated. In the slow dynamic analysis, each lesion was scored according to the BI-RADS classification. Two readers evaluated all data prospectively. ROC and multivariate analysis were performed. The slow dynamic analysis resulted in an AUC of 0.85 and 0.83, respectively. The fast dynamic analysis resulted in an AUC of 0.83 in both readers. The combination of both the slow and fast dynamic analyses resulted in a significant improvement of diagnostic performance with an AUC of 0.93 and 0.90 (P = 0.02). The increased diagnostic performance found when combining both methods demonstrates the additional value of our method in further improving the diagnostic performance of breast MRI.

SUBMITTER: Veltman J

PROVIDER: S-EPMC2373858 | biostudies-other | 2008 Jun

REPOSITORIES: biostudies-other

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Project description:The aim of this study was to assess the feasibility of combining dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI) with the measurement of the radiofrequency (RF) transmit field B1 and pre-contrast longitudinal relaxation time T10 . A novel approach has been proposed to simultaneously estimate B1 and T10 from a modified DCE-MRI scan that actively encodes the washout phase of the curve with different amounts of T1 and B1 weighting using multiple flip angles and repetition times, hence referred to as active contrast encoding (ACE)-MRI. ACE-MRI aims to simultaneously measure B1 and T10 , together with contrast kinetic parameters, such as the transfer constant Ktrans , interstitial space volume fraction ve and vascular space volume fraction vp . The proposed method was tested using numerical simulations and in vivo studies with mouse models of breast cancer implanted in the flank and mammary fat pad, and glioma in the brain. In the numerical simulation study with a signal-to-noise ratio of 10, both B1 and T10 were estimated accurately with errors of 5.1 ± 3.5% and 12.3 ± 8.8% and coefficients of variation (CV) of 14.9 ± 8.6% and 15.0 ± 5.0%, respectively. Using the same ACE-MRI data, the kinetic parameters Ktrans , ve and vp were also estimated with errors of 14.2 ± 8.3% (CV = 13.5 ± 4.6%), 14.7 ± 9.9% (CV = 13.3 ± 4.5%) and 14.0 ± 9.3% (CV = 14.0 ± 4.5%), respectively. For the in vivo tumor data from 11 mice, voxel-wise comparisons between ACE-MRI and DCE-MRI methods showed that the mean differences for the five parameters were as follows: ΔKtrans = 0.006 (/min), Δve = 0.016, Δvp = 0.000, ΔB1 = -0.014 and ΔT1 = -0.085 (s), which suggests a good agreement between the two methods. When compared with separately measured B1 and T10 , and DCE-MRI estimated kinetic parameters as a reference, the mean relative errors of ACE-MRI estimation were B1 = -0.3%, T10 = -8.5%, Ktrans = 11.4%, ve = 14.5% and vp = 4.5%. This proof-of-concept study demonstrates that the proposed ACE-MRI method can be used to estimate B1 and T10 , together with contrast kinetic model parameters.

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Contrast-enhanced magnetic resonance imaging of the breast: the value of pharmacokinetic parameters derived from fast dynamic imaging during initial enhancement in classifying lesions.

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