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Breast DCE-MRI: influence of postcontrast timing on automated lesion kinetics assessments and discrimination of benign and malignant lesions.

Abstract：

RATIONALE AND OBJECTIVES:Breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) scanning protocols vary widely. The purpose of this study was to determine the effects of postcontrast timing on delayed-phase lesion kinetics assessment and ability to discriminate malignant from benign lesions. MATERIALS AND METHODS:Following institutional review board approval, we retrospectively reviewed all lesions assessed on magnetic resonance examinations from April 2005 to June 2006. DCE-MRI was performed with 90-second temporal resolution. Delayed-phase kinetic parameters including percentages of persistent, plateau, and washout, and categorizations of predominant and worst curve type were compared between 4.5 and 7.5 minutes postcontrast. Ability to discriminate benign and malignant lesions based on delayed-phase kinetic parameters was compared between postcontrast timings by receiver operating characteristic (ROC) analysis. RESULTS:Two hundred eighty consecutive breast lesions (206 malignant and 74 benign) were evaluated in 228 women. Comparing kinetics assessments at 7.5 versus 4.5 minutes: volume percentage of washout increased in malignancies by a mean of 9.4% (P<.0001) and increased slightly in benign lesions (mean 3.2%, P=.007); predominant curve type categorizations changed significantly only for malignancies (P<.0001); and worst curve categorizations did not change significantly for either benign or malignant lesions (P>.05). There were no significant differences between timings in area under ROC curves for delayed-phase kinetic parameters. CONCLUSIONS:The choice of delayed postcontrast timing more strongly affects the kinetics assessments for malignancies than benign breast lesions, but our results suggest that a shortened breast DCE-MRI protocol may not significantly impact diagnostic accuracy. Furthermore, worst curve type classifications are least affected by postcontrast timing and may provide reliable assessment of delayed-phase kinetics across protocols.

journal_name

Acad Radiol

journal_title

Academic radiology

authors

Partridge SC,Stone KM,Strigel RM,DeMartini WB,Peacock S,Lehman CD

doi

10.1016/j.acra.2014.04.013

subject

Has Abstract

pub_date

2014-09-01 00:00:00

pages

1195-203

issue

eissn

1076-6332

issn

1878-4046

pii

S1076-6332(14)00161-5

journal_volume

pub_type

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Breast DCE-MRI: influence of postcontrast timing on automated lesion kinetics assessments and discrimination of benign and malignant lesions.