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01-02-2020 | Breast MRI | Breast

Differentiation between subcentimeter carcinomas and benign lesions using kinetic parameters derived from ultrafast dynamic contrast-enhanced breast MRI

Authors: Natsuko Onishi, Meredith Sadinski, Peter Gibbs, Katherine M. Gallagher, Mary C. Hughes, Eun Sook Ko, Brittany Z. Dashevsky, Dattesh D. Shanbhag, Maggie M. Fung, Theodore M. Hunt, Danny F. Martinez, Amita Shukla-Dave, Elizabeth A. Morris, Elizabeth J. Sutton

Published in: European Radiology | Issue 2/2020

Abstract

Objectives

This study aims to evaluate ultrafast DCE-MRI-derived kinetic parameters that reflect contrast agent inflow effects in differentiating between subcentimeter BI-RADS 4–5 breast carcinomas and benign lesions.

Methods

We retrospectively reviewed consecutive 3-T MRI performed from February to October 2017, during which ultrafast DCE-MRI was performed as part of a hybrid clinical protocol with conventional DCE-MRI. In total, 301 female patients with 369 biopsy-proven breast lesions were included. Ultrafast DCE-MRI was acquired continuously over approximately 60 s (temporal resolution, 2.7–7.1 s/phase) starting simultaneously with the start of contrast injection. Four ultrafast DCE-MRI-derived kinetic parameters (maximum slope [MS], contrast enhancement ratio [CER], bolus arrival time [BAT], and initial area under gadolinium contrast agent concentration [IAUGC]) and one conventional DCE-MRI-derived kinetic parameter (signal enhancement ratio [SER]) were calculated for each lesion. Wilcoxon rank sum test or Fisher’s exact test was performed to compare kinetic parameters, volume, diameter, age, and BI-RADS morphological descriptors between subcentimeter carcinomas and benign lesions. Univariate/multivariate logistic regression analyses were performed to determine predictive parameters for subcentimeter carcinomas.

Results

In total, 125 lesions (26 carcinomas and 99 benign lesions) were identified as BI-RADS 4–5 subcentimeter lesions. Subcentimeter carcinomas demonstrated significantly larger MS and SER and shorter BAT than benign lesions (p = 0.0117, 0.0046, and 0.0102, respectively). MS, BAT, and age were determined as significantly predictive for subcentimeter carcinoma (p = 0.0208, 0.0023, and < 0.0001, respectively).

Conclusions

Ultrafast DCE-MRI-derived kinetic parameters may be useful in differentiating subcentimeter BI-RADS 4 and 5 carcinomas from benign lesions.

Key Points

• Ultrafast DCE-MRI can generate kinetic parameters, effectively differentiating breast carcinomas from benign lesions.

• Subcentimeter carcinomas demonstrated significantly larger maximum slope and shorter bolus arrival time than benign lesions.

• Maximum slope and bolus arrival time contribute to better management of suspicious subcentimeter breast lesions.

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Title: Differentiation between subcentimeter carcinomas and benign lesions using kinetic parameters derived from ultrafast dynamic contrast-enhanced breast MRI
Authors: Natsuko Onishi
Meredith Sadinski
Peter Gibbs
Katherine M. Gallagher
Mary C. Hughes
Eun Sook Ko
Brittany Z. Dashevsky
Dattesh D. Shanbhag
Maggie M. Fung
Theodore M. Hunt
Danny F. Martinez
Amita Shukla-Dave
Elizabeth A. Morris
Elizabeth J. Sutton
Publication date: 01-02-2020
Publisher: Springer Berlin Heidelberg
Keyword: Breast MRI
Published in: European Radiology / Issue 2/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-019-06392-5

At a glance: The STEP trials

Springer Medicine

Differentiation between subcentimeter carcinomas and benign lesions using kinetic parameters derived from ultrafast dynamic contrast-enhanced breast MRI

Abstract

Objectives

Methods

Results

Conclusions

Key Points

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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