Optimizing ultrafast dynamic contrast-enhanced MRI scan duration in the differentiation of benign and malignant breast lesions

To determine the optimal scan duration for ultrafast DCE-MRI in effectively differentiating benign from malignant breast lesions.

The study prospectively recruited participants who underwent breast ultrafast DCE-MRI from September 2021 to March 2023. A 30-phase breast ultrafast DCE-MRI on a 3.0-T MRI system was conducted with a 4.5-s temporal resolution. Scan durations ranged from 40.5 s to 135.0 s, during which the analysis is performed at three-phase intervals, forming eight dynamic sets (scan duration [SD]_40.5s: 40.5 s, SD_54s: 54.0 s, SD_67.5s: 67.5 s, SD_81s: 81.0 s, SD_94.5s: 94.5 s, SD_108s: 108.0 s, SD_121.5s: 121.5 s, and SD_135s: 135.0 s). Two ultrafast DCE-MRI parameters, maximum slope (MS) and initial area under the curve in 60 s (iAUC), were calculated for each dynamic set and compared between benign and malignant lesions. Areas under the receiver operating characteristic curve (AUCs) were used to assess their diagnostic performance.

A total of 140 women (mean age, 47 ± 11 years) with 151 lesions were included. MS and iAUC from eight dynamic sets exhibited significant differences between benign and malignant lesions (all p < 0.05), except iAUC at SD_40.5s. The AUC of MS (AUC = 0.804) and iAUC (AUC = 0.659) at SD_67.5s were significantly higher than their values at SD_40.5s (AUC = 0.606 and 0.516; corrected p < 0.05). No significant differences in AUCs for MS and iAUC were observed from SD_67.5s to SD_135s (all corrected p > 0.05).

Ultrafast DCE-MRI with a 67.5-s scan duration appears optimal for effectively differentiating malignant from benign breast lesions.

By evaluating scan durations (40.5–135 s) and analyzing two ultrafast DCE-MRI parameters, we found a scan duration of 67.5 s optimal for discriminating between these lesions and offering a balance between acquisition time and diagnostic efficacy.

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