title: Quantitative differentiation of breast lesions based on three-dimensional morphology from magnetic resonance imaging.
abstract: OBJECTIVE
  The purpose of this study was to develop geometric indices, based on morphologic measurements, of contrast-enhanced breast lesions using three-dimensional magnetic resonance imaging (MRI) that can statistically differentiate between benign and malignant lesions.
  
  
  METHODS
  Thirty-three patients with abnormal mammograms were scanned using three-dimensional MRI. The lesion was then extracted from the volume data set using interactive volume-rendering software. From the extracted region of interest, the surface boundary corresponding to the lesion was extracted using an isosurface method. The boundary was represented as a triangular mesh, from which the surface area and volume enclosed by the surface were computed. The following variables were tested for discrimination ability between benign and malignant lesions: 1) the volume-to-surface area (V/S) ratio, 2) spherical shape index (SSI), and 3) resolution reduction for V/S and SSI values (100%, 16%, 8%, 4%, 2%, and 1% resolution). In addition, comparisons were made between the V/S and SSI values at 100% versus their reduced resolutions.
  
  
  RESULTS
  Thirty-three subjects (15 malignant tumors and 18 benign tumors) were studied. The SSI index (P = 0.0063) was a significant discriminator for malignancy. The V/S ratio (P = 0.9280) did not seem to be a useful variable in distinguishing benign and malignant masses. The V/S resolution comparisons (P > 0.5897) and the SSI resolution comparisons (P > 0.05) were also not useful discriminating variables.
  
  
  CONCLUSIONS
  The SSI seems to be a useful factor in differentiating between benign and malignant lesions. Current clinical interpretation of breast lesions using MRI may be enhanced by the adjunctive use of this objective postanalysis method.
authors.affiliation: The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, 600 North Wolfe Street, Baltimore, MD 21287, USA.
authors.forename: Karen H
authors.initials: KH
authors.lastname: Shahar
authors.forename: Meiyappan
authors.initials: M
authors.lastname: Solaiyappan
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001941:Breast Diseases / Q000175:diagnosis / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology*; D003287:Contrast Media / Q000008:administration & dosage; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008327:Mammography; D008875:Middle Aged; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media