title: Evaluation of tumor angiogenesis with contrast-enhanced dynamic magnetic resonance mammography.
abstract: The goal of this research was to correlate dynamic magnetic resonance (MR) mammographic contrast enhancement and microvessel densities in breast masses. Forty-six female patients with breast masses detected by mammography and/or ultrasonography were included in the study. MR contrast enhancements of the lesions were investigated dynamically using axial three-dimensional fast low-angle shot sequences. After excisional biopsy or mastectomy, immunohistochemical staining with factor VIII-RA was performed, followed by microvessel density measurements. Contrast enhancement patterns in dynamic MR mammography were compared with microvessel density measurements using Student's t-test, Pearson's moment correlation coefficients, and one-way analysis of variance (ANOVA). Malignant lesions exhibited three different enhancement patterns: 1) a peak enhancement within 120 seconds (early phase), followed by a decrease in the delayed phase (25 cases); 2) an increase in the early phase, followed by a plateau in the delayed phase (9 cases); and 3) an increase throughout the examination without any peak (5 cases). In benign lesions, signal intensity did not exhibited a peak in five cases, whereas in two cases enhancement was increased in the early phase and made a plateau in the delayed phase. A significant correlation was found between microvessel density and the percentage of maximal signal increase following paramagnetic contrast administration (r=0.322, p<0.05). Dynamic enhancement patterns and rates of maximal signal increase predict microvessel density in breast malignancies and may possibly be used as prognostic indicators.
authors.affiliation: Department of Radiology, Trakya University, Edirne, Turkey. drtuncbilek@hotmail.com
authors.forename: Nermin
authors.initials: N
authors.lastname: Tuncbilek
authors.forename: Ercument
authors.initials: E
authors.lastname: Unlu
authors.forename: Hakki M
authors.initials: HM
authors.lastname: Karakas
authors.forename: Bilge
authors.initials: B
authors.lastname: Cakir
authors.forename: Filiz
authors.initials: F
authors.lastname: Ozyilmaz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000098:blood supply / Q000473:pathology; D018275:Carcinoma, Lobular / Q000098:blood supply / Q000473:pathology; D018276:Carcinoma, Medullary / Q000098:blood supply / Q000473:pathology; D003287:Contrast Media; D005260:Female; D018226:Fibroadenoma / Q000098:blood supply / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000592:standards*; D008327:Mammography / Q000379:methods / Q000592:standards*; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000473:pathology*; D011237:Predictive Value of Tests; D014463:Ultrasonography
chemical_list: D003287:Contrast Media