title: Differentiation of benign and malignant sub-1 cm breast lesions using dynamic contrast enhanced MRI.
abstract: The purpose of this work is to assess the additional benefit of MRI-based morphology and quantification of contrast enhancement in the differential diagnosis of sub-1cm breast lesions. Forty-three women with suspected breast cancer were examined using X-ray mammography, ultrasound mammography, and MRI. Dynamic contrast imaging was performed and relative enhancement at various time-points was calculated. The dynamic data was also processed using a two-compartment pharmacokinetic model. Radiological interpretation of high-resolution post-contrast images revealed a similar accuracy (69%) compared to X-ray mammography (69%) and ultrasound mammography (67%). The best individual parameter calculated from the dynamic images was found to be the exchange rate constant which revealed a diagnostic accuracy of 0.74 +/- 0.08. When information from the post-contrast images and dynamic data was combined in a logistic regression model a diagnostic accuracy of 0.92 +/- 0.03 was achieved. In conclusion, MR imaging of small breast lesions is feasible and the incorporation of quantitative MR derived parameters is beneficial.
authors.affiliation: Centre for MR Investigations, Division of Cancer, Postgraduate Medical Institute, University of Hull, Hull HU6 7RX, UK. p.gibbs@hull.ac.uk
authors.forename: P
authors.initials: P
authors.lastname: Gibbs
authors.forename: G P
authors.initials: GP
authors.lastname: Liney
authors.forename: M
authors.initials: M
authors.lastname: Lowry
authors.forename: P J
authors.initials: PJ
authors.lastname: Kneeshaw
authors.forename: L W
authors.initials: LW
authors.lastname: Turnbull
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D044584:Carcinoma, Ductal / Q000175:diagnosis / Q000473:pathology; D005260:Female; D006801:Humans; D007089:Image Enhancement; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary