title: Predictive value of the time-intensity curves on dynamic contrast-enhanced magnetic resonance imaging for lymphatic spreading in breast cancer.
abstract: OBJECTIVE
  Dynamic contrast-enhanced magnetic resonance imaging (CE-MRI) has emerged as a promising diagnostic modality in various breast cancer treatments. However, little is known about the correlation between the pattern of time to signal intensity curves (TIC) on the CE-MRI and clinicopathologic features. This study was designed to investigate these correlations and evaluate the predictive value of TIC on CE-MRI in order to identify high-risk patients.
  
  
  METHODS
  Between 2001 and 2003, 101 lesions were evaluated to detect malignancy on CE-MRI in 101 women who were suspected of having breast tumors based on either clinical findings or conventional imaging studies. Moreover, the clinicopathologic findings were compared with the pattern of TIC for the 69 surgically treated malignant lesions.
  
  
  RESULTS
  In detecting malignancy, the sensitivity, specificity, and accuracy were 78.7%, 88.5%, and 81.2%, respectively, in the 101 breast lesions. Especially for the 69 surgically treated malignant lesions, in comparison with breast cancer tumors with the benign pattern of TIC, the breast cancer tumors with a malignant pattern were found more frequently in lymphatic invasion (P < 0.01) and lymph node metastasis (P < 0.005), although no statistical correlation regarding the histological type, tumor size, vascular invasion, extensive intraductal component, hormone receptor status, or pathological stage was noted between the two groups. According to a logistic regression model, lymph node metastasis was found to be a significant independent variable.
  
  
  CONCLUSIONS
  The pattern of TIC could be used to predict lymphatic spreading associated with lymph node metastasis prior to surgery as well as to detect malignancy. Therefore, a more detailed evaluation should be made to identify the presence of lymphatic spreading in patients with a malignant pattern of TIC.
authors.affiliation: Department of Surgery, Kyoto First Red Cross Hospital, Kyoto, Japan.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Komatsu
authors.forename: Chol Joo
authors.initials: CJ
authors.lastname: Lee
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ichikawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Hamashima
authors.forename: Noriaki
authors.initials: N
authors.lastname: Morofuji
authors.forename: Koichi
authors.initials: K
authors.lastname: Shirono
authors.forename: Yohei
authors.initials: Y
authors.lastname: Hosokawa
authors.forename: Harumi
authors.initials: H
authors.lastname: Okabe
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kurioka
authors.forename: Hisakazu
authors.initials: H
authors.lastname: Yamagishi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Oka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D016015:Logistic Models; D008207:Lymphatic Metastasis / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA