Evaluation of the three-time-point method for diagnosis of breast lesions in contrast-enhanced MR mammography.
OBJECTIVE
To evaluate the three-time-point (3TP) method for diagnosis of breast lesions detected on contrast-enhanced MR mammography.


METHODS
MR imaging was performed in 40 women with 120 suspected breast lesions in mammography and/or sonography. The contrast kinetics was converted by 3TP software on a pixel-by-pixel basis into color-coded images. Lesion diagnosis was made by analysis of color intensity and color hue. The 3TP results were compared with the results of the region-of-interest (ROI) method. In 16 patients, we were able to correlate the results with histopathological findings.


RESULTS
The 3TP method could successfully be performed in all MR mammographies. Forty (33%) lesions had a diameter of less than 5 mm, 56 (47%) lesions between 5 and 10 mm, and 24 (20%) lesions were greater than 1 cm. Of all 120 lesions, 65 (54%) showed heterogeneous contrast enhancement. In 117 (97%) of all 120 lesions the results of ROI and the automated 3TP method were considered equivalent. However, in three lesions the manual ROI differed from the 3TP method. After a second, repeated manual ROI placement, we were able to confirm equivalent results with the 3TP images as well.


CONCLUSIONS
The 3TP method automatically and reliably converts contrast kinetic information of the entire breast into a color-coded image. The 3TP method presents kinetic information of the entire dynamic series in an easy-to-interpret format and this automated method may allow to forego time-consuming and sometimes subjective manual ROI placements. This method displays the heterogeneity of the contrast enhancement pattern often observed in malignant lesions and makes it usable as diagnostic criterion.
Hauth
Elke A M
EA
Department of Diagnostic and Interventional Radiology, University Hospital Essen, Essen, Federal Republic of Germany. elke.hauth@uni-essen.de
Stockamp
Christin
C
Maderwald
Stefan
S
Mühler
Andreas
A
Kimmig
Rainer
R
Jaeger
Horst
H
Barkhausen
Jörg
J
Forsting
Michael
M
D000328:Adult; D000368:Aged; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis*; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis*; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D015203:Reproducibility of Results; D013997:Time Factors
D003287:Contrast Media; D019786:Gadolinium DTPA