title: Contrast-enhanced magnetic resonance imaging of the breast: the value of pharmacokinetic parameters derived from fast dynamic imaging during initial enhancement in classifying lesions.
abstract: The value of pharmacokinetic parameters derived from fast dynamic imaging during initial enhancement in characterizing breast lesions on magnetic resonance imaging (MRI) was evaluated. Sixty-eight malignant and 34 benign lesions were included. In the scanning protocol, high temporal resolution imaging was combined with high spatial resolution imaging. The high temporal resolution images were recorded every 4.1 s during initial enhancement (fast dynamic analysis). The high spatial resolution images were recorded at a temporal resolution of 86 s (slow dynamic analysis). In the fast dynamic evaluation pharmacokinetic parameters (K(trans), V(e) and k(ep)) were evaluated. In the slow dynamic analysis, each lesion was scored according to the BI-RADS classification. Two readers evaluated all data prospectively. ROC and multivariate analysis were performed. The slow dynamic analysis resulted in an AUC of 0.85 and 0.83, respectively. The fast dynamic analysis resulted in an AUC of 0.83 in both readers. The combination of both the slow and fast dynamic analyses resulted in a significant improvement of diagnostic performance with an AUC of 0.93 and 0.90 (P = 0.02). The increased diagnostic performance found when combining both methods demonstrates the additional value of our method in further improving the diagnostic performance of breast MRI.
authors.affiliation: Department of Radiology, University Medical Center Nijmegen, Geert Grooteplein-Zuid 10, 6525 Nijmegen, GA, The Netherlands. j.veltman@rad.umcn.nl
authors.forename: J
authors.initials: J
authors.lastname: Veltman
authors.forename: M
authors.initials: M
authors.lastname: Stoutjesdijk
authors.forename: R
authors.initials: R
authors.lastname: Mann
authors.forename: H J
authors.initials: HJ
authors.lastname: Huisman
authors.forename: J O
authors.initials: JO
authors.lastname: Barentsz
authors.forename: J G
authors.initials: JG
authors.lastname: Blickman
authors.forename: C
authors.initials: C
authors.lastname: Boetes
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001943:Breast Neoplasms / Q000473:pathology*; D003287:Contrast Media / Q000493:pharmacokinetics*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008536:Meglumine / Q000493:pharmacokinetics*; D008875:Middle Aged; D009942:Organometallic Compounds / Q000493:pharmacokinetics*; D011446:Prospective Studies; D012372:ROC Curve
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; C072417:gadoterate meglumine