title: Differentiation between benign and malignant breast lesions detected by bilateral dynamic contrast-enhanced MRI: a sensitivity and specificity study.
abstract: The purpose of this study was to apply an empirical mathematical model (EMM) to kinetic data acquired under a clinical protocol to determine if the sensitivity and specificity can be improved compared with qualitative BI-RADS descriptors of kinetics. 3D DCE-MRI data from 100 patients with 34 benign and 79 malignant lesions were selected for review under an Institutional Review Board (IRB)-approved protocol. The sensitivity and specificity of the delayed phase classification were 91% and 18%, respectively. The EMM was able to accurately fit these curves. There was a statistically significant difference between benign and malignant lesions for several model parameters: the uptake rate, initial slope, signal enhancement ratio, and curvature at the peak enhancement (at most P=0.04). These results demonstrated that EMM analysis provided at least the diagnostic accuracy of the kinetic classifiers described in the BI-RADS lexicon, and offered a few key advantages. It can be used to standardize data from institutions with different dynamic protocols and can provide a more objective classification with continuous variables so that thresholds can be set to achieve desired sensitivity and specificity. This suggests that the EMM may be useful for analysis of routine clinical data.
authors.affiliation: Department of Radiology, University of Chicago, Chicago, Illinois 60637, USA.
authors.forename: Sanaz A
authors.initials: SA
authors.lastname: Jansen
authors.forename: Xiaobing
authors.initials: X
authors.lastname: Fan
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Karczmar
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Abe
authors.forename: Robert A
authors.initials: RA
authors.lastname: Schmidt
authors.forename: Gillian M
authors.initials: GM
authors.lastname: Newstead
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003198:Computer Simulation; D003287:Contrast Media / Q000493:pharmacokinetics; D003937:Diagnosis, Differential; D005260:Female; D019786:Gadolinium DTPA / Q000493:pharmacokinetics; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008175:Lung Neoplasms / Q000145:classification* / Q000175:diagnosis* / Q000378:metabolism; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D008954:Models, Biological; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA