Kinetic curves of malignant lesions are not consistent across MRI systems: need for improved standardization of breast dynamic contrast-enhanced MRI acquisition.
OBJECTIVE
The purpose of this study was to compare MRI kinetic curve data acquired with three systems in the evaluation of malignant lesions of the breast.


METHODS
The cases of 601 patients with 682 breast lesions (185 benign, 497 malignant) were selected for review. The malignant lesions were classified as ductal carcinoma in situ (DCIS), invasive ductal carcinoma (IDC), and other. The dynamic MRI protocol consisted of one unenhanced and three to seven contrast-enhanced images acquired with one of three imaging protocols and systems. An experienced radiologist analyzed the shapes of the kinetic curves according to the BI-RADS lexicon. Several quantitative kinetic parameters were calculated, and the kinetic parameters of malignant lesions were compared across the three systems.


RESULTS
Imaging protocol and system 1 were used to image 304 malignant lesions (185 IDC, 62 DCIS); imaging protocol and system 2, 107 lesions (72 IDC, 21 DCIS); and imaging protocol and system 3, 86 lesions (64 IDC, 17 DCIS). Compared with those visualized with imaging protocols and systems 1 and 2, IDC lesions visualized with imaging protocol and system 3 had significantly less initial enhancement, longer time to peak enhancement, and a slower washout rate (p < 0.004). Only 47% of IDC lesions imaged with imaging protocol and system 3 exhibited washout type curves, compared with 75% and 74% of those imaged with imaging protocols and systems 2 and 1, respectively. The diagnostic accuracy of kinetic analysis was lowest for imaging protocol and system 3, but the difference was not statistically significant.


CONCLUSIONS
The kinetic curve data on malignant lesions acquired with one system showed significantly lower initial contrast uptake and a different curve shape in comparison with data acquired with the other two systems. Differences in k-space sampling, T1 weighting, and magnetization transfer effects may be explanations for the difference.
Jansen
Sanaz A
SA
Department of Radiology, University of Chicago, 5841 S Maryland Ave., MC 2026, Chicago, IL 60637, USA.
Shimauchi
Akiko
A
Zak
Lindsay
L
Fan
Xiaobing
X
Wood
Abbie M
AM
Karczmar
Gregory S
GS
Newstead
Gillian M
GM
D001706:Biopsy; D001943:Breast Neoplasms / Q000473:pathology*; D002278:Carcinoma in Situ / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology*; D003287:Contrast Media / Q000493:pharmacokinetics*; D003937:Diagnosis, Differential; D005260:Female; D019786:Gadolinium DTPA / Q000493:pharmacokinetics*; D006801:Humans; D007700:Kinetics; D008279:Magnetic Resonance Imaging / Q000592:standards*; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies
D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA
Radiology. 2007 Dec;245(3):684-91
18024450
Radiology. 2007 Aug;244(2):356-78
17641361
Radiol Clin North Am. 2000 Jul;38(4):899-913
10943285
Breast J. 1999 Jan;5(1):13-21
11348250
Eur Radiol. 2008 May;18(5):931-8
18270717
Acta Radiol. 2003 Jul;44(4):379-86
12846687
JBR-BTR. 2005 Sep-Oct;88(5):225-32
16302331
Cancer. 2005 Aug 15;104(4):708-18
15971199
Radiology. 2006 Jan;238(1):42-53
16373758
Med Phys. 2008 Jul;35(7):3102-9
18697535
Med Phys. 2004 May;31(5):1076-82
15191295
Semin Ultrasound CT MR. 2006 Aug;27(4):320-32
16916000
Eur J Cancer. 2003 Aug;39(12):1755-60
12888371
CA Cancer J Clin. 2007 Mar-Apr;57(2):75-89
17392385
Stat Med. 1998 May 15;17(9):1033-53
9612889
Radiology. 1999 Apr;211(1):101-10
10189459
J Clin Oncol. 2008 Jan 20;26(3):352-3
18202408
Magn Reson Imaging Clin N Am. 2006 Aug;14(3):305-28, v
17098173
Radiology. 1989 Apr;171(1):95-103
2648479
J Clin Oncol. 2008 Jul 1;26(19):3248-58
18474876
MAGMA. 2000 Dec;11(3):129-37
11154954
Lancet. 2007 Aug 11;370(9586):485-92
17693177
Dtsch Med Wochenschr. 1989 Sep 8;114(36):1351-7
2776660
Breast J. 2005 Nov-Dec;11(6):379-81
16297079
Radiology. 1989 Mar;170(3 Pt 1):681-6
2916021
Top Magn Reson Imaging. 2008 Jun;19(3):143-50
18941394
J Magn Reson Imaging. 2000 Dec;12(6):965-74
11105038
Radiology. 2008 Jul;248(1):79-87
18566170
Eur Radiol. 2001;11(4):531-46
11354744