title: Relating dose of contrast media administered to uptake and washout of malignant lesions on DCEMRI of the breast.
abstract: OBJECTIVE
  To quantify the relationship between dose of contrast administered and contrast kinetics of malignant breast lesions.
  
  
  METHODS
  A total of 108 patients with 120 malignant lesions were selected for an institutional review board-approved review. Dynamic magnetic resonance protocol: one pre- and three or five post-contrast (at a fixed volume of 20 mL of 0.5 M gadodiamide) images. Patients were stratified into groups based on dose of contrast administered, after calculation of body weight (kg): Dose Group 1, <0.122 mmol/kg; Dose Group 2, 0.123-0.155 mmol/kg; Dose Group, 3 > 0.155 mmol/kg. Analysis of kinetic curve shape was made according to the Breast Imaging Reporting and Data System lexicon. Several quantitative parameters were calculated including initial and peak enhancement percentage (E(1) and E(peak)). Linear regression was used to model the variation of kinetic parameters with dose.
  
  
  RESULTS
  There was no difference found in the qualitative Breast Imaging Reporting and Data System descriptors of curve shape between the three dose groups. There was a trend for E(1) and E(peak) to increase from Dose Group 1 to Dose Group 3 in malignant lesions overall, as well as in invasive ductal carcinoma lesions separately. Each decrement/increment of 0.05 mmol/kg in dose yielded a decrease/increase of 78% and 97% in E(1) for in situ and invasive cancers, respectively.
  
  
  CONCLUSIONS
  Contrast should be administered at fixed dose to achieve comparable levels of lesion uptake in women of different weights. Our results suggest that reducing the contrast administered to 0.05 mmol/kg, as has been suggested for patients at risk of developing nephrogenic systemic fibrosis, could substantially decrease the observed initial enhancement in some cancers.
authors.affiliation: Department of Radiology, University of Chicago, Chicago, IL 60637, USA.
authors.forename: Sanaz A
authors.initials: SA
authors.lastname: Jansen
authors.forename: Xiaobing
authors.initials: X
authors.lastname: Fan
authors.forename: Cheng
authors.initials: C
authors.lastname: Yang
authors.forename: Akiko
authors.initials: A
authors.lastname: Shimauchi
authors.forename: Gregory
authors.initials: G
authors.lastname: Karczmar
authors.forename: Gillian M
authors.initials: GM
authors.lastname: Newstead
mesh_terms: D001943:Breast Neoplasms / Q000378:metabolism* / Q000473:pathology*; D003287:Contrast Media / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage / Q000493:pharmacokinetics*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008657:Metabolic Clearance Rate / Q000187:drug effects; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA