title: Computer-aided diagnosis in breast DCE-MRI--quantification of the heterogeneity of breast lesions.
abstract: OBJECTIVE
  In our study we aim at the quantification of the heterogeneity for differential diagnosis of breast lesions in MRI.
  
  
  METHODS
  We tested a software tool for quantification of heterogeneity. The software tool provides a three-dimensional analysis of the whole breast lesion. The lesions were divided in regions with similar perfusion characteristics. Voxels were merged to the same region, if the perfusion parameters (wash-in, wash-out, integral, peak enhancement and time to peak) correlated to 99%. We evaluated 68 lesions from 50 patients. 31 lesions proved to be benign (45.6%) and 37 malignant (54.4%). We included small lesions which could only be detected with MRI.
  
  
  RESULTS
  The analysis of heterogeneity showed significant differences (p<0.005; AUC 0.7). Malignant lesions were more heterogeneous than benign ones. Significant differences were also found for morphologic parameters such as shape (p<0.001) and margin (p<0.007). The analysis of the enhancement dynamics did not prove successful in lesion discrimination.
  
  
  CONCLUSIONS
  Our study indicates that the region analysis for quantification of heterogeneity may be a helpful additional method to differentiate benign lesions from malignant ones.
authors.affiliation: Herzzentrum Leipzig, Universitätsklinik, Strümpellstraße 39, 04289 Leipzig, Germany. uta.preim@googlemail.com
authors.forename: Uta
authors.initials: U
authors.lastname: Preim
authors.forename: Sylvia
authors.initials: S
authors.lastname: Glaßer
authors.forename: Bernhard
authors.initials: B
authors.lastname: Preim
authors.forename: Frank
authors.initials: F
authors.lastname: Fischbach
authors.forename: Jens
authors.initials: J
authors.lastname: Ricke
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001706:Biopsy; D001943:Breast Neoplasms / Q000175:diagnosis*; D003287:Contrast Media; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012984:Software; D018709:Statistics, Nonparametric
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA