title: The diverse pathology and kinetics of mass, nonmass, and focus enhancement on MR imaging of the breast.
abstract: OBJECTIVE
  To compare the pathology and kinetic characteristics of breast lesions with focus-, mass-, and nonmass-like enhancement.
  
  
  METHODS
  A total of 852 MRI detected breast lesions in 697 patients were selected for an IRB approved review. Patients underwent dynamic contrast enhanced MRI using one pre- and three to six postcontrast T(1)-weighted images. The "type" of enhancement was classified as mass, nonmass, or focus, and kinetic curves quantified by the initial enhancement percentage (E(1)), time to peak enhancement (T(peak)), and signal enhancement ratio (SER). These kinetic parameters were compared between malignant and benign lesions within each morphologic type.
  
  
  RESULTS
  A total of 552 lesions were classified as mass (396 malignant, 156 benign), 261 as nonmass (212 malignant, 49 benign), and 39 as focus (9 malignant, 30 benign). The most common pathology of malignant/benign lesions by morphology: for mass, invasive ductal carcinoma/fibroadenoma; for nonmass, ductal carcinoma in situ (DCIS)/fibrocystic change(FCC); for focus, DCIS/FCC. Benign mass lesions exhibited significantly lower E(1), longer T(peak), and lower SER compared with malignant mass lesions (P < 0.0001). Benign nonmass lesions exhibited only a lower SER compared with malignant nonmass lesions (P < 0.01).
  
  
  CONCLUSIONS
  By considering the diverse pathology and kinetic characteristics of different lesion morphologies, diagnostic accuracy may be improved.
authors: Department of Radiology, The University of Chicago, Chicago, Illinois 60637, USA.
authors: Sanaz A
authors: SA
authors: Jansen
authors: Akiko
authors: A
authors: Shimauchi
authors: Lindsay
authors: L
authors: Zak
authors: Xiaobing
authors: X
authors: Fan
authors: Gregory S
authors: GS
authors: Karczmar
authors: Gillian M
authors: GM
authors: Newstead
references: Eur Radiol. 2008 Jun;18(6):1123-33
references: 18270714
references: Magn Reson Imaging Clin N Am. 2010 May;18(2):171-85, vii
references: 20494304
references: Radiologe. 2008 Apr;48(4):358-66
references: 18369582
references: J Magn Reson Imaging. 2007 Jan;25(1):104-12
references: 17152054
references: AJR Am J Roentgenol. 2003 Aug;181(2):519-25
references: 12876038
references: Breast. 2007 Dec;16 Suppl 2:S34-44
references: 17959382
references: Magn Reson Imaging. 2005 Jul;23(6):733-8
references: 16198828
references: J Clin Oncol. 2006 Oct 1;24(28):4603-10
references: 17008702
references: Breast J. 2005 Nov-Dec;11(6):379-81
references: 16297079
references: Acta Radiol. 2003 Jul;44(4):379-86
references: 12846687
references: Phys Med Biol. 2010 Oct 7;55(19):N473-85
references: 20858914
references: Acad Radiol. 2010 Jan;17(1):24-30
references: 19836270
references: Radiology. 2006 Jan;238(1):42-53
references: 16373758
references: Med Phys. 2006 Aug;33(8):2878-87
references: 16964864
references: Med Phys. 2008 Jul;35(7):3102-9
references: 18697535
references: Br J Radiol. 2003 Jan;76(901):3-12
references: 12595319
references: Radiology. 2007 Dec;245(3):684-91
references: 18024450
references: Am J Surg. 2007 May;193(5):600-5; discussion 605
references: 17434364
references: Eur J Radiol. 2010 Jul;75(1):e126-32
references: 19796900
references: AJR Am J Roentgenol. 2006 Aug;187(2):330-7
references: 16861534
references: Eur Radiol. 2003 Nov;13(11):2425-35
references: 12898176
references: AJR Am J Roentgenol. 2002 Jul;179(1):171-8
references: 12076929
references: Semin Ultrasound CT MR. 2006 Aug;27(4):320-32
references: 16916000
references: Radiology. 2007 Oct;245(1):80-7
references: 17885182
references: CA Cancer J Clin. 2007 Mar-Apr;57(2):75-89
references: 17392385
references: Radiology. 2007 Jul;244(1):94-103
references: 17507720
references: Radiology. 1999 Apr;211(1):101-10
references: 10189459
references: Radiology. 2009 Nov;253(2):399-406
references: 19864527
references: MAGMA. 2000 Dec;11(3):129-37
references: 11154954
references: Eur Radiol. 2010 Apr;20(4):771-81
references: 19789878
references: Breast J. 1999 Jan;5(1):13-21
references: 11348250
references: AJR Am J Roentgenol. 2006 Mar;186(3):865-70
references: 16498122
references: Breast Cancer. 2008;15(3):241-6
references: 18224381
references: AJR Am J Roentgenol. 2009 Sep;193(3):832-9
references: 19696299
references: J Comput Assist Tomogr. 2000 Sep-Oct;24(5):724-31
references: 11045693
references: AJR Am J Roentgenol. 2010 Jun;194(6):1658-63
references: 20489110
references: JBR-BTR. 2005 Sep-Oct;88(5):225-32
references: 16302331
references: Breast J. 2007 Nov-Dec;13(6):545-50
references: 17983393
references: Radiology. 2007 Aug;244(2):381-8
references: 17641362
references: Radiology. 2006 May;239(2):351-60
references: 16569783
references: Magn Reson Med. 2007 Sep;58(3):572-81
references: 17685424
references: Radiology. 2008 Jul;248(1):79-87
references: 18566170
references: Eur Radiol. 2001;11(4):531-46
references: 11354744