title: Evaluation of the kinetic properties of background parenchymal enhancement throughout the phases of the menstrual cycle.
abstract: OBJECTIVE
  To develop and apply a semiautomatic method of segmenting fibroglandular tissue to quantify magnetic resonance (MR) imaging contrast material-enhancement kinetics of breast background parenchyma (BP) and lesions throughout the phases of the menstrual cycle in women with benign and malignant lesions.
  
  
  METHODS
  The institutional review board approved this retrospective HIPAA-compliant study, and informed consent was waived. From December 2008 to August 2011, 58 premenopausal women who had undergone contrast material-enhanced MR imaging and MR imaging-guided biopsy were identified. The longest time from the start of the last known period was 34 days. One lesion per patient (37 benign and 21 malignant) was analyzed. The patient groups were stratified according to the week of the menstrual cycle when MR imaging was performed. A method based on principal component analysis (PCA) was applied for quantitative analysis of signal enhancement in the BP and lesions by using the percentage of slope and percentage of enhancement. Linear regression and the Mann-Whitney U test were used to assess the association between the kinetic parameters and the week of the menstrual cycle.
  
  
  RESULTS
  In the women with benign lesions, percentages of slope and enhancement for both BP and lesions during week 2 were significantly (P < .05) lower than those in week 4. Percentage of enhancement in the lesion in week 2 was lower than that in week 3 (P < .05). The MR images of women with malignant lesions showed no significant difference between the weeks for any of the parameters. There was a strong positive correlation between lesion and BP percentage of slope (r = 0.72) and between lesion and BP percentage of enhancement (r = 0.67) in the benign group. There was also a significant (P = .03) difference in lesion percentage of slope between the benign and malignant groups at week 2.
  
  
  CONCLUSIONS
  The PCA-based method can quantify contrast enhancement kinetics of BP semiautomatically, and kinetics of BP and lesions vary according to the week of the menstrual cycle in benign but not in malignant lesions.
authors: Department of Radiology, Center for Biomedical Imaging, New York University School of Medicine, 660 First Ave, 4th Floor, New York, NY 10016, USA. Alana.Amarosa@nyumc.org
authors: Alana R
authors: AR
authors: Amarosa
authors: Jason
authors: J
authors: McKellop
authors: Ana Paula
authors: AP
authors: Klautau Leite
authors: Melanie
authors: M
authors: Moccaldi
authors: Tess V
authors: TV
authors: Clendenen
authors: James S
authors: JS
authors: Babb
authors: Anne
authors: A
authors: Zeleniuch-Jacquotte
authors: Linda
authors: L
authors: Moy
authors: Sungheon
authors: S
authors: Kim
mesh_terms: D000328:Adult; D001706:Biopsy; D001940:Breast / Q000502:physiology*; D001943:Breast Neoplasms / Q000473:pathology*; D003287:Contrast Media / Q000493:pharmacokinetics*; D005260:Female; D019786:Gadolinium DTPA / Q000493:pharmacokinetics*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D016014:Linear Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D053783:Magnetic Resonance Imaging, Interventional; D008597:Menstrual Cycle / Q000502:physiology*; D008875:Middle Aged; D025341:Principal Component Analysis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA
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