title: Positive enhancement integral values in dynamic contrast enhanced magnetic resonance imaging of breast carcinoma: ductal carcinoma in situ vs. invasive ductal carcinoma.
abstract: OBJECTIVE
  The aim of this study was to contribute to the standardization of the numeric positive enhancement integral (PEI) values in breast parenchyma, ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC) and to evaluate the significance of the difference in PEI values between IDC and parenchyma, DCIS and parenchyma and IDC and DCIS.
  
  
  METHODS
  In the prospective trial, we analyzed the dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of 60 consecutive patients with histologically confirmed unilateral DCIS (n=30) and IDC (n=30) and defined the PEI values (range; mean ± SD) for the lesions and the breast parenchyma. Tumor-to-non-tumor (T/NT) ratios were calculated for DCIS and IDC and compared. PEI color maps (PEICM) were created. The differences in PEI values between IDC and parenchyma and between DCIS and parenchyma were tested according to t-test. Analysis of variance (ANOVA) was used to test the differences between the mean PEI values of parenchyma, DCIS and IDC.
  
  
  RESULTS
  IDC showed highly statistically different PEI numeric values compared to breast parenchyma (748.7 ± 32.2 vs. 74.6 ± 17.0; p<0.0001). The same applied to the differences in the group of patients with DCIS (428.0 ± 25.0 vs. 66.0 ± 10.6; p<0.0001). The difference between IDC, DCIS and parenchyma were also considered highly statistically significant (p<0.0001) and so were the T/NT ratios for IDC and DCIS (10.1 ± 2.4 vs. 6.6 ± 1.4; p<0.0001).
  
  
  CONCLUSIONS
  PEI numeric values may contribute to differentiation between invasive and in situ breast carcinoma.
authors.affiliation: Clinic for Radiology and Radiation Oncology, Institute of Oncology and Radiology of Serbia, Pasterova 14, 11000 Belgrade, Serbia. Electronic address: dr.m.nadrljanski@gmail.com.
authors.forename: Mirjan
authors.initials: M
authors.lastname: Nadrljanski
authors.affiliation: Center for Radiology and Magnetic Resonance Imaging, Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Dr Subotića 8, 11000 Belgrade, Serbia.
authors.forename: Ružica
authors.initials: R
authors.lastname: Maksimović
authors.affiliation: Clinic for Radiology and Radiation Oncology, Institute of Oncology and Radiology of Serbia, Pasterova 14, 11000 Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Dr Subotića 8, 11000 Belgrade, Serbia.
authors.forename: Vesna
authors.initials: V
authors.lastname: Plešinac-Karapandžić
authors.affiliation: Clinic for Radiology and Radiation Oncology, Institute of Oncology and Radiology of Serbia, Pasterova 14, 11000 Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Dr Subotića 8, 11000 Belgrade, Serbia.
authors.forename: Marina
authors.initials: M
authors.lastname: Nikitović
authors.affiliation: Center for Radiology and Magnetic Resonance Imaging, Clinical Center of Serbia, Pasterova 2, 11000 Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Dr Subotića 8, 11000 Belgrade, Serbia.
authors.forename: Biljana
authors.initials: B
authors.lastname: Marković-Vasiljković
authors.affiliation: Clinic for Radiology and Radiation Oncology, Institute of Oncology and Radiology of Serbia, Pasterova 14, 11000 Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Dr Subotića 8, 11000 Belgrade, Serbia.
authors.forename: Zorica
authors.initials: Z
authors.lastname: Milošević
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008327:Mammography; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA
keywords: Breast; Breast neoplasms; Carcinoma; Ductal; Intraductal; Invasive; Magnetic resonance imaging; Noninfiltrating