title: Quantitative discrimination between invasive ductal carcinomas and benign lesions based on semi-automatic analysis of time intensity curves from breast dynamic contrast enhanced MRI.
abstract: BACKGROUND
  Traditional subjective method for the analysis of time-intensity curves (TICs) from breast dynamic contrast enhanced MRI (DCE-MRI) presented a low specificity. Hence, a semi-automatic quantitative method was proposed and evaluated for distinguishing invasive ductal carcinomas from benign lesions.
  
  
  METHODS
  In the traditional method, the lesion was extracted by placing a region of interest (ROI) manually. The mean curve of the TICs from the ROI was subjectively classified as one of three patterns. Only one quantitative parameter, the mean value of maximum slope of increase (MSI), was provided. In the new method, the lesion was identified semi-automatically, and the mean curve was classified quantitatively. Some additional parameters, the signal intensity slope (SIslope), initial percentage of enhancement (Einitial), percentage of peak enhancement (Epeak), early signal enhancement ratio (ESER), and second enhancement percentage (SEP) were derived from the mean curves as well as the lesion areas. Wilcoxon's test and receiver operating characteristic (ROC) analyses were performed, and P < 0.05 was considered significant.
  
  
  RESULTS
  According to the TIC classification results, the accuracies were 59.16% for the traditional manual method and 76.05% for the new method (P < 0.05). For the mean MSI values from the manual method, the accuracy was 63.35%. For the mean TICs derived from the semi-automatic method, the accuracies were 77.47% for SIslope, 65.24% for MSI, 58.45% for Einitial, 66.20% for Epeak, 71.83% for ESER, and 54.93% for SEP, respectively. For the lesion regions identified by the semi-automatic method, the accuracies were 73.24%, 72.54%, 58.45%, 62.68%, 64.09%, and 55.64%, respectively.
  
  
  CONCLUSIONS
  Compared with traditional subjective method, the semi-automatic quantitative method proposed in this study showed a higher performance, and should be used as a supplementary tool to aid radiologist's subjective interpretation.
authors.affiliation: Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, P.R. China. jiandongyin@sina.com.
authors.forename: Jiandong
authors.initials: J
authors.lastname: Yin
authors.affiliation: Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, P.R. China. yinjd@sj-hospital.org.
authors.forename: Jiawen
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, P.R. China. 27427848@qq.com.
authors.forename: Lu
authors.initials: L
authors.lastname: Han
authors.affiliation: Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, P.R. China. cmuguoqy@163.com.
authors.forename: Qiyong
authors.initials: Q
authors.lastname: Guo
authors.affiliation: Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, P.R. China. 2283963483@qq.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000473:pathology; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D060787:Neoplasm Grading; D012372:ROC Curve; D055815:Young Adult
chemical_list: D003287:Contrast Media