title: Differentiation of Fibroadenomas and Pure Mucinous Carcinomas on Dynamic Contrast-Enhanced MRI of the Breast Using Volume Segmentation for Kinetic Analysis: A Feasibility Study.
abstract: OBJECTIVE
  The objective of this study was to retrospectively evaluate the diagnostic performance of volume-based kinetic analysis in dynamic contrast-enhanced MRI (DCE-MRI) of the breast for the differentiation of fibroadenomas (FAs) with high T2 signal intensity from pure mucinous carcinomas (PMCs).
  
  
  METHODS
  A review of records from 2007 to 2013 that were stored in the pathology department database at our institution identified nine patients with PMCs (defined as tumor cells with a mucinous component ≥ 90%) who underwent preoperative breast MRI. The PMCs were compared with 15 biopsy-proven FAs from 13 patients. Characteristics noted on DCE-MRI were evaluated using computer-assisted diagnosis software. For each mass, the proportion of progressive enhancement in the lesion at the delayed phase was quantified. Both groups of masses were compared using a Wilcoxon signed rank test. A ROC curve was used to define an appropriate cutoff point.
  
  
  RESULTS
  The median rate of progressive enhancement was 100% (range, 99-100%) for FAs and 97% (range, 87-99%) for PMCs (p = 0.0326). The AUC of the kinetic curve for progressive enhancement was 0.7519 (95% CI, 0.5258-0.9407). A more appropriate cutoff value to maximize sensitivity and specificity was 98.5%. With this cutoff, sensitivity was 66.7% (95% CI, 11.1-100%) and specificity was 80% (95% CI, 39.6-99.8%) for the diagnosis of PMCs.
  
  
  CONCLUSIONS
  Volume-based kinetic analysis may aid in differentiating FAs from PMCs on DCE-MRI studies of the breast.
authors.affiliation: 1 Department of Radiology, Cedar Breast Clinic, McGill University Health Center, Royal Victoria Hospital, 687 Pine Ave West, Montreal, QC, H3H 1A1, Canada.
authors.forename: Romuald
authors.initials: R
authors.lastname: Ferré
authors.affiliation: 1 Department of Radiology, Cedar Breast Clinic, McGill University Health Center, Royal Victoria Hospital, 687 Pine Ave West, Montreal, QC, H3H 1A1, Canada.
authors.forename: Ann
authors.initials: A
authors.lastname: Aldis
authors.affiliation: 1 Department of Radiology, Cedar Breast Clinic, McGill University Health Center, Royal Victoria Hospital, 687 Pine Ave West, Montreal, QC, H3H 1A1, Canada.
authors.forename: Shaza
authors.initials: S
authors.lastname: AlSharif
authors.affiliation: 2 Department of Pathology, Cedar Breast Clinic, McGill University Health Center, Royal Victoria Hospital, Montreal, Canada.
authors.forename: Atilla
authors.initials: A
authors.lastname: Omeroglu
authors.affiliation: 1 Department of Radiology, Cedar Breast Clinic, McGill University Health Center, Royal Victoria Hospital, 687 Pine Ave West, Montreal, QC, H3H 1A1, Canada.
authors.forename: Benoît
authors.initials: B
authors.lastname: Mesurolle
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology*; D005240:Feasibility Studies; D005260:Female; D018226:Fibroadenoma / Q000473:pathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007700:Kinetics; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009929:Organ Size; D012189:Retrospective Studies
keywords: breast dynamic contrast-enhanced MRI; fibroadenomas; kinetic analysis; pure mucinous carcinomas; volume segmentation tool