title: Breast Contrast Enhanced MR Imaging: Semi-Automatic Detection of Vascular Map and Predominant Feeding Vessel.
abstract: OBJECTIVE
  To obtain breast vascular map and to assess correlation between predominant feeding vessel and tumor location with a semi-automatic method compared to conventional radiologic reading.
  
  
  METHODS
  148 malignant and 75 benign breast lesions were included. All patients underwent bilateral MR imaging. Written informed consent was obtained from the patients before MRI. The local ethics committee granted approval for this study. Semi-automatic breast vascular map and predominant vessel detection was performed on MRI, for each patient. Semi-automatic detection (depending on grey levels threshold manually chosen by radiologist) was compared with results of two expert radiologists; inter-observer variability and reliability of semi-automatic approach were assessed.
  
  
  RESULTS
  Anatomic analysis of breast lesions revealed that 20% of patients had masses in internal half, 50% in external half and the 30% in subareolar/central area. As regards the 44 tumors in internal half, based on radiologic consensus, 40 demonstrated a predominant feeding vessel (61% were supplied by internal thoracic vessels, 14% by lateral thoracic vessels, 16% by both thoracic vessels and 9% had no predominant feeding vessel-p<0.01), based on semi-automatic detection, 38 tumors demonstrated a predominant feeding vessel (66% were supplied by internal thoracic vessels, 11% by lateral thoracic vessels, 9% by both thoracic vessels and 14% had no predominant feeding vessel-p<0.01). As regards the 111 tumors in external half, based on radiologic consensus, 91 demonstrated a predominant feeding vessel (25% were supplied by internal thoracic vessels, 39% by lateral thoracic vessels, 18% by both thoracic vessels and 18% had no predominant feeding vessel-p<0.01), based on semi-automatic detection, 94 demonstrated a predominant feeding vessel (27% were supplied by internal thoracic vessels, 45% by lateral thoracic vessels, 4% by both thoracic vessels and 24% had no predominant feeding vessel-p<0.01). An excellent agreement between two radiologic assessments (k = 0.81) and between radiologic consensus and semi-automatic assessment (k = 0.80) was found to identify origin of predominant feeding vessel. An excellent reliability for semi-automatic assessment (Cronbach's alpha = 0.96) was reported.
  
  
  CONCLUSIONS
  Predominant feeding vessel location was correlated with breast lesion location: internal thoracic artery supplied the highest proportion of breasts with tumor in internal half and lateral thoracic artery supplied the highest proportion of breasts with lateral tumor.
authors: Division of Radiology, Department of Diagnostic Imaging, radiant and metabolic Therapy, "Istituto Nazionale Tumori Fondazione Giovanni Pascale-IRCCS", Via Mariano Semmola, Naples, Italy.
authors: Antonella
authors: A
authors: Petrillo
authors: Division of Radiology, Department of Diagnostic Imaging, radiant and metabolic Therapy, "Istituto Nazionale Tumori Fondazione Giovanni Pascale-IRCCS", Via Mariano Semmola, Naples, Italy.
authors: Roberta
authors: R
authors: Fusco
authors: Division of Radiology, Department of Diagnostic Imaging, radiant and metabolic Therapy, "Istituto Nazionale Tumori Fondazione Giovanni Pascale-IRCCS", Via Mariano Semmola, Naples, Italy.
authors: Salvatore
authors: S
authors: Filice
authors: Division of Radiology, Department of Diagnostic Imaging, radiant and metabolic Therapy, "Istituto Nazionale Tumori Fondazione Giovanni Pascale-IRCCS", Via Mariano Semmola, Naples, Italy.
authors: Vincenza
authors: V
authors: Granata
authors: Division of Radiology, Department of Diagnostic Imaging, radiant and metabolic Therapy, "Istituto Nazionale Tumori Fondazione Giovanni Pascale-IRCCS", Via Mariano Semmola, Naples, Italy.
authors: Orlando
authors: O
authors: Catalano
authors: Division of Radiology, Department of Diagnostic Imaging, radiant and metabolic Therapy, "Istituto Nazionale Tumori Fondazione Giovanni Pascale-IRCCS", Via Mariano Semmola, Naples, Italy.
authors: Paolo
authors: P
authors: Vallone
authors: Division of Diagnostic Pathology, Department of Diagnostic and Laboratory Pathology "Istituto Nazionale Tumori Fondazione Giovanni Pascale-IRCCS", Via Mariano Semmola, Naples, Italy.
authors: Maurizio
authors: M
authors: Di Bonito
authors: Divison of Senology Surgery, Department of Senology "Istituto Nazionale Tumori Fondazione Giovanni Pascale-IRCCS", Via Mariano Semmola, Naples, Italy.
authors: Massimiliano
authors: M
authors: D'Aiuto
authors: Divison of Senology Surgery, Department of Senology "Istituto Nazionale Tumori Fondazione Giovanni Pascale-IRCCS", Via Mariano Semmola, Naples, Italy.
authors: Massimo
authors: M
authors: Rinaldo
authors: Divison of Senology Surgery, Department of Senology "Istituto Nazionale Tumori Fondazione Giovanni Pascale-IRCCS", Via Mariano Semmola, Naples, Italy.
authors: Immacolata
authors: I
authors: Capasso
authors: Department of Electrical Engineering and Information Technologies, University "Federico II" of Naples, Via Claudio, Naples, Italy.
authors: Mario
authors: M
authors: Sansone
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult