title: Separation of benign and malignant breast lesions using dynamic contrast enhanced MRI in a biopsy cohort.
abstract: To assess the diagnostic utility of contrast kinetic analysis for breast lesions and background parenchyma of women undergoing MRI-guided biopsies, for whom standard clinical analysis had failed to separate benign and malignant lesions.
  
  
  
  This study included 115 women who had indeterminate lesions based on routine diagnostic breast MRI exams and underwent an MRI (3 Tesla) -guided biopsy of one or more lesions suspicious for breast cancer. Breast dynamic contrast-enhanced (DCE)-MRI was performed using a radial stack-of-stars three-dimensional spoiled gradient echo pulse sequence and modified k-space weighted image contrast image reconstruction. Contrast kinetic model analysis was conducted to characterize the contrast enhancement patterns measured in lesions and background parenchyma (BP). The transfer rate (Ktrans), interstitial volume fraction (ve), and vascular volume fraction (vp) estimated from the lesion and BP were used to separate malignant from benign lesions.
  
  
  
  The patients with malignant lesions had significantly (P < 0.05) higher median lesion-Ktrans(0.081 min-1), higher median BP-Ktrans(0.032 min-1), and BP-vp(0.020) than those without malignant lesions (0.056 min-1, 0.017 min-1and 0.012, respectively). The area under the receiver operating characteristic curve (AUC) of the BP-Ktrans(0.687) was highest among the single parameters and higher than that of the lesion-Ktrans(0.664). The combined logistic regression model of lesion-Ktrans, lesion-ve, BP-Ktrans, BP-ve, and BP-vphad the highest AUC of 0.730.
  
  
  
  Our results suggest that the contrast kinetic analysis of DCE-MRI data can be used to differentiate the malignant lesions from the benign and high-risk lesions among the indeterminate breast lesions recommended for MRI-guided biopsy exams.
  
  
  
  3 J. MAGN. RESON. IMAGING 2017;45:1385-1393.
authors.affiliation: Center for Advanced Imaging Innovation and Research (CAIR), New York, New York, USA.|Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA.
authors.forename: Sungheon Gene
authors.initials: SG
authors.lastname: Kim
authors.affiliation: Center for Advanced Imaging Innovation and Research (CAIR), New York, New York, USA.|Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA.
authors.forename: Melanie
authors.initials: M
authors.lastname: Freed
authors.affiliation: Center for Advanced Imaging Innovation and Research (CAIR), New York, New York, USA.|Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA.
authors.forename: Ana Paula Klautau
authors.initials: APK
authors.lastname: Leite
authors.affiliation: Center for Advanced Imaging Innovation and Research (CAIR), New York, New York, USA.|Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA.
authors.forename: Jin
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Center for Advanced Imaging Innovation and Research (CAIR), New York, New York, USA.|Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA.
authors.forename: Claudia
authors.initials: C
authors.lastname: Seuss
authors.affiliation: Center for Advanced Imaging Innovation and Research (CAIR), New York, New York, USA.|Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Moy
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D001940:Breast / Q000000981:diagnostic imaging / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D003287:Contrast Media / Q000737:chemistry*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007091:Image Processing, Computer-Assisted; D007700:Kinetics; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media
keywords: biopsy; breast cancer; breast compression; contrast kinetic analysis; dynamic contrast enhanced MRI