title: Evaluation of background parenchymal enhancement on breast MRI: a systematic review.
abstract: OBJECTIVE
  To perform a systematic review of the methods used for background parenchymal enhancement (BPE) evaluation on breast MRI.
  
  
  METHODS
  Studies dealing with BPE assessment on breast MRI were retrieved from major medical libraries independently by four reviewers up to 6 October 2015. The keywords used for database searching are "background parenchymal enhancement", "parenchymal enhancement", "MRI" and "breast". The studies were included if qualitative and/or quantitative methods for BPE assessment were described.
  
  
  RESULTS
  Of the 420 studies identified, a total of 52 articles were included in the systematic review. 28 studies performed only a qualitative assessment of BPE, 13 studies performed only a quantitative assessment and 11 studies performed both qualitative and quantitative assessments. A wide heterogeneity was found in the MRI sequences and in the quantitative methods used for BPE assessment.
  
  
  CONCLUSIONS
  A wide variability exists in the quantitative evaluation of BPE on breast MRI. More studies focused on a reliable and comparable method for quantitative BPE assessment are needed. Advances in knowledge: More studies focused on a quantitative BPE assessment are needed.
authors.affiliation: 2 Department of Health Sciences, Institute of Statistics, University of Genoa, Genoa, Italy.
authors.forename: Bianca
authors.initials: B
authors.lastname: Bignotti
authors.affiliation: 3 Department of Experimental Medicine, Institute of Anatomy, University of Genoa, Genoa, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Signori
authors.affiliation: 4 School of Medicine, Genoa, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Valdora
authors.affiliation: 1 Department of Health Sciences, University of Genova, Genoa, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Rossi
authors.affiliation: 5 IRCCS AOU San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Calabrese
authors.affiliation: 6 Department of Diagnostic Imaging and Radiotherapy, AOU Città della Salute e della Scienza of Turin, Breast Imaging Service, Division of Radiology, University of Turin, Turin, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Durando
authors.affiliation: 6 Department of Diagnostic Imaging and Radiotherapy, AOU Città della Salute e della Scienza of Turin, Breast Imaging Service, Division of Radiology, University of Turin, Turin, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Mariscotto
authors.affiliation: 3 Department of Experimental Medicine, Institute of Anatomy, University of Genoa, Genoa, Italy.|5 IRCCS AOU San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Tagliafico
mesh_terms: D001940:Breast / Q000000981:diagnostic imaging*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D000072356:Parenchymal Tissue / Q000000981:diagnostic imaging*