title: Computer-aided Diagnosis-generated Kinetic Features of Breast Cancer at Preoperative MR Imaging: Association with Disease-free Survival of Patients with Primary Operable Invasive Breast Cancer.
abstract: Purpose To retrospectively investigate the relationship between the kinetic features of breast cancer assessed with computer-aided diagnosis (CAD) at preoperative magnetic resonance (MR) imaging and disease-free survival in patients with primary operable invasive breast cancer. Materials and Methods This retrospective study was approved by the institutional review board. The requirement to obtain informed consent was waived. The authors identified 329 consecutive women (mean age, 52.9 years; age range, 32-88 years) with newly diagnosed invasive breast cancer who had undergone preoperative MR imaging and surgery between January 2012 and February 2013. All MR images were retrospectively reviewed by using a commercially available CAD system, and the following kinetic parameters were noted for each lesion: peak enhancement (highest pixel signal intensity in the first series obtained after administration of contrast material), angio-volume (total volume of the enhancing lesion), and delayed enhancement profiles (the proportions of washout, plateau, and persistently enhancing component within a tumor). Cox proportional hazards modeling was used to identify the relationship between CAD-generated kinetics and disease-free survival after adjusting for clinical-pathologic variables. Results A total of 36 recurrences developed at a median follow-up of 50 months (range, 15-55 months). CAD-measured peak enhancement at preoperative MR imaging enabled differentiation between patients with and patients without recurrence (area under the receiver operating characteristic curve = 0.728; 95% confidence interval [CI]: 0.676, 0.775; P < .001). Multivariate Cox analysis showed that a higher peak enhancement (hazard ratio [HR] = 1.001; 95% CI: 1.000, 1.002; P = .004), a higher washout component (HR = 1.029; 95% CI: 1.005, 1.054; P = .017), and lymphovascular invasion at histopathologic examination (HR = 3.011; 95% CI: 1.302, 6.962; P = .010) were associated with poorer disease-free survival. Conclusion Higher values of CAD-measured peak enhancement and washout component at preoperative MR imaging were significantly associated with poorer disease-free survival of patients with primary operable breast cancer.©RSNA, 2017.
authors.affiliation: From the Department of Radiology (J.J.K., J.Y.K., H.J.K.), Busan Cancer Center (T.K.), and Department of Surgery (S.W.L., Y.T.B.), Pusan National University Hospital, 1-10 Ami-Dong, Seo-gu, Busan 602-739, Republic of Korea; and Medical Research Institute, Pusan National University School of Medicine, Busan, Republic of Korea (J.J.K., J.Y.K., J.K.S.).From the 2016 RSNA Annual Meeting.
authors.forename: Jin Joo
authors.initials: JJ
authors.lastname: Kim
authors.affiliation: From the Department of Radiology (J.J.K., J.Y.K., H.J.K.), Busan Cancer Center (T.K.), and Department of Surgery (S.W.L., Y.T.B.), Pusan National University Hospital, 1-10 Ami-Dong, Seo-gu, Busan 602-739, Republic of Korea; and Medical Research Institute, Pusan National University School of Medicine, Busan, Republic of Korea (J.J.K., J.Y.K., J.K.S.).From the 2016 RSNA Annual Meeting.
authors.forename: Jin You
authors.identifier: 0000-0002-9631-501X
authors.initials: JY
authors.lastname: Kim
authors.affiliation: From the Department of Radiology (J.J.K., J.Y.K., H.J.K.), Busan Cancer Center (T.K.), and Department of Surgery (S.W.L., Y.T.B.), Pusan National University Hospital, 1-10 Ami-Dong, Seo-gu, Busan 602-739, Republic of Korea; and Medical Research Institute, Pusan National University School of Medicine, Busan, Republic of Korea (J.J.K., J.Y.K., J.K.S.).From the 2016 RSNA Annual Meeting.
authors.forename: Hyun Jung
authors.initials: HJ
authors.lastname: Kang
authors.affiliation: From the Department of Radiology (J.J.K., J.Y.K., H.J.K.), Busan Cancer Center (T.K.), and Department of Surgery (S.W.L., Y.T.B.), Pusan National University Hospital, 1-10 Ami-Dong, Seo-gu, Busan 602-739, Republic of Korea; and Medical Research Institute, Pusan National University School of Medicine, Busan, Republic of Korea (J.J.K., J.Y.K., J.K.S.).From the 2016 RSNA Annual Meeting.
authors.forename: Jong Ki
authors.initials: JK
authors.lastname: Shin
authors.affiliation: From the Department of Radiology (J.J.K., J.Y.K., H.J.K.), Busan Cancer Center (T.K.), and Department of Surgery (S.W.L., Y.T.B.), Pusan National University Hospital, 1-10 Ami-Dong, Seo-gu, Busan 602-739, Republic of Korea; and Medical Research Institute, Pusan National University School of Medicine, Busan, Republic of Korea (J.J.K., J.Y.K., J.K.S.).From the 2016 RSNA Annual Meeting.
authors.forename: Taewoo
authors.initials: T
authors.lastname: Kang
authors.affiliation: From the Department of Radiology (J.J.K., J.Y.K., H.J.K.), Busan Cancer Center (T.K.), and Department of Surgery (S.W.L., Y.T.B.), Pusan National University Hospital, 1-10 Ami-Dong, Seo-gu, Busan 602-739, Republic of Korea; and Medical Research Institute, Pusan National University School of Medicine, Busan, Republic of Korea (J.J.K., J.Y.K., J.K.S.).From the 2016 RSNA Annual Meeting.
authors.forename: Seok Won
authors.initials: SW
authors.lastname: Lee
authors.affiliation: From the Department of Radiology (J.J.K., J.Y.K., H.J.K.), Busan Cancer Center (T.K.), and Department of Surgery (S.W.L., Y.T.B.), Pusan National University Hospital, 1-10 Ami-Dong, Seo-gu, Busan 602-739, Republic of Korea; and Medical Research Institute, Pusan National University School of Medicine, Busan, Republic of Korea (J.J.K., J.Y.K., J.K.S.).From the 2016 RSNA Annual Meeting.
authors.forename: Young Tae
authors.initials: YT
authors.lastname: Bae
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D003287:Contrast Media; D003936:Diagnosis, Computer-Assisted; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007700:Kinetics; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008408:Mastectomy; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009942:Organometallic Compounds; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol