Shandong Wu PhD, MSc, Presenter: Nothing to Disclose

Margarita Louise Zuley MD, Abstract Co-Author: Research Grant, Hologic, Inc

Wendie A. Berg MD, PhD, Abstract Co-Author: Research Grant, Gamma Medica, Inc Research Grant, General Electric Company Equipment support, Gamma Medica, Inc Equipment support, General Electric Company

Brenda F. Kurland PhD, Abstract Co-Author: Nothing to Disclose

Rachel Jankowitz MD, Abstract Co-Author: Nothing to Disclose

Jules Henry Sumkin DO, Abstract Co-Author: Scientific Advisory Board, Hologic, Inc

David Gur PhD, Abstract Co-Author: Nothing to Disclose

Contrast enhancement kinetics derived from breast dynamic contrast enhanced MRI (DCE-MRI) has been shown to have diagnostic value. We investigated the relationship between objectively quantified kinetic parameters in DCE-MRI and breast cancer risk.

A retrospective case-control study was performed based on a group of 102 women (mean 47.2±7.3 YO) who underwent breast biopsies from 2009-2011: 51 women had unilateral breast cancer and 51 were age- and date-of-MRI matched controls with a unilateral biopsy-proven benign. BI-RADS-based mammographic breast density was retrieved from the latest (< 6 months) mammography report prior to diagnosis. The breast MRI at time of diagnosis (cancer or benign) was analyzed on the normal breast contralateral to cancer (for cancer cases) or benign (for controls). The region of the fibroglandular tissue (FGT) was estimated in the MRI for each analyzed breast using a fully automated computer algorithm. Based on the enhancement time-signal intensity curves of three DCE post-contrast series, four kinetic parameters, i.e., peak enhancement, time to peak enhancement, wash-in-slope, and wash-out-slope were quantified for each voxel specifically over the estimated FGT region; mean and variance of the voxel-wise values of each of the four kinetic parameters were then computed, generating a total of 8 kinetic measures. We compared these kinetic measures between the normal breasts contralateral to the cancers and the contralateral (negative) breasts of the controls. Multivariable conditional logistic regression was performed to estimate odd ratios (ORs) for breast cancer.

After adjustment for breast density and the amount of FGT, the OR for mean wash-in-slope was 1.12 (95% Confidence Interval (CI): 1.01, 1.25; p=0.04) and 1.81 (95% CI: 1.13, 2.91; p=0.01) for the variance of wash-in-slope. Variance remained significant (OR was 1.80 [95% CI: 1.07, 3.03; p=0.03]), even after additional adjustment for quantitative measures of background parenchymal enhancement (BPE). The ORs for all other 6 kinetic measures were not statistically significant.

The mean and variance of wash-in-slope in breast DCE-MRI are associated with breast cancer risk.

The kinetic parameters of wash-in-slope quantified in breast DCE-MRI show potential as biomarkers of breast cancer risk and may be included to potentially improve breast cancer risk prediction.

Wu, S, Zuley, M, Berg, W, Kurland, B, Jankowitz, R, Sumkin, J, Gur, D, Contrast Enhancement Kinetics Quantified in Breast DCE-MRI and Breast Cancer Risk.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014829.html