Sanaz A. Jansen, Presenter: Nothing to Disclose

Xiaobing Fan PhD, Abstract Co-Author: Nothing to Disclose

Gregory Stanislaus Karczmar PhD, Abstract Co-Author: Research Consultant, Perceptive Informatics, Inc Employer Patent Holder, UCHI Patent # 092234-9059-00 titled "A Magnetic Resonance Imaging Method using Vanadyl-based Molecular Imaging Probes" Employer Patent Holder, UCHI Patent titled "High spectral and spatial resolution magnetic resonacne imaging"

Hiroyuki Abe MD, Abstract Co-Author: Research grant, Totoku Electric Co, Ltd

Robert Albert Schmidt MD, Abstract Co-Author: Minor stockholder, Hologic/R2 Technology, Inc, Los Altos, CA Research grant, Fuji Photo Film Co, Ltd, Stamford, CT Research Grant, Konica Minolta Consultant, Konica Minolta Advisory Board, Konica Minolta Spouse: Philips research grants Spouse: Berlex, speaker's bureau

Gillian Maclaine Newstead MD, Abstract Co-Author: Research support, Fuji Photo Film Co, Ltd Advisory Board, Konica Minolta Group Advisory Board, Koninklijke Philips Electronics Research support, Bayer AG Speakers Bureau, Bayer AG Spouse, stockholder, Hologic, Inc

To analyze contrast media uptake and washout kinetics in benign and malignant breast lesions using an empirical mathematical model (EMM) and to compare results obtained for these lesions with mass-like and non-mass-like enhancement characteristics.

34 benign and 78 malignant lesions were selected for review. Dynamic MR protocol: 1 pre and 5 post-contrast images using a T1-weighted SPGR with 68 second timing resolution. An experienced radiologist classified the type of enhancement according to the BI-RADS lexicon (mass, non-mass or focus) and generated a kinetic curve by tracing a region of interest around the most enhancing part of the lesion. The kinetic curve was analyzed quantitatively using the EMM:ΔS(t)=A(1-e-αt)e-βt, where A is the upper limit of signal intensity,α is the rate of signal increase, and β is the rate of signal decrease during washout. Several secondary parameters were derived including the initial slope (Slopeini), curvature at the peak (κpeak), area under the curve at 30 seconds (AUC30) and the signal enhancement ratio (SER).

Overall, there were 70 lesions with mass-like enhancement, 38 non-mass lesions and 4 focus. EMM parameters α, SER, Slopeini, and κpeak differed significantly between benign and malignant lesions (p0.5).

Kinetic parameters could distinguish benign and malignant mass lesions, but were not useful in discriminating non-mass-like benign from malignant lesions. This suggests that to maximize diagnostic utility, the first step before kinetic analysis should be to classify lesion morphology as mass or non-mass-like enhancement.

The diagnostic utility of kinetic analysis of breast lesions, i.e., in computer aided diagnosis schemes, is likely improved if performed after identifying the lesion as mass or non-mass enhancement.

Jansen, S, Fan, X, Karczmar, G, Abe, H, Schmidt, R, Newstead, G, DCEMRI of Breast Lesions: Is Kinetic Analysis Equally Effective for Both Mass and Non-mass-like Enhancement?.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5003279.html