Akiko Shimauchi MD, Presenter: Nothing to Disclose

Sanaz A. Jansen PhD, Abstract Co-Author: Nothing to Disclose

Lindsay Zak, Abstract Co-Author: Nothing to Disclose

Hiroyuki Abe MD, Abstract Co-Author: Nothing to Disclose

Maryellen L. Giger PhD, Abstract Co-Author: Stockholder, Hologic, Inc Royalties, Hologic, Inc Research funded, Hologic, Inc Royalties, Riverain Medical Royalties, Mitsubishi Corporation Royalties, MEDIAN Technologies Royalties, General Electric Company Royalties, Toshiba Corporation

Gillian Maclaine Newstead MD, Abstract Co-Author: Consultant, Naviscan Inc Consultant, Three Palm Software LLC Research suppport, Koninklijke Philips Electronics NV Spouse, stockholder, Hologic, Inc

Li Lan MS, Abstract Co-Author: Nothing to Disclose

Kirti Manohar Kulkarni MBBS, Abstract Co-Author: Nothing to Disclose

00030490-DMT et al, Abstract Co-Author: Nothing to Disclose

To evaluate whether the assessment of the kinetic heterogeneity of the internal enhancement pattern of mass lesions, improves the specificity of breast diagnosis at DCE-MRI.

Retrospective review of an institutional breast MRI database, yielded 237 breast mass lesions (176 malignant, 61 benign) ,which were selected for study. All masses were evaluated with standard commercial software (CADstream), using a 50%/100% threshold for display of medium/rapid uptake. Standard kinetic time-course curves were documented for each lesion. Lesion histology included: 6 ductal carcinoma in situ, 145 infiltrative ductal carcinoma, 14 infiltrative lobular carcinoma, 1 invasive ductal and lobular carcinoma, 10 unspecified malignancies, 37 fibroadenomata, 18 papillomata, 2 intramammary lymph nodes and 1 benign phyllodes tumor, 2 fat necrosis, and 1 cyst. The internal enhancement kinetic heterogeneity composition for each mass, medium-persistent, medium-plateau, medium-washout, rapid-persistent, rapid-plateau, rapid-washout, was documented. Lesions in which one of the 6 kinetic patterns accounted for more than 50% of mass volume were considered to exhibit homogeneous enhancement. Heterogeneity of the kinetic pattern and standard kinetic curves were evaluated using chi-square test, and sensitivity/specificity were also evaluated.   

Heterogeneous kinetic pattern was present in 109/176 (62%) malignant lesions and in 18/61 (30%) benign lesions. Standard kinetic curves showed washout pattern in 134/176 (76%) malignant lesions and in 21/61 (34%) benign lesions. Sensitivity/specificity of heterogeneous kinetic pattern analysis was 62%/70%.Sensitivity/specificity of washout pattern were 76%/66%. When kinetic heterogeneity and standard kinetic curves are combined, sensitivity/specificity were 54%/81%.

In this study, it has been shown that assessment of kinetic heterogeneity in addition to the assessment of kinetic time course curve improves the specificity of breast malignant mass lesions. Computer-aided assessment of kinetic internal enhancement patterns, in addition to standard enhancement curves, may prove useful in the evaluation of masses at MR imaging.

CAD assessment of the kinetic heterogeneity of mass lesions in addition to standard dynamic curve evaluation, may improve the specificity of diagnosis at MR imaging.

Shimauchi, A, Jansen, S, Zak, L, Abe, H, Giger, M, Newstead, G, Lan, L, Kulkarni, K, et al, 0, Does the Assessment of Kinetic Heterogeneity in Addition to the Kinetic Time Course Curve Improve the Specificity of Diagnosis of Breast Masses at DCE-MRI?.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8008132.html