Matthias Dietzel MD, Presenter: Nothing to Disclose

Pascal Andreas Thomas Baltzer MD, Abstract Co-Author: Nothing to Disclose

Ramy Zoubi, Abstract Co-Author: Nothing to Disclose

Tibor Vag MD, Abstract Co-Author: Nothing to Disclose

Oumar Camara, Abstract Co-Author: Nothing to Disclose

Werner Alois Kaiser MD, PhD, Abstract Co-Author: Researcher, Siemens AG Researcher, Bayer AG Researcher, General Electric Company Researcher, Suros Surgical Systems, Inc Researcher, C. R. Bard, Inc Researcher, Boston Scientific Corporation Researcher, Galil Medical Ltd Researcher, Koninklijke Philips Electronics NV Researcher, Confirma, Inc Researcher, CAD Sciences LLC Researcher, Carl Zeiss Stiftung

Repetitive T1-weigthed measurements after intravenous application of contrast agent are highly sensitive for detection of malignant breast tumors. Furthermore they provide functional information on tissue vascularisation. Computer assisted diagnosis (CAD) is a new approach to quantitatively assess breast MRI. Thus, this study was designed to identify the potential of breast MRI to predict metachronous distant metastasis using CAD.

59 consecutive patients with newly diagnosed invasive breast cancer received pretherapeutic breast MRI examination at 1.5 Tesla according to international guidelines (data acquisition: 01.01.2004 to 31.12.2004). In all patients follow up interval and occurrence of distant metastasis was documented. For breast MRI analysis, dedicated commercial software was used (Brevis, cooperation of Siemens & Mevis, Erlangen/Bremen, Germany). It allows semiautomatic quantitative measurement of typical enhancement parameters (Initial-Enhancement, Wash-out, Peak-Enhancement, Time to Peak Enhancement [TTP]). Results were evaluated to identify significant and independent parameters to predict metachronous distant metastasis using logistic regression with backward selection. Significant parameters were further analyzed by Kaplan-Meier statistics.

During follow-up 6 patients were diagnosed with metachronous distant metastasis. Median follow-up time was 1560 days. Wash out above 40% could be identified as significant and independent predictor for occurrence of distant metastasis (sensitivity: 100%, negative predictive value: 100%). Using this parameter, Kaplan-Meier statistics were performed, successfully (Logrank-Test: P<0.001).

Computer assisted evaluation of enhancement parameters in breast MRI provides functional information. According to our initial data, this approach allows accurate identification of patients that will develop metachronous metastases.

Computer assisted evaluation of tumor vasculature by breast MRI alows risk stratification of patients that will develop metachronous metastases. Such data could be used for therapy planning.

Dietzel, M, Baltzer, P, Zoubi, R, Vag, T, Camara, O, Kaiser, W, Application of Computer-assisted Diagnosis in Breast MRI: Is There a Potential to Predict  Metachronous Distant Metastasis?.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9008325.html