Discrimination of benign and malignant breast lesions by using shutter-speed dynamic contrast-enhanced MR imaging 1

Wei Huang, Luminita (Alina) Tudorica, Xin Li, Sunitha B. Thakur, Yiyi Chen, Elizabeth A. Morris, Ian J. Tagge, Maayan E. Korenblit, William Rooney, Jason A. Koutcher, Charles Jr Springer

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

Purpose: To assess the accuracy of the shutter-speed approach compared with standard approach dynamic contrast material-enhanced magnetic resonance (MR) imaging pharmacokinetic analysis for breast cancer diagnosis. Materials and Methods: This study was approved by the institutional review board and was HIPAA compliant. Informed consent was obtained from 89 high-risk women (age range, 28-83 years) who had 92 suspicious lesions with negative findings at mammography (but visible at MR imaging). Each underwent a research dynamic contrast-enhanced MR imaging examination just prior to a clinical MR imaging-guided interventional procedure. Tumor region of interest (ROI) averaged and (for some) pixel-by-pixel dynamic contrastenhanced time-course data, together with mean arterial input function, were subjected to serial standard and shutter-speed approach analyses to extract pharmacokinetic parameters, including rate constant for passive contrast reagent transfer between plasma and interstitium (K trans) and interstitial space volume fraction, or v e. Pathologic findings were used as reference standards. Diagnostic accuracy was assessed with receiver operating characteristic analyses. Results: The pathologic analyses revealed 20 malignant and 72 benign lesions. Positive predictive value of the institutional clinical breast MR imaging protocol was 22%. At 100% sensitivity, ROI-averaged shutter-speed approach K transhad significantly(P = .008) higher diagnostic specificity than standard approach K trans:86.1% versus 77.8%. The difference in the ROI-averaged K trans parameter value, or ΔK trans (≡ K trans [shutter-speed approach] - K trans [standard approach]), had even higher specificity (88.9%). Combined use of ROI analysis and pixel-by-pixel mapping of ΔK trans achieved 98.6% specificity at 100% sensitivity. Conclusion: The use of the shutter-speed dynamic contrast-enhanced MR imaging method has the potential to improve breast cancer diagnostic accuracy and reduce putatively unnecessary biopsy procedures that yield benign pathologic findings.

Original languageEnglish (US)
Pages (from-to)394-403
Number of pages10
JournalRadiology
Volume261
Issue number2
DOIs
StatePublished - Nov 2011

Fingerprint

Breast
Magnetic Resonance Imaging
Interventional Magnetic Resonance Imaging
Pharmacokinetics
Breast Neoplasms
Health Insurance Portability and Accountability Act
Unnecessary Procedures
Research Ethics Committees
Mammography
Informed Consent
ROC Curve
Contrast Media
Biopsy
Research
Neoplasms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Discrimination of benign and malignant breast lesions by using shutter-speed dynamic contrast-enhanced MR imaging 1. / Huang, Wei; Tudorica, Luminita (Alina); Li, Xin; Thakur, Sunitha B.; Chen, Yiyi; Morris, Elizabeth A.; Tagge, Ian J.; Korenblit, Maayan E.; Rooney, William; Koutcher, Jason A.; Springer, Charles Jr.

In: Radiology, Vol. 261, No. 2, 11.2011, p. 394-403.

Research output: Contribution to journalArticle

Huang, Wei ; Tudorica, Luminita (Alina) ; Li, Xin ; Thakur, Sunitha B. ; Chen, Yiyi ; Morris, Elizabeth A. ; Tagge, Ian J. ; Korenblit, Maayan E. ; Rooney, William ; Koutcher, Jason A. ; Springer, Charles Jr. / Discrimination of benign and malignant breast lesions by using shutter-speed dynamic contrast-enhanced MR imaging 1. In: Radiology. 2011 ; Vol. 261, No. 2. pp. 394-403.
@article{5dba2f4b11cc41259cf286cd7f3810f9,
title = "Discrimination of benign and malignant breast lesions by using shutter-speed dynamic contrast-enhanced MR imaging 1",
abstract = "Purpose: To assess the accuracy of the shutter-speed approach compared with standard approach dynamic contrast material-enhanced magnetic resonance (MR) imaging pharmacokinetic analysis for breast cancer diagnosis. Materials and Methods: This study was approved by the institutional review board and was HIPAA compliant. Informed consent was obtained from 89 high-risk women (age range, 28-83 years) who had 92 suspicious lesions with negative findings at mammography (but visible at MR imaging). Each underwent a research dynamic contrast-enhanced MR imaging examination just prior to a clinical MR imaging-guided interventional procedure. Tumor region of interest (ROI) averaged and (for some) pixel-by-pixel dynamic contrastenhanced time-course data, together with mean arterial input function, were subjected to serial standard and shutter-speed approach analyses to extract pharmacokinetic parameters, including rate constant for passive contrast reagent transfer between plasma and interstitium (K trans) and interstitial space volume fraction, or v e. Pathologic findings were used as reference standards. Diagnostic accuracy was assessed with receiver operating characteristic analyses. Results: The pathologic analyses revealed 20 malignant and 72 benign lesions. Positive predictive value of the institutional clinical breast MR imaging protocol was 22{\%}. At 100{\%} sensitivity, ROI-averaged shutter-speed approach K transhad significantly(P = .008) higher diagnostic specificity than standard approach K trans:86.1{\%} versus 77.8{\%}. The difference in the ROI-averaged K trans parameter value, or ΔK trans (≡ K trans [shutter-speed approach] - K trans [standard approach]), had even higher specificity (88.9{\%}). Combined use of ROI analysis and pixel-by-pixel mapping of ΔK trans achieved 98.6{\%} specificity at 100{\%} sensitivity. Conclusion: The use of the shutter-speed dynamic contrast-enhanced MR imaging method has the potential to improve breast cancer diagnostic accuracy and reduce putatively unnecessary biopsy procedures that yield benign pathologic findings.",
author = "Wei Huang and Tudorica, {Luminita (Alina)} and Xin Li and Thakur, {Sunitha B.} and Yiyi Chen and Morris, {Elizabeth A.} and Tagge, {Ian J.} and Korenblit, {Maayan E.} and William Rooney and Koutcher, {Jason A.} and Springer, {Charles Jr}",
year = "2011",
month = "11",
doi = "10.1148/radiol.11102413",
language = "English (US)",
volume = "261",
pages = "394--403",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "2",

}

TY - JOUR

T1 - Discrimination of benign and malignant breast lesions by using shutter-speed dynamic contrast-enhanced MR imaging 1

AU - Huang, Wei

AU - Tudorica, Luminita (Alina)

AU - Li, Xin

AU - Thakur, Sunitha B.

AU - Chen, Yiyi

AU - Morris, Elizabeth A.

AU - Tagge, Ian J.

AU - Korenblit, Maayan E.

AU - Rooney, William

AU - Koutcher, Jason A.

AU - Springer, Charles Jr

PY - 2011/11

Y1 - 2011/11

N2 - Purpose: To assess the accuracy of the shutter-speed approach compared with standard approach dynamic contrast material-enhanced magnetic resonance (MR) imaging pharmacokinetic analysis for breast cancer diagnosis. Materials and Methods: This study was approved by the institutional review board and was HIPAA compliant. Informed consent was obtained from 89 high-risk women (age range, 28-83 years) who had 92 suspicious lesions with negative findings at mammography (but visible at MR imaging). Each underwent a research dynamic contrast-enhanced MR imaging examination just prior to a clinical MR imaging-guided interventional procedure. Tumor region of interest (ROI) averaged and (for some) pixel-by-pixel dynamic contrastenhanced time-course data, together with mean arterial input function, were subjected to serial standard and shutter-speed approach analyses to extract pharmacokinetic parameters, including rate constant for passive contrast reagent transfer between plasma and interstitium (K trans) and interstitial space volume fraction, or v e. Pathologic findings were used as reference standards. Diagnostic accuracy was assessed with receiver operating characteristic analyses. Results: The pathologic analyses revealed 20 malignant and 72 benign lesions. Positive predictive value of the institutional clinical breast MR imaging protocol was 22%. At 100% sensitivity, ROI-averaged shutter-speed approach K transhad significantly(P = .008) higher diagnostic specificity than standard approach K trans:86.1% versus 77.8%. The difference in the ROI-averaged K trans parameter value, or ΔK trans (≡ K trans [shutter-speed approach] - K trans [standard approach]), had even higher specificity (88.9%). Combined use of ROI analysis and pixel-by-pixel mapping of ΔK trans achieved 98.6% specificity at 100% sensitivity. Conclusion: The use of the shutter-speed dynamic contrast-enhanced MR imaging method has the potential to improve breast cancer diagnostic accuracy and reduce putatively unnecessary biopsy procedures that yield benign pathologic findings.

AB - Purpose: To assess the accuracy of the shutter-speed approach compared with standard approach dynamic contrast material-enhanced magnetic resonance (MR) imaging pharmacokinetic analysis for breast cancer diagnosis. Materials and Methods: This study was approved by the institutional review board and was HIPAA compliant. Informed consent was obtained from 89 high-risk women (age range, 28-83 years) who had 92 suspicious lesions with negative findings at mammography (but visible at MR imaging). Each underwent a research dynamic contrast-enhanced MR imaging examination just prior to a clinical MR imaging-guided interventional procedure. Tumor region of interest (ROI) averaged and (for some) pixel-by-pixel dynamic contrastenhanced time-course data, together with mean arterial input function, were subjected to serial standard and shutter-speed approach analyses to extract pharmacokinetic parameters, including rate constant for passive contrast reagent transfer between plasma and interstitium (K trans) and interstitial space volume fraction, or v e. Pathologic findings were used as reference standards. Diagnostic accuracy was assessed with receiver operating characteristic analyses. Results: The pathologic analyses revealed 20 malignant and 72 benign lesions. Positive predictive value of the institutional clinical breast MR imaging protocol was 22%. At 100% sensitivity, ROI-averaged shutter-speed approach K transhad significantly(P = .008) higher diagnostic specificity than standard approach K trans:86.1% versus 77.8%. The difference in the ROI-averaged K trans parameter value, or ΔK trans (≡ K trans [shutter-speed approach] - K trans [standard approach]), had even higher specificity (88.9%). Combined use of ROI analysis and pixel-by-pixel mapping of ΔK trans achieved 98.6% specificity at 100% sensitivity. Conclusion: The use of the shutter-speed dynamic contrast-enhanced MR imaging method has the potential to improve breast cancer diagnostic accuracy and reduce putatively unnecessary biopsy procedures that yield benign pathologic findings.

UR - http://www.scopus.com/inward/record.url?scp=80054781289&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80054781289&partnerID=8YFLogxK

U2 - 10.1148/radiol.11102413

DO - 10.1148/radiol.11102413

M3 - Article

C2 - 21828189

AN - SCOPUS:80054781289

VL - 261

SP - 394

EP - 403

JO - Radiology

JF - Radiology

SN - 0033-8419

IS - 2

ER -