The magnetic resonance shutter speed discriminates vascular properties of malignant and benign breast tumors in vivo

Wei Huang, Xin Li, Elizabeth A. Morris, Luminita A. Tudorica, Venkatraman E. Seshan, William D. Rooney, Ian Tagge, Ya Wang, Jingang Xu, Charles S. Springer

Research output: Contribution to journalArticle

71 Scopus citations

Abstract

The pharmacokinetic analysis of dynamic-contrast-enhanced (DCE) MRI data yields Ktrans and kep, two parameters independently measuring the capillary wall contrast reagent transfer rate. The almost universally used standard model (SM) embeds the implicit assumption that equilibrium transcytolemmal water exchange is effectively infinitely fast. In analyses of routine DCE-MRI data from 22 patients with suspicious breast lesions initially ruled positive by institutional screening protocols, the SM K trans values for benign and malignant lesions exhibit considerable overlap. A form of the shutter-speed model (SSM), which allows for finite exchange kinetics, agrees with the SM Ktrans value for each of the 15 benign lesions. However, it reveals that the SM underestimates K trans for each of the seven malignant tumors in this population. The fact that this phenomenon is unique to malignant tumors allows their complete discrimination from the benign lesions, as validated by comparison with gold-standard pathology analyses of subsequent biopsy tissue samples. Likewise, the SM overestimates kep, particularly for the benign tumors. Thus, incorporation of the SSM into the screening protocols would have precluded all 68% of the biopsy/pathology procedures that yielded benign findings. The SM/SSM difference is well understood from molecular first principles.

Original languageEnglish (US)
Pages (from-to)17943-17948
Number of pages6
JournalProceedings of the National Academy of Sciences of the United States of America
Volume105
Issue number46
DOIs
StatePublished - Nov 18 2008

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Keywords

  • Cancer
  • DCE
  • MRI
  • Screening
  • Water exchange

ASJC Scopus subject areas

  • General

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