期刊
ACADEMIC RADIOLOGY
卷 21, 期 9, 页码 1195-1203出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.acra.2014.04.013
关键词
Breast cancer; magnetic resonance imaging (MRI); dynamic contrast-enhanced MRI (DCE-MRI); kinetic analysis; postbontrast timing; differential diagnosis
资金
- National Institutes of Health [R01 CA151326, P50 CA138293]
- Safeway Foundation
Rationale and Objectives: Breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) scanning protocols vary widely. The purpose of this study was to determine the effects of postcontrast timing on delayed-phase lesion kinetics assessment and ability to discriminate malignant from benign lesions. Materials and Methods: Following institutional review board approval, we retrospectively reviewed all lesions assessed on magnetic resonance examinations from April 2005 to June 2006. DCE-MRI was performed with 90-second temporal resolution. Delayed-phase kinetic parameters including percentages of persistent, plateau, and washout, and categorizations of predominant and worst curve type were compared between 4.5 and 7.5 minutes postcontrast. Ability to discriminate benign and malignant lesions based on delayed-phase kinetic parameters was compared between postcontrast timings by receiver operating characteristic (ROC) analysis. Results: Two hundred eighty consecutive breast lesions (206 malignant and 74 benign) were evaluated in 228 women. Comparing kinetics assessments at 7.5 versus 4.5 minutes: volume percentage of washout increased in malignancies by a mean of 9.4% (P < .0001) and increased slightly in benign lesions (mean 3.2%, P = .007); predominant Curve type categorizations changed significantly only for malignancies (P < .0001); and worst curve categorizations did not change significantly for either benign or malignant lesions (P > .05). There were no significant differences between timings in area under ROC curves for delayed-phase kinetic parameters. Conclusions: The choice of delayed postcontrast timing more strongly affects the kinetics assessments for malignancies than benign breast lesions, but our results suggest that a shortened breast DCE-MRI protocol may not significantly impact diagnostic accuracy. Furthermore, worst curve type classifications are least affected by postcontrast timing and may provide reliable assessment of delayed-phase kinetics across protocols.
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