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Pharmacokinetic mapping for lesion classification in dynamic breast MRI
Author(s) -
Schabel Matthias C.,
Morrell Glen R.,
Oh Karen Y.,
Walczak Cheryl A.,
Barlow R. Brad,
Neumayer Leigh A.
Publication year - 2010
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.22179
Subject(s) - dynamic contrast enhanced mri , breast mri , medicine , radiology , bi rads , lesion , computer science , magnetic resonance imaging , medical physics , breast cancer , pathology , mammography , cancer
Purpose: To prospectively investigate whether a rapid dynamic MRI protocol, in conjunction with pharmacokinetic modeling, could provide diagnostically useful information for discriminating biopsy‐proven benign lesions from malignancies. Materials and Methods: Patients referred to breast biopsy based on suspicious screening findings were eligible. After anatomic imaging, patients were scanned using a dynamic protocol with complete bilateral breast coverage. Maps of pharmacokinetic parameters representing transfer constant ( K trans ), efflux rate constant ( k ep ), blood plasma volume fraction ( v p ), and extracellular extravascular volume fraction ( v e ) were averaged over lesions and used, with biopsy results, to generate receiver operating characteristic curves for linear classifiers using one, two, or three parameters. Results: Biopsy and imaging results were obtained from 93 lesions in 74 of 78 study patients. Classification based on K trans and k ep gave the greatest accuracy, with an area under the receiver operating characteristic curve of 0.915, sensitivity of 91%, and specificity of 85%, compared with values of 88% and 68%, respectively, obtained in a recent study of clinical breast MRI in a similar patient population. Conclusion: Pharmacokinetic classification of breast lesions is practical on modern MRI hardware and provides significant accuracy for identification of malignancies. Sensitivity of a two‐parameter linear classifier is comparable to that reported in a recent multicenter study of clinical breast MRI, while specificity is significantly higher. J. Magn. Reson. Imaging 2010;31:1371–1378. © 2010 Wiley‐Liss, Inc.