Premium
Does breast MRI background parenchymal enhancement indicate metabolic activity? Qualitative and 3D quantitative computer imaging analysis
Author(s) -
Mema Eralda,
Mango Victoria L.,
Guo Xiaotao,
Karcich Jenika,
Yeh Randy,
Wynn Ralph T.,
Zhao Binsheng,
Ha Richard S.
Publication year - 2018
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.25798
Subject(s) - medicine , nuclear medicine , breast mri , magnetic resonance imaging , breast imaging , breast cancer , radiology , positron emission tomography , institutional review board , mammography , cancer , surgery
Purpose To investigate whether the degree of breast magnetic resonance imaging (MRI) background parenchymal enhancement (BPE) is associated with the amount of breast metabolic activity measured by breast parenchymal uptake (BPU) of 18F‐FDG on positron emission tomography / computed tomography (PET/CT). Materials and Methods An Institutional Review Board (IRB)‐approved retrospective study was performed. Of 327 patients who underwent preoperative breast MRI from 1/1/12 to 12/31/15, 73 patients had 18F‐FDG PET/CT evaluation performed within 1 week of breast MRI and no suspicious findings in the contralateral breast. MRI was performed on a 1.5T or 3.0T system. The imaging sequence included a triplane localizing sequence followed by sagittal fat‐suppressed T 2 ‐weighted sequence, and a bilateral sagittal T 1 ‐weighted fat‐suppressed fast spoiled gradient‐echo sequence, which was performed before and three times after a rapid bolus injection (gadobenate dimeglumine, Multihance; Bracco Imaging; 0.1 mmol/kg) delivered through an IV catheter. The unaffected contralateral breast in these 73 patients underwent BPE and BPU assessments. For PET/CT BPU calculation, a 3D region of interest (ROI) was drawn around the glandular breast tissue and the maximum standardized uptake value (SUV max ) was determined. Qualitative MRI BPE assessments were performed on a 4‐point scale, in accordance with BI‐RADS categories. Additional 3D quantitative MRI BPE analysis was performed using a previously published in‐house technique. Spearman's correlation test and linear regression analysis was performed (SPSS, v. 24). Result The median time interval between breast MRI and 18F‐FDG PET/CT evaluation was 3 days (range, 0–6 days). BPU SUV max mean value was 1.6 (SD, 0.53). Minimum and maximum BPU SUV max values were 0.71 and 4.0. The BPU SUV max values significantly correlated with both the qualitative and quantitative measurements of BPE, respectively ( r (71) = 0.59, P < 0.001 and r (71) = 0.54, P < 0.001). Qualitatively assessed high BPE group (BI‐RADS 3/4) had significantly higher BPU SUV max of 1.9 (SD = 0.44) compared to low BPE group (BI‐RADS 1/2) with an average BPU SUV max of 1.17 (SD = 0.32) ( P < 0.001). On linear regression analysis, BPU SUV max significantly predicted qualitative and quantitative measurements of BPE (β = 1.29, t (71) = 3.88, P < 0.001 and β = 19.52, t (71) = 3.88, P < 0.001). Conclusion There is a significant association between breast BPU and BPE, measured both qualitatively and quantitatively. Increased breast cancer risk in patients with high MRI BPE could be due to elevated basal metabolic activity of the normal breast tissue, which may provide a susceptible environment for tumor growth. Level of Evidence : 3 Technical Efficacy : Stage 3 J. Magn. Reson. Imaging 2018;47:753–759.