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Feasibility of Velocity‐Selective Arterial Spin Labeling in Breast Cancer Patients for Noncontrast‐Enhanced Perfusion Imaging
Author(s) -
Franklin Suzanne L.,
Voormolen Nora,
Bones Isabell K.,
Korteweg Tijmen,
Wasser Martin N. J. M.,
Dankers Henrike G.,
Cohen Daniele,
Stralen Marijn,
Bos Clemens,
Osch Matthias J. P.
Publication year - 2021
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.27781
Subject(s) - medicine , radiology , breast cancer , vascularity , lesion , neuroradiology , breast mri , nuclear medicine , magnetic resonance imaging , perfusion , artifact (error) , cancer , pathology , mammography , neurology , psychiatry , neuroscience , biology
Background Dynamic contrast‐enhanced (DCE) MRI is the most sensitive method for detection of breast cancer. However, due to high costs and retention of intravenously injected gadolinium‐based contrast agent, screening with DCE‐MRI is only recommended for patients who are at high risk for developing breast cancer. Thus, a noncontrast‐enhanced alternative to DCE is desirable. Purpose To investigate whether velocity selective arterial spin labeling (VS‐ASL) can be used to identify increased perfusion and vascularity within breast lesions compared to surrounding tissue. Study Type Prospective. Population Eight breast cancer patients. Field Strength/Sequence A 3 T; VS‐ASL with multislice single‐shot gradient‐echo echo‐planar‐imaging readout. Assessment VS‐ASL scans were independently assessed by three radiologists, with 3–25 years of experience in breast radiology. Scans were scored on lesion visibility and artifacts, based on a 3‐point Likert scale. A score of 1 corresponded to “lesions being distinguishable from background” (lesion visibility), and “no or few artifacts visible, artifacts can be distinguished from blood signal” (artifact score). A distinction was made between mass and nonmass lesions (based on BI‐RADS lexicon), as assessed in the standard clinical exam. Statistical Tests Intra‐class correlation coefficient (ICC) for interobserver agreement. Results The ICC was 0.77 for lesion visibility and 0.84 for the artifact score. Overall, mass lesions had a mean score of 1.27 on lesion visibility and 1.53 on the artifact score. Nonmass lesions had a mean score of 2.11 on lesion visibility and 2.11 on the artifact score. Data Conclusion We have demonstrated the technical feasibility of bilateral whole‐breast perfusion imaging using VS‐ASL in breast cancer patients. Evidence Level 1 Technical Efficacy Stage 1