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A one‐step biomarker quantification methodology for DCE‐MRI of adnexal masses: Capturing kinetic pattern from early to late enhancement
Author(s) -
Fathi Kazerooni Anahita,
Nabil Mahnaz,
Haghighat Khah Hamidreza,
Parviz Sara,
Gity Masoumeh,
Saligheh Rad Hamidreza
Publication year - 2018
Publication title -
magnetic resonance in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.696
H-Index - 225
eISSN - 1522-2594
pISSN - 0740-3194
DOI - 10.1002/mrm.26743
Subject(s) - sigmoid function , receiver operating characteristic , indeterminate , magnetic resonance imaging , sensitivity (control systems) , nuclear medicine , cutoff , mathematics , computer science , medicine , radiology , statistics , artificial intelligence , physics , electronic engineering , artificial neural network , pure mathematics , engineering , quantum mechanics
Purpose To develop a one‐step quantification approach that accounts for joint preprocessing and quantification of whole‐range kinetics (early and late‐phase washout) of dynamic contrast‐enhanced (DCE) MRI of indeterminate adnexal masses. Methods Preoperative DCE‐MRI of 43 (24 benign, 19 malignant) sonographically indeterminate adnexal masses were analyzed prospectively. A five‐parameter sigmoid function was implemented to model the enhancement curves calculated within regions of interest. Diagnostic performance of five‐parameter sigmoid model parameters ( P 1 through P 5 ) was compared with pharmacokinetic (PK) modeling, semiquantitative analysis, and three‐parameter sigmoid. Statistical analysis was performed using two‐tailed student's t‐test. Results The results revealed that P 2 , representing the enhancement amplitude, is significantly higher, and P 5 , indicating the terminal phase, is generally negative in malignant lesions ( P < 0.001). P 2 (sensitivity = 79%, specificity = 87.5%, accuracy = 84%, area under the receiver operating characteristic curve = 91%) outperforms classification performances of PK and semiquantitative parameters. A combination of P 2 and P 5 shows comparable performance (sensitivity = 79%, specificity = 87.5%, accuracy = 84%, area under the receiver operating characteristic curve = 92%) to that of the combination of PK parameters, whereas the five‐parameter sigmoid function maintains fewer assumptions than PK. Conclusions The presented one‐step quantification approach is helpful for accurate discrimination of benign from malignant indeterminate adnexal masses. Accordingly, P 2 has considerably high diagnostic performance and terminal slope ( P 5 ), as a previously overlooked feature, contributes more than widely accepted early‐enhancement kinetic features. Magn Reson Med 79:1165–1171, 2018. © 2017 International Society for Magnetic Resonance in Medicine.