Pharmacokinetic Analysis of Dynamic Contrast-Enhanced Magnetic Resonance Imaging at 7T for Breast Cancer Diagnosis and Characterization
The purpose of this study was to investigate whether ultra-high-field dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the breast at 7T using quantitative pharmacokinetic (PK) analysis can differentiate between benign and malignant breast tumors for improved breast cancer diagnosis...
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doaj-a973ef6c7f5942afa039ac8cf388e1b12020-12-15T00:03:11ZengMDPI AGCancers2072-66942020-12-01123763376310.3390/cancers12123763Pharmacokinetic Analysis of Dynamic Contrast-Enhanced Magnetic Resonance Imaging at 7T for Breast Cancer Diagnosis and CharacterizationR. Elena Ochoa-Albiztegui0Varadan Sevilimedu1Joao V. Horvat2Sunitha B. Thakur3Thomas H. Helbich4Siegfried Trattnig5Elizabeth A. Morris6Jeffrey S. Reiner7Katja Pinker8Breast Imaging Service, Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY 10065, USAMemorial Sloan Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY 10065, USABreast Imaging Service, Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY 10065, USABreast Imaging Service, Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY 10065, USAMolecular and Gender Imaging Service, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, AustriaMR Centre of Excellence, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, AustriaBreast Imaging Service, Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY 10065, USABreast Imaging Service, Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY 10065, USABreast Imaging Service, Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY 10065, USAThe purpose of this study was to investigate whether ultra-high-field dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the breast at 7T using quantitative pharmacokinetic (PK) analysis can differentiate between benign and malignant breast tumors for improved breast cancer diagnosis and to predict molecular subtypes, histologic grade, and proliferation rate in breast cancer. In this prospective study, 37 patients with 43 lesions suspicious on mammography or ultrasound underwent bilateral DCE-MRI of the breast at 7T. PK parameters (K<sup>Trans</sup>, k<sub>ep</sub>, V<sub>e</sub>) were evaluated with two region of interest (ROI) approaches (2D whole-tumor ROI or 2D 10 mm standardized ROI) manually drawn by two readers (senior reader, R1, and R2) independently. Histopathology served as the reference standard. PK parameters differentiated benign and malignant lesions (n = 16, 27, respectively) with good accuracy (AUCs = 0.655–0.762). The addition of quantitative PK analysis to subjective BI-RADS classification improved breast cancer detection from 88.4% to 97.7% for R1 and 86.04% to 97.67% for R2. Different ROI approaches did not influence diagnostic accuracy for both readers. Except for K<sup>Trans</sup> for whole-tumor ROI for R2, none of the PK parameters were valuable to predict molecular subtypes, histologic grade, or proliferation rate in breast cancer. In conclusion, PK-enhanced BI-RADS is promising for the noninvasive differentiation of benign and malignant breast tumors.https://www.mdpi.com/2072-6694/12/12/3763breast cancerultra-high-field magnetic resonance imagingquantitative pharmacokineticsimmunohistochemistrymolecular subtypesproliferation rate |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
R. Elena Ochoa-Albiztegui Varadan Sevilimedu Joao V. Horvat Sunitha B. Thakur Thomas H. Helbich Siegfried Trattnig Elizabeth A. Morris Jeffrey S. Reiner Katja Pinker |
spellingShingle |
R. Elena Ochoa-Albiztegui Varadan Sevilimedu Joao V. Horvat Sunitha B. Thakur Thomas H. Helbich Siegfried Trattnig Elizabeth A. Morris Jeffrey S. Reiner Katja Pinker Pharmacokinetic Analysis of Dynamic Contrast-Enhanced Magnetic Resonance Imaging at 7T for Breast Cancer Diagnosis and Characterization Cancers breast cancer ultra-high-field magnetic resonance imaging quantitative pharmacokinetics immunohistochemistry molecular subtypes proliferation rate |
author_facet |
R. Elena Ochoa-Albiztegui Varadan Sevilimedu Joao V. Horvat Sunitha B. Thakur Thomas H. Helbich Siegfried Trattnig Elizabeth A. Morris Jeffrey S. Reiner Katja Pinker |
author_sort |
R. Elena Ochoa-Albiztegui |
title |
Pharmacokinetic Analysis of Dynamic Contrast-Enhanced Magnetic Resonance Imaging at 7T for Breast Cancer Diagnosis and Characterization |
title_short |
Pharmacokinetic Analysis of Dynamic Contrast-Enhanced Magnetic Resonance Imaging at 7T for Breast Cancer Diagnosis and Characterization |
title_full |
Pharmacokinetic Analysis of Dynamic Contrast-Enhanced Magnetic Resonance Imaging at 7T for Breast Cancer Diagnosis and Characterization |
title_fullStr |
Pharmacokinetic Analysis of Dynamic Contrast-Enhanced Magnetic Resonance Imaging at 7T for Breast Cancer Diagnosis and Characterization |
title_full_unstemmed |
Pharmacokinetic Analysis of Dynamic Contrast-Enhanced Magnetic Resonance Imaging at 7T for Breast Cancer Diagnosis and Characterization |
title_sort |
pharmacokinetic analysis of dynamic contrast-enhanced magnetic resonance imaging at 7t for breast cancer diagnosis and characterization |
publisher |
MDPI AG |
series |
Cancers |
issn |
2072-6694 |
publishDate |
2020-12-01 |
description |
The purpose of this study was to investigate whether ultra-high-field dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the breast at 7T using quantitative pharmacokinetic (PK) analysis can differentiate between benign and malignant breast tumors for improved breast cancer diagnosis and to predict molecular subtypes, histologic grade, and proliferation rate in breast cancer. In this prospective study, 37 patients with 43 lesions suspicious on mammography or ultrasound underwent bilateral DCE-MRI of the breast at 7T. PK parameters (K<sup>Trans</sup>, k<sub>ep</sub>, V<sub>e</sub>) were evaluated with two region of interest (ROI) approaches (2D whole-tumor ROI or 2D 10 mm standardized ROI) manually drawn by two readers (senior reader, R1, and R2) independently. Histopathology served as the reference standard. PK parameters differentiated benign and malignant lesions (n = 16, 27, respectively) with good accuracy (AUCs = 0.655–0.762). The addition of quantitative PK analysis to subjective BI-RADS classification improved breast cancer detection from 88.4% to 97.7% for R1 and 86.04% to 97.67% for R2. Different ROI approaches did not influence diagnostic accuracy for both readers. Except for K<sup>Trans</sup> for whole-tumor ROI for R2, none of the PK parameters were valuable to predict molecular subtypes, histologic grade, or proliferation rate in breast cancer. In conclusion, PK-enhanced BI-RADS is promising for the noninvasive differentiation of benign and malignant breast tumors. |
topic |
breast cancer ultra-high-field magnetic resonance imaging quantitative pharmacokinetics immunohistochemistry molecular subtypes proliferation rate |
url |
https://www.mdpi.com/2072-6694/12/12/3763 |
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