Roel D Mus1, Cristina Borelli2, Peter Bult3, Elisabeth Weiland4, Nico Karssemeijer5, Jelle O Barentsz6, Albert Gubern-Mérida7, Bram Platel8, Ritse M Mann9. 1. Department of Radiology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA Nijmegen, The Netherlands. Electronic address: aroel.mus@radboudumc.nl. 2. Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, Viale Cappuccini 1, 71013, San Giovanni Rotondo, Foggia, Italy; Department of Radiology, Radboud University Medical Center (internal address 766), Geert Grooteplein Zuid 10, 6525GA Nijmegen, The Netherlands. Electronic address: cristinaborelli@hotmail.it. 3. Department of Pathology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA Nijmegen, The Netherlands. Electronic address: peter.bult@radboudumc.nl. 4. Siemens Healthcare, Erlangen, Germany. Electronic address: elisabeth.weiland@siemens.com. 5. Department of Radiology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA Nijmegen, The Netherlands. Electronic address: nico.karssemeijer@radboudumc.nl. 6. Department of Radiology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA Nijmegen, The Netherlands. Electronic address: jelle.barentsz@radboudumc.nl. 7. Department of Radiology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA Nijmegen, The Netherlands. Electronic address: albert.gubernmerida@radboudumc.nl. 8. Department of Radiology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA Nijmegen, The Netherlands. Electronic address: bram.platel@radboudumc.nl. 9. Department of Radiology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525GA Nijmegen, The Netherlands. Electronic address: ritse.mann@radboudumc.nl.
Abstract
OBJECTIVES: To investigate time to enhancement (TTE) as novel dynamic parameter for lesion classification in breast magnetic resonance imaging (MRI). METHODS: In this retrospective study, 157 women with 195 enhancing abnormalities (99 malignant and 96 benign) were included. All patients underwent a bi-temporal MRI protocol that included ultrafast time-resolved angiography with stochastic trajectory (TWIST) acquisitions (1.0×0.9×2.5mm, temporal resolution 4.32s), during the inflow of contrast agent. TTE derived from TWIST series and relative enhancement versus time curve type derived from volumetric interpolated breath-hold examination (VIBE) series were assessed and combined with basic morphological information to differentiate benign from malignant lesions. Receiver operating characteristic analysis and kappa statistics were applied. RESULTS: TTE had a significantly better discriminative ability than curve type (p<0.001 and p=0.026 for reader 1 and 2, respectively). Including morphology, sensitivity of TWIST and VIBE assessment was equivalent (p=0.549 and p=0.344, respectively). Specificity and diagnostic accuracy were significantly higher for TWIST than for VIBE assessment (p<0.001). Inter-reader agreement in differentiating malignant from benign lesions was almost perfect for TWIST evaluation (κ=0.86) and substantial for conventional assessment (κ=0.75). CONCLUSIONS: TTE derived from ultrafast TWIST acquisitions is a valuable parameter that allows robust differentiation between malignant and benign breast lesions with high accuracy.
OBJECTIVES: To investigate time to enhancement (TTE) as novel dynamic parameter for lesion classification in breast magnetic resonance imaging (MRI). METHODS: In this retrospective study, 157 women with 195 enhancing abnormalities (99 malignant and 96 benign) were included. All patients underwent a bi-temporal MRI protocol that included ultrafast time-resolved angiography with stochastic trajectory (TWIST) acquisitions (1.0×0.9×2.5mm, temporal resolution 4.32s), during the inflow of contrast agent. TTE derived from TWIST series and relative enhancement versus time curve type derived from volumetric interpolated breath-hold examination (VIBE) series were assessed and combined with basic morphological information to differentiate benign from malignant lesions. Receiver operating characteristic analysis and kappa statistics were applied. RESULTS: TTE had a significantly better discriminative ability than curve type (p<0.001 and p=0.026 for reader 1 and 2, respectively). Including morphology, sensitivity of TWIST and VIBE assessment was equivalent (p=0.549 and p=0.344, respectively). Specificity and diagnostic accuracy were significantly higher for TWIST than for VIBE assessment (p<0.001). Inter-reader agreement in differentiating malignant from benign lesions was almost perfect for TWIST evaluation (κ=0.86) and substantial for conventional assessment (κ=0.75). CONCLUSIONS: TTE derived from ultrafast TWIST acquisitions is a valuable parameter that allows robust differentiation between malignant and benign breast lesions with high accuracy.
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Authors: Natsuko Onishi; Meredith Sadinski; Mary C Hughes; Eun Sook Ko; Peter Gibbs; Katherine M Gallagher; Maggie M Fung; Theodore J Hunt; Danny F Martinez; Amita Shukla-Dave; Elizabeth A Morris; Elizabeth J Sutton Journal: Breast Cancer Res Date: 2020-05-28 Impact factor: 6.466