1
|
Kim YS, Yun BL, Chu AJ, Lee SH, Shin HJ, Kim SM, Jang M, Shin SU, Moon WK. Background Breast Parenchymal Signal During Menstrual Cycle on Diffusion-Weighted MRI: A Prospective Study in Healthy Premenopausal Women. Korean J Radiol 2024; 25:511-517. [PMID: 38807333 PMCID: PMC11136950 DOI: 10.3348/kjr.2023.1189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 04/04/2024] [Accepted: 04/05/2024] [Indexed: 05/30/2024] Open
Abstract
OBJECTIVE To prospectively investigate the influence of the menstrual cycle on the background parenchymal signal (BPS) and apparent diffusion coefficient (ADC) of the breast on diffusion-weighted MRI (DW-MRI) in healthy premenopausal women. MATERIALS AND METHODS Seven healthy premenopausal women (median age, 37 years; range, 33-49 years) with regular menstrual cycles participated in this study. DW-MRI was performed during each of the four phases of the menstrual cycle (four examinations in total). Three radiologists independently assessed the BPS visual grade on images with b-values of 800 sec/mm² (b800), 1200 sec/mm² (b1200), and a synthetic 1500 sec/mm² (sb1500). Additionally, one radiologist conducted a quantitative analysis to measure the BPS volume (%) and ADC values of the BPS (ADCBPS) and fibroglandular tissue (ADCFGT). Changes in the visual grade, BPS volume (%), ADCBPS, and ADCFGT during the menstrual cycle were descriptively analyzed. RESULTS The visual grade of BPS in seven women varied from mild to marked on b800 and from minimal to moderate on b1200 and sb1500. As the b-value increased, the visual grade of BPS decreased. On b800 and sb1500, two of the seven volunteers showed the highest visual grade in the early follicular phase (EFP). On b1200, three of the seven volunteers showed the highest visual grades in EFP. The BPS volume (%) on b800 and b1200 showed the highest value in three of the six volunteers with dense breasts in EFP. Three of the seven volunteers showed the lowest ADCBPS in the EFP. Four of the seven volunteers showed the highest ADCBPS in the early luteal phase (ELP) and the lowest ADCFGT in the late follicular phase (LFP). CONCLUSION Most volunteers did not exhibit specific BPS patterns during their menstrual cycles. However, the highest BPS and lowest ADCBPS were more frequently observed in EFP than in the other menstrual cycle phases, whereas the highest ADCBPS was more common in ELP. The lowest ADCFGT was more frequent in LFP.
Collapse
Affiliation(s)
- Yeon Soo Kim
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Bo La Yun
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
| | - A Jung Chu
- Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Su Hyun Lee
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hee Jung Shin
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sun Mi Kim
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Mijung Jang
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Sung Ui Shin
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Woo Kyung Moon
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
2
|
Mokry T, Pantke J, Mlynarska-Bujny A, Hasse FC, Kuder TA, Schlemmer HP, Kauczor HU, Rom J, Bickelhaupt S. Diffusivity mapping of the ovaries: Variability of apparent diffusion and kurtosis variables over the menstrual cycle and influence of oral contraceptives. Magn Reson Imaging 2021; 80:50-57. [PMID: 33905830 DOI: 10.1016/j.mri.2021.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 04/14/2021] [Accepted: 04/21/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE We aimed to investigate whether quantitative diffusivity variables of healthy ovaries vary during the menstrual cycle and to evaluate alterations in women using oral contraceptives (OC). METHODS This prospective study (S-339/2016) included 30 healthy female volunteers, with (n = 15) and without (n = 15) intake of OC between 07/2017 and 09/2019. Participants underwent 3T diffusion-weighted MRI (b-values 0-2000 s/mm2) three times during a menstrual cycle (T1 = day 1-5; T2 = day 7-12; T3 = day 19-24). Both ovaries were manually three-dimensionally segmented on b = 1500 s/mm2; apparent diffusion coefficient (ADC) calculation and kurtosis fitting (Dapp, Kapp) were performed. Differences in ADC, Dapp and Kapp between time points and groups were compared using repeated measures ANOVA and t-test after Shapiro-Wilk and Brown-Forsythe test for normality and equal variance. RESULTS In women with a natural menstrual cycle, ADC and kurtosis variables showed significant changes in ovaries with the dominant follicle between T1 vs T2 and T1 vs T3, whilst no differences were observed between T2 vs T3: ADC ± SD for T1 1.524 ± 0.160, T2 1.737 ± 0.160, and T3 1.747 ± 0.241 μm2/ms (p = 0.01 T2 vs T1; p = 1.0 T2 vs T3, p = 0.003 T3 vs T1); Dapp ± SD for T1 2.018 ± 0.140, T2 2.272 ± 0.189, and T3 2.230 ± 0.256 μm2/ms (p = 0.003 T2 vs T1, p = 1.0 T2 vs T3, p = 0.02 T3 vs T1); Kapp ± SD for T1 0.614 ± 0.0339, T2 0.546 ± 0.0637, and T3 0.529 ± 0.0567 (p < 0.001 T2 vs T1, p = 0.86 T2 vs T3, p < 0.001 T3 vs T1). No significant differences were found in the contralateral ovaries or in females taking OC. CONCLUSION Physiological cycle-dependent changes in quantitative diffusivity variables of ovaries should be considered especially when interpreting radiomics analyses in reproductive women.
Collapse
Affiliation(s)
- Theresa Mokry
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
| | - Judith Pantke
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
| | - Anna Mlynarska-Bujny
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany; Department of Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany; Medical Faculty Heidelberg, Heidelberg University, Germany
| | - Felix Christian Hasse
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
| | - Tristan Anselm Kuder
- Department of Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany
| | | | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
| | - Joachim Rom
- Hospital for General Obstetrics and Gynecology, Hospital Frankfurt Hoechst, Frankfurt, Germany
| | - Sebastian Bickelhaupt
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany; Junior Group Medical Imaging and Radiology - Cancer Prevention, German Cancer Research Center, Heidelberg, Germany; Institute of Radiology, Erlangen University Hospital, Erlangen, Germany
| |
Collapse
|
3
|
Virostko J, Sorace AG, Wu C, Ekrut D, Jarrett AM, Upadhyaya RM, Avery S, Patt D, Goodgame B, Yankeelov TE. Magnetization Transfer MRI of Breast Cancer in the Community Setting: Reproducibility and Preliminary Results in Neoadjuvant Therapy. ACTA ACUST UNITED AC 2020; 5:44-52. [PMID: 30854441 PMCID: PMC6403021 DOI: 10.18383/j.tom.2018.00019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Repeatability and reproducibility of magnetization transfer magnetic resonance imaging of the breast, and the ability of this technique to assess the response of locally advanced breast cancer to neoadjuvant therapy (NAT), are determined. Reproducibility scans at 3 different 3 T scanners, including 2 scanners in community imaging centers, found a 16.3% difference (n = 3) in magnetization transfer ratio (MTR) in healthy breast fibroglandular tissue. Repeatability scans (n = 10) found a difference of ∼8.1% in the MTR measurement of fibroglandular tissue between the 2 measurements. Thus, MTR is repeatable and reproducible in the breast and can be integrated into community imaging clinics. Serial magnetization transfer magnetic resonance imaging performed at longitudinal time points during NAT indicated no significant change in average tumoral MTR during treatment. However, histogram analysis indicated an increase in the dispersion of MTR values of the tumor during NAT, as quantified by higher standard deviation (P = .005), higher full width at half maximum (P = .02), and lower kurtosis (P = .02). Patients' stratification into those with pathological complete response (pCR; n = 6) at the conclusion of NAT and those with residual disease (n = 9) showed wider distribution of tumor MTR values in patients who achieved pCR after 2-4 cycles of NAT, as quantified by higher standard deviation (P = .02), higher full width at half maximum (P = .03), and lower kurtosis (P = .03). Thus, MTR can be used as an imaging metric to assess response to breast NAT.
Collapse
Affiliation(s)
- John Virostko
- Department of Diagnostic Medicine.,Livestrong Cancer Institutes.,Department of Oncology
| | - Anna G Sorace
- Department of Diagnostic Medicine.,Livestrong Cancer Institutes.,Department of Biomedical Engineering.,Department of Oncology
| | | | - David Ekrut
- Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, TX
| | - Angela M Jarrett
- Livestrong Cancer Institutes.,Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, TX
| | | | | | | | - Boone Goodgame
- Seton Hospital, Austin, TX; and.,Department of Internal Medicine, University of Texas at Austin, Austin, TX
| | - Thomas E Yankeelov
- Department of Diagnostic Medicine.,Livestrong Cancer Institutes.,Department of Biomedical Engineering.,Department of Oncology.,Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, TX
| |
Collapse
|
4
|
Mema E, Schnabel F, Chun J, Kaplowitz E, Price A, Goodgal J, Moy L. The relationship of breast density in mammography and magnetic resonance imaging in women with triple negative breast cancer. Eur J Radiol 2020; 124:108813. [PMID: 31927471 DOI: 10.1016/j.ejrad.2020.108813] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/08/2019] [Accepted: 12/30/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate the relationship between mammographic density, background parenchymal enhancement and fibroglandular tissue on MRI in women with triple negative breast cancer (TNBC) compared to women with non-triple negative breast cancer (non-TNBC). METHODS The institutional Breast Cancer Database was queried to identify the clinicopathologic and imaging characteristics among women who underwent mammography and breast MRI between 2010-2018. Statistical analyses included Pearson's Chi Square, Wilcoxon Rank-Sum and logistic regression. RESULTS Of 2995 women, 225 (7.5 %) had TNBC with a median age of 60 years (23-96) and median follow-up of 5.69 years. Compared to women with non-TNBC, TNBC was associated with African-American race 36/225 (16 %), BRCA1,2 positivity 34/225 (15.1 %), previous history of breast cancer 35/225 (15.6 %), presenting on breast exam 126/225 (56 %) or MRI 13/225 (5.8 %), palpability 133/225 (59.1 %), more invasive ductal carcinoma (IDC) 208/225 (92.4 %), higher stage (stage III) 37/225 (16.5 %), higher grade (grade 3) 186/225 (82.7 %) (all p < 0.001), lower mammographic breast density (MBD) 18/225 (8 %) (p = 0.04), lower fibroglandular tissue (FGT) 17/225 (7.6 %) (p = 0.01), and lower background parenchymal enhancement (BPE) 89/225 (39.8 %) (p = 0.02). Nine of 225 (4 %) women with TNBC experienced recurrence with no significant association with MBD, FGT, or BPE. There was no significant difference in median age of our TNBC and non-TNBC cohorts. CONCLUSIONS The higher proportion of women with lower MBD, FGT and BPE in women with TNBC suggests that MBD, amount of FGT and degree of BPE may be associated with breast cancer risk in women with TNBC.
Collapse
Affiliation(s)
- Eralda Mema
- Weill Cornell Medical Center, New York Presbyterian Hospital, Department of Radiology, United States; New York University Langone Medical Center, Department of Population Health, Division of Biostatistics, United States.
| | - Freya Schnabel
- New York University Langone Medical Center, Department of Surgery, Division of Breast Surgery, United States; New York University Langone Medical Center, Department of Population Health, Division of Biostatistics, United States
| | - Jennifer Chun
- New York University Langone Medical Center, Department of Surgery, Division of Breast Surgery, United States; New York University Langone Medical Center, Department of Population Health, Division of Biostatistics, United States
| | - Elianna Kaplowitz
- New York University Langone Medical Center, Department of Surgery, Division of Breast Surgery, United States; New York University Langone Medical Center, Department of Population Health, Division of Biostatistics, United States
| | - Alison Price
- New York University Langone Medical Center, Department of Surgery, Division of Breast Surgery, United States; New York University Langone Medical Center, Department of Population Health, Division of Biostatistics, United States
| | - Jenny Goodgal
- New York University Langone Medical Center, Department of Surgery, Division of Breast Surgery, United States; New York University Langone Medical Center, Department of Population Health, Division of Biostatistics, United States
| | - Linda Moy
- New York University Langone Medical Center, Department of Radiology, United States; New York University, Center for Advanced Imaging Innovation and Research, United States; New York University Langone Medical Center, Department of Population Health, Division of Biostatistics, United States
| |
Collapse
|
5
|
Jung Y, Kim TH, Kim JY, Han S, An YS. The effect of sex hormones on normal breast tissue metabolism: Evaluation by FDG PET/CT. Medicine (Baltimore) 2019; 98:e16306. [PMID: 31277170 PMCID: PMC6635257 DOI: 10.1097/md.0000000000016306] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This study investigated the effect of sex hormones on F-fluorodeoxyglucose (FDG) uptake in normal breast tissue.The retrospective study included 249 premenopausal women (median age, 45 years) who were diagnosed with unilateral breast cancer and underwent FDG positron emission tomography/computed tomography and hormone tests. The volume of interest was within the contralateral normal breast and the standardized uptake values (SUVs) were measured. The correlations of sex hormones (including estrogen, progesterone, testosterone, follicle-stimulating hormone [FSH] and luteinizing hormone [LH]) with the SUVs of the normal breast were analyzed.There was a weak negative correlation between age and breast FDG uptake (P = .012, Spearman coefficient = -.16 for the maximum standardized uptake values [SUVmax]), especially in the luteal phase group (P = .005, Spearman coefficient = -.27 for SUVmax). The SUVs of normal breast tissue were increased when progesterone levels were higher (P = .043, Spearman coefficient = .13 for SUVmax). In the irregular menstrual cycle group, FDG uptake in the breast decreased as FSH (P = .027, Spearman coefficient = -.42 for SUVmax) and LH (P = .048, Spearman coefficient = -.44 for SUVmax) increased.Glucose metabolism of normal breast tissue decreases with age, and progesterone weakly affects breast FDG uptake. Gonadotropins may affect breast FDG uptake in premenopausal women with irregular menstrual cycles.
Collapse
Affiliation(s)
| | | | | | | | - Young-Sil An
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, South Korea
| |
Collapse
|
6
|
Di Leo G, Ioan I, Luciani ML, Midulla C, Podo F, Sardanelli F, Pediconi F. Changes in total choline concentration in the breast of healthy fertile young women in relation to menstrual cycle or use of oral contraceptives: a 3-T 1H-MRS study. Eur Radiol Exp 2018; 2:43. [PMID: 30560497 PMCID: PMC6297122 DOI: 10.1186/s41747-018-0075-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 10/26/2018] [Indexed: 02/03/2023] Open
Abstract
Background To evaluate changes in total choline (tCho) absolute concentration ([tCho]) in the breast of healthy fertile women in relation to menstrual cycle (MC) or use of oral contraceptives (OC). Methods After institutional review board approval, we prospectively evaluated 40 healthy fertile volunteers: 20 with physiological MC, aged 28 ± 3 years (mean ± standard deviation; nOC group); 20 using OC, aged 26 ± 3 years (OC group). Hormonal assays and water-suppressed single-voxel 3-T proton magnetic resonance spectroscopy (1H-MRS) were performed on MC days 7, 14, and 21 in the nOC group and only on MC day 14 in the OC group. [tCho] was measured versus an external phantom. Mann-Whitney U test and Spearman coefficient were used; data are given as median and interquartile interval. Results All spectra had good quality. In the nOC group, [tCho] (mM) did not change significantly during MC: 0.8 (0.3–2.4) on day 7, 0.9 (0.4–1.2) on day 14, and 0.4 (0.2–0.8) on day 21 (p = 0.963). In the OC group, [tCho] was 0.7 (0.2–1.7) mM. The between-groups difference was not significant on all days (p ≥ 0.411). All hormones except prolactin changed during MC (p ≤ 0.024). In the OC group, [tCho] showed a borderline correlation with estradiol (r = 0.458, p = 0.056), but no correlation with other hormones (p ≥ 0.128). In the nOC group, [tCho] negatively correlated with prolactin (r = -0.587, p = 0.006) on day 7; positive correlation was found with estradiol on day 14 (r = 0.679, p = 0.001). Conclusions A tCho peak can be detected in the normal mammary gland using 3-T 1H-MRS. The [tCho] in healthy volunteers was 0.4–0.9 mM, constant over the MC and independent of OC use.
Collapse
Affiliation(s)
- Giovanni Di Leo
- Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy.
| | - Ileana Ioan
- Postgraduate School in Radiodiagnostics, Università degli Studi di Milano, Milan, Italy
| | - Maria Laura Luciani
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Cecilia Midulla
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Franca Podo
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, Rome, Italy
| | - Francesco Sardanelli
- Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy.,Department of Biomedical Sciences for Health, Università degli Studi di Milano, San Donato Milanese, Italy
| | - Federica Pediconi
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
7
|
Alikhassi A, Miratashi Yazdi SN, Akbari H, Kia SA, Baikpour M. Correlation Between Mammographic Breast Density, Breast Tissue Type in Ultrasonography, Fibroglandular Tissue, and Background Parenchymal Enhancement in Magnetic Resonance Imaging. BREAST CANCER-BASIC AND CLINICAL RESEARCH 2018; 12:1178223418771971. [PMID: 29706765 PMCID: PMC5912268 DOI: 10.1177/1178223418771971] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 03/18/2018] [Indexed: 11/16/2022]
Abstract
Objective Breast cancer is the most common malignancy in the female population, and imaging studies play a critical role for its early detection. Mammographic breast density (MBD) is one of the markers used to predict the risk stratification of breast cancer in patients. We aimed to assess the correlations among MBD, ultrasound breast composition (USBC), fibroglandular tissue (FGT), and the amount of background parenchymal enhancement (BPE) in magnetic resonance imaging, after considering the subjects' menopausal status. Methods In this retrospective cross-sectional study, the medical records' archives in a tertiary referral hospital were reviewed. Data including age, menopausal status, their mammograms, and ultrasound assessments were extracted from their records. All of their imaging studies were reviewed, and MBD, USBC, FGT, and BPE were determined, recorded, and entered into SPSS software for analysis. Results A total of 121 women (mean age = 42.7 ± 11.0 years) were included, of which 35 out of 115 (30.4%) had reached menopause. Using the Jonckheere-Terpstra test for evaluating the trends among above mentioned 4 radiologic characteristics in the total sample population, a significant positive relation was found between each of these paired variables: (1) USBC-MBD (P = .006), (2) FGT-MBD (P = .001), (3) USBC-BPE (P = .046), (4) USBC-FGT (P = .036), and (5) BPE-FGT (P < .001). These trends were not found to be significant among premenopausal subjects. Conclusions Considering the trends between different measures of breast density in the 3 radiologic modalities, these factors can be used interchangeably in certain settings.
Collapse
Affiliation(s)
- Afsaneh Alikhassi
- Department of Radiology, Cancer Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hedieh Akbari
- Department of Radiology, Cancer Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sona Akbari Kia
- Department of Radiology, Cancer Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Baikpour
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
8
|
Sorace AG, Wu C, Barnes SL, Jarrett AM, Avery S, Patt D, Goodgame B, Luci JJ, Kang H, Abramson RG, Yankeelov TE, Virostko J. Repeatability, reproducibility, and accuracy of quantitative mri of the breast in the community radiology setting. J Magn Reson Imaging 2018; 48:10.1002/jmri.26011. [PMID: 29570895 PMCID: PMC6151298 DOI: 10.1002/jmri.26011] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 03/02/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Quantitative diffusion-weighted MRI (DW-MRI) and dynamic contrast-enhanced MRI (DCE-MRI) have the potential to impact patient care by providing noninvasive biological information in breast cancer. PURPOSE/HYPOTHESIS To quantify the repeatability, reproducibility, and accuracy of apparent diffusion coefficient (ADC) and T1 -mapping of the breast in community radiology practices. STUDY TYPE Prospective. SUBJECTS/PHANTOM Ice-water DW-MRI and T1 gel phantoms were used to assess accuracy. Normal subjects (n = 3) and phantoms across three sites (one academic, two community) were used to assess reproducibility. Test-retest analysis at one site in normal subjects (n = 12) was used to assess repeatability. FIELD STRENGTH/SEQUENCE 3T Siemens Skyra MRI quantitative DW-MRI and T1 -mapping. ASSESSMENT Quantitative DW-MRI and T1 -mapping parametric maps of phantoms and fibroglandular and adipose tissue of the breast. STATISTICAL TESTS Average values of breast tissue were quantified and Bland-Altman analysis was performed to assess the repeatability of the MRI techniques, while the Friedman test assessed reproducibility. RESULTS ADC measurements were reproducible across sites, with an average difference of 1.6% in an ice-water phantom and 7.0% in breast fibroglandular tissue. T1 measurements in gel phantoms had an average difference of 2.8% across three sites, whereas breast fibroglandular and adipose tissue had 8.4% and 7.5% average differences, respectively. In the repeatability study, we found no bias between first and second scanning sessions (P = 0.1). The difference between repeated measurements was independent of the mean for each MRI metric (P = 0.156, P = 0.862, P = 0.197 for ADC, T1 of fibroglandular tissue, and T1 of adipose tissue, respectively). DATA CONCLUSION Community radiology practices can perform repeatable, reproducible, and accurate quantitative T1 -mapping and DW-MRI. This has the potential to dramatically expand the number of sites that can participate in multisite clinical trials and increase clinical translation of quantitative MRI techniques for cancer response assessment. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018.
Collapse
Affiliation(s)
- Anna G. Sorace
- Department of Diagnostic Medicine, University of Texas at Austin, Austin, Texas, USA
- Livestrong Cancer Institutes, University of Texas at Austin, Austin, Texas, USA
- Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas, USA
| | - Chengyue Wu
- Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas, USA
| | - Stephanie L. Barnes
- Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas, USA
- Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Angela M. Jarrett
- Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Sarah Avery
- Austin Radiological Association, Austin, Texas, USA
| | | | - Boone Goodgame
- Seton Hospital, Austin, Texas, USA
- Department of Internal Medicine, University of Texas at Austin, Austin, Texas, USA
| | - Jeffery J. Luci
- Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas, USA
- Department of Neuroscience, University of Texas at Austin, Austin, Texas, USA
| | - Hakmook Kang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Richard G. Abramson
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Thomas E. Yankeelov
- Department of Diagnostic Medicine, University of Texas at Austin, Austin, Texas, USA
- Livestrong Cancer Institutes, University of Texas at Austin, Austin, Texas, USA
- Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas, USA
- Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, Texas, USA
| | - John Virostko
- Department of Diagnostic Medicine, University of Texas at Austin, Austin, Texas, USA
- Livestrong Cancer Institutes, University of Texas at Austin, Austin, Texas, USA
| |
Collapse
|
9
|
Iima M, Kataoka M, Kanao S, Kawai M, Onishi N, Koyasu S, Murata K, Ohashi A, Sakaguchi R, Togashi K. Variability of non-Gaussian diffusion MRI and intravoxel incoherent motion (IVIM) measurements in the breast. PLoS One 2018; 13:e0193444. [PMID: 29494639 PMCID: PMC5832256 DOI: 10.1371/journal.pone.0193444] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 02/12/2018] [Indexed: 01/12/2023] Open
Abstract
We prospectively examined the variability of non-Gaussian diffusion magnetic resonance imaging (MRI) and intravoxel incoherent motion (IVIM) measurements with different numbers of b-values and excitations in normal breast tissue and breast lesions. Thirteen volunteers and fourteen patients with breast lesions (seven malignant, eight benign; one patient had bilateral lesions) were recruited in this prospective study (approved by the Internal Review Board). Diffusion-weighted MRI was performed with 16 b-values (0–2500 s/mm2 with one number of excitations [NEX]) and five b-values (0–2500 s/mm2, 3 NEX), using a 3T breast MRI. Intravoxel incoherent motion (flowing blood volume fraction [fIVIM] and pseudodiffusion coefficient [D*]) and non-Gaussian diffusion (theoretical apparent diffusion coefficient [ADC] at b value of 0 sec/mm2 [ADC0] and kurtosis [K]) parameters were estimated from IVIM and Kurtosis models using 16 b-values, and synthetic apparent diffusion coefficient (sADC) values were obtained from two key b-values. The variabilities between and within subjects and between different diffusion acquisition methods were estimated. There were no statistical differences in ADC0, K, or sADC values between the different b-values or NEX. A good agreement of diffusion parameters was observed between 16 b-values (one NEX), five b-values (one NEX), and five b-values (three NEX) in normal breast tissue or breast lesions. Insufficient agreement was observed for IVIM parameters. There were no statistical differences in the non-Gaussian diffusion MRI estimated values obtained from a different number of b-values or excitations in normal breast tissue or breast lesions. These data suggest that a limited MRI protocol using a few b-values might be relevant in a clinical setting for the estimation of non-Gaussian diffusion MRI parameters in normal breast tissue and breast lesions.
Collapse
Affiliation(s)
- Mami Iima
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- The Hakubi Center for Advanced Research, Kyoto University, Kyoto, Japan
- * E-mail:
| | - Masako Kataoka
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shotaro Kanao
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Makiko Kawai
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Natsuko Onishi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Sho Koyasu
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | | - Akane Ohashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Rena Sakaguchi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| |
Collapse
|
10
|
Horvat JV, Durando M, Milans S, Patil S, Massler J, Gibbons G, Giri D, Pinker K, Morris EA, Thakur SB. Apparent diffusion coefficient mapping using diffusion-weighted MRI: impact of background parenchymal enhancement, amount of fibroglandular tissue and menopausal status on breast cancer diagnosis. Eur Radiol 2018; 28:2516-2524. [PMID: 29330631 DOI: 10.1007/s00330-017-5202-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 11/14/2017] [Accepted: 11/22/2017] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To investigate the impact of background parenchymal enhancement (BPE), amount of fibroglandular tissue (FGT) and menopausal status on apparent diffusion coefficient (ADC) values in differentiation between malignant and benign lesions. METHODS In this HIPAA-compliant study, mean ADC values of 218 malignant and 130 benign lesions from 288 patients were retrospectively evaluated. The differences in mean ADC values between benign and malignant lesions were calculated within groups stratified by BPE level (high/low), amount of FGT (dense/non-dense) and menopausal status (premenopausal/postmenopausal). Sensitivities and specificities for distinguishing malignant from benign lesions within different groups were compared for statistical significance. RESULTS The mean ADC value for malignant lesions was significantly lower compared to that for benign lesions (1.07±0.21 x 10-3 mm2/s vs. 1.53±0.26 x 10-3 mm2/s) (p<0.0001). Using the optimal cut-off point of 1.30 x 10-3 mm2/s, an area under the curve of 0.918 was obtained, with sensitivity and specificity both of 87 %. There was no statistically significant difference in sensitivities and specificities of ADC values between different groups stratified by BPE level, amount of FGT or menopausal status. CONCLUSIONS Differentiation between benign and malignant lesions on ADC values is not significantly affected by BPE level, amount of FGT or menopausal status. KEY POINTS • ADC allows differentiation between benign and malignant lesions. • ADC is useful for breast cancer diagnosis despite different patient characteristics. • BPE, FGT or menopause do not significantly affect sensitivity and specificity.
Collapse
Affiliation(s)
- Joao V Horvat
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Manuela Durando
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Diagnostic Imaging and Radiotherapy, A. O. U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Soledad Milans
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Hospital de Clínicas, University of the Republic, Montevideo, Uruguay
| | - Sujata Patil
- Department of Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jessica Massler
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Girard Gibbons
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Dilip Giri
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Katja Pinker
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria
| | - Elizabeth A Morris
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sunitha B Thakur
- Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, 00 East 66th Street, New York, NY, 10065, USA.
| |
Collapse
|
11
|
Rakow-Penner R, Murphy PM, Dale A, Ojeda-Fournier H. State of the Art Diffusion Weighted Imaging in the Breast: Recommended Protocol. CURRENT RADIOLOGY REPORTS 2017. [DOI: 10.1007/s40134-017-0195-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
12
|
Arlinghaus LR, Dortch RD, Whisenant JG, Kang H, Abramson RG, Yankeelov TE. Quantitative Magnetization Transfer Imaging of the Breast at 3.0 T: Reproducibility in Healthy Volunteers. ACTA ACUST UNITED AC 2016; 2:260-266. [PMID: 28090588 PMCID: PMC5228602 DOI: 10.18383/j.tom.2016.00142] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Quantitative magnetization transfer magnetic resonance imaging provides a means for indirectly detecting changes in the macromolecular content of tissue noninvasively. A potential application is the diagnosis and assessment of treatment response in breast cancer; however, before quantitative magnetization transfer imaging can be reliably used in such settings, the technique's reproducibility in healthy breast tissue must be established. Thus, this study aims to establish the reproducibility of the measurement of the macromolecular-to-free water proton pool size ratio (PSR) in healthy fibroglandular (FG) breast tissue. Thirteen women with no history of breast disease were scanned twice within a single scanning session, with repositioning between scans. Eleven women had appreciable FG tissue for test–retest measurements. Mean PSR values for the FG tissue ranged from 9.5% to 16.7%. The absolute value of the difference between 2 mean PSR measurements for each volunteer ranged from 0.1% to 2.1%. The 95% confidence interval for the mean difference was ±0.75%, and the repeatability value was 2.39%. These results indicate that the expected measurement variability would be ±0.75% for a cohort of a similar size and would be ±2.39% for an individual, suggesting that future studies of change in PSR in patients with breast cancer are feasible.
Collapse
Affiliation(s)
- Lori R Arlinghaus
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Richard D Dortch
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee
| | - Jennifer G Whisenant
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Hakmook Kang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee; Center for Quantitative Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Richard G Abramson
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee; Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Thomas E Yankeelov
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas; Department of Internal Medicine, The University of Texas at Austin, Austin, Texas; Institute for Computational and Engineering Sciences, The University of Texas at Austin, Austin, Texas; Livestrong Cancer Institutes, The University of Texas at Austin, Austin, Texas
| |
Collapse
|
13
|
Partridge SC, Nissan N, Rahbar H, Kitsch AE, Sigmund EE. Diffusion-weighted breast MRI: Clinical applications and emerging techniques. J Magn Reson Imaging 2016; 45:337-355. [PMID: 27690173 DOI: 10.1002/jmri.25479] [Citation(s) in RCA: 215] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 08/29/2016] [Indexed: 12/28/2022] Open
Abstract
Diffusion-weighted MRI (DWI) holds potential to improve the detection and biological characterization of breast cancer. DWI is increasingly being incorporated into breast MRI protocols to address some of the shortcomings of routine clinical breast MRI. Potential benefits include improved differentiation of benign and malignant breast lesions, assessment and prediction of therapeutic efficacy, and noncontrast detection of breast cancer. The breast presents a unique imaging environment with significant physiologic and inter-subject variations, as well as specific challenges to achieving reliable high quality diffusion-weighted MR images. Technical innovations are helping to overcome many of the image quality issues that have limited widespread use of DWI for breast imaging. Advanced modeling approaches to further characterize tissue perfusion, complexity, and glandular organization may expand knowledge and yield improved diagnostic tools. LEVEL OF EVIDENCE 5 J. Magn. Reson. Imaging 2016 J. Magn. Reson. Imaging 2017;45:337-355.
Collapse
Affiliation(s)
- Savannah C Partridge
- Department of Radiology, University of Washington School of Medicine, Seattle, Washington, USA.,Breast Imaging, Seattle Cancer Care Alliance, Seattle, Washington, USA
| | - Noam Nissan
- Department of Biological Regulation, Weizmann Institute of Science, Rehovot, Israel
| | - Habib Rahbar
- Department of Radiology, University of Washington School of Medicine, Seattle, Washington, USA.,Breast Imaging, Seattle Cancer Care Alliance, Seattle, Washington, USA
| | - Averi E Kitsch
- Department of Radiology, University of Washington School of Medicine, Seattle, Washington, USA.,Breast Imaging, Seattle Cancer Care Alliance, Seattle, Washington, USA
| | - Eric E Sigmund
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| |
Collapse
|
14
|
Fracol M, Datta J, Lowenfeld L, Xu S, Zhang PJ, Fisher CS, Czerniecki BJ. Loss of Anti-HER-3 CD4+ T-Helper Type 1 Immunity Occurs in Breast Tumorigenesis and is Negatively Associated with Outcomes. Ann Surg Oncol 2016; 24:407-417. [PMID: 27663569 DOI: 10.1245/s10434-016-5584-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Indexed: 01/15/2023]
Abstract
BACKGROUND We previously demonstrated a progressive loss of the anti-human epidermal growth factor receptor 2 (HER2) CD4+ T-helper type 1 (Th1) response during HER2pos breast tumorigenesis. This loss is associated with residual disease following neoadjuvant therapy and increased risk of recurrence. In this study, we assessed the fate of anti-HER3 Th1 immunity during breast tumorigenesis. METHODS Peripheral blood from 131 subjects, including healthy donors (HDs), patients with benign breast disease (BD), ductal carcinoma in situ (DCIS) and invasive breast cancer (IBC), was collected. Interferon (IFN)-γpos immune responses to four HER3-derived major histocompatibility complex (MHC) class II promiscuous peptides were tested via enzyme-linked immunosorbent (ELISPOT) assays, and three immune response parameters were compared: anti-HER3 (i) responsivity, or proportion of subjects responding to at least one peptide; (ii) repertoire, or number of responding peptides; and (iii) cumulative response, or summed peptide response. RESULTS A significant decline in anti-HER3 Th1 response was observed going from HDs to IBC patients; patients with triple-negative breast cancer (TNBC) demonstrated the lowest responses. HDs had significantly higher Th1 responses versus estrogen receptor (ER)pos IBC and TNBC patients across all three immune parameters; HER2pos IBC patients displayed responses similar to HDs and BDs. Patients with recurrent breast cancer and residual disease following neoadjuvant therapy demonstrated significantly lower anti-HER3 Th1 immunity compared with patients without recurrence or with a pathologic complete response to neoadjuvant therapy. CONCLUSIONS Anti-HER3 CD4+ Th1 responses decline during breast tumorigenesis, particularly in TNBC. Attempts to immunologically restore depressed responses in vulnerable subgroups may help mitigate recurrence.
Collapse
Affiliation(s)
- Megan Fracol
- Harrison Department of Surgical Research, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Jashodeep Datta
- Harrison Department of Surgical Research, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Lea Lowenfeld
- Harrison Department of Surgical Research, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Shuwen Xu
- Harrison Department of Surgical Research, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Paul J Zhang
- Department of Pathology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Carla S Fisher
- Harrison Department of Surgical Research, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.,Rena Rowen Breast Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Brian J Czerniecki
- Harrison Department of Surgical Research, Hospital of the University of Pennsylvania, Philadelphia, PA, USA. .,Rena Rowen Breast Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA. .,Department of Breast Oncology, Moffitt Cancer Center, Tampa, FL, USA.
| |
Collapse
|
15
|
Apparent diffusion coefficient of breast cancer and normal fibroglandular tissue in diffusion-weighted imaging: the effects of menstrual cycle and menopausal status. Breast Cancer Res Treat 2016; 157:31-40. [PMID: 27091644 DOI: 10.1007/s10549-016-3793-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 04/07/2016] [Indexed: 10/21/2022]
Abstract
The purpose of this study was to investigate prospectively whether the apparent diffusion coefficients (ADCs) of both breast cancer and normal fibroglandular tissue vary with the menstrual cycle and menopausal status. Institutional review board approval was obtained, and informed consent was obtained from each participant. Fifty-seven women (29 premenopausal, 28 postmenopausal) with newly diagnosed breast cancer underwent diffusion-weighted imaging twice (interval 12-20 days) before surgery. Two radiologists independently measured ADC of breast cancer and normal contralateral breast tissue, and we quantified the differences according to the phases of menstrual cycle and menopausal status. With normal fibroglandular tissue, ADC was significantly lower in postmenopausal than in premenopausal women (P = 0.035). In premenopausal women, ADC did not differ significantly between proliferative and secretory phases in either breast cancer or normal fibroglandular tissue (P = 0.969 and P = 0.519, respectively). In postmenopausal women, no significant differences were found between ADCs measured at different time intervals in either breast cancer or normal fibroglandular tissue (P = 0.948 and P = 0.961, respectively). The within-subject variability of the ADC measurements was quantified using the coefficient of variation (CV) and was small: the mean CVs of tumor ADC were 2.90 % (premenopausal) and 3.43 % (postmenopausal), and those of fibroglandular tissue ADC were 4.37 % (premenopausal) and 2.55 % (postmenopausal). Both intra- and interobserver agreements were excellent for ADC measurements, with intraclass correlation coefficients in the range of 0.834-0.974. In conclusion, the measured ADCs of breast cancer and normal fibroglandular tissue were not affected significantly by menstrual cycle, and the measurements were highly reproducible both within and between observers.
Collapse
|
16
|
Volumetric Evaluation of the Mammary Gland and Pectoralis Major Muscle following Subglandular and Submuscular Breast Augmentation. Plast Reconstr Surg 2016; 137:62-69. [DOI: 10.1097/prs.0000000000001874] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
17
|
Roxo ACW, Nahas FX, Bazi F, de Castro CC, Aboudib JH, Marques RG. Evaluation of the effects of silicone implants on the breast parenchyma. Aesthet Surg J 2015; 35:929-35. [PMID: 26508645 DOI: 10.1093/asj/sjv120] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite being the cosmetic procedure most performed worldwide, there are still few objective measurements of postoperative volumetric analysis of breast augmentation available in the literature. OBJECTIVE The aim of this study was to evaluate volumetric changes in the breast parenchyma after the placement of silicone implants in the subglandular plane. METHODS Thirty-four women were randomly allocated to the intervention group (n = 24), who underwent breast augmentation in the subglandular plane, or to the control group (n = 10), who received no intervention. Volumetric magnetic resonance imaging was performed at inclusion, and after 6 and 12 months in all participants. The non-parametric Friedman's test was used for statistical analysis. RESULTS There was a significant reduction in glandular volume (mean, 22%) at 12 months postoperatively in patients who underwent breast augmentation. CONCLUSIONS Breast augmentation caused reduction in the volume of the breast parenchyma. LEVEL OF EVIDENCE 3 Therapeutic.
Collapse
Affiliation(s)
- Ana Claudia Weck Roxo
- Dr Roxo is a PhD Student, Graduate Program in Physiopathology and Surgical Sciences, and Drs Nahas, de Castro, and Aboudib are Associate Professors, Division of Plastic and Reconstructive Surgery, "Pedro Ernesto" University Hospital, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil. Dr Bazi is a Radiologist, Breast Division, Rio Imagem Center for Diagnostic Imaging of the State of Rio de Janeiro, Rio de Janeiro, Brazil. Dr Marques is an Assistant Professor, Graduate Program in Physiopathology and Surgical Sciences, Department of General Surgery, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Fabio Xerfan Nahas
- Dr Roxo is a PhD Student, Graduate Program in Physiopathology and Surgical Sciences, and Drs Nahas, de Castro, and Aboudib are Associate Professors, Division of Plastic and Reconstructive Surgery, "Pedro Ernesto" University Hospital, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil. Dr Bazi is a Radiologist, Breast Division, Rio Imagem Center for Diagnostic Imaging of the State of Rio de Janeiro, Rio de Janeiro, Brazil. Dr Marques is an Assistant Professor, Graduate Program in Physiopathology and Surgical Sciences, Department of General Surgery, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Fernanda Bazi
- Dr Roxo is a PhD Student, Graduate Program in Physiopathology and Surgical Sciences, and Drs Nahas, de Castro, and Aboudib are Associate Professors, Division of Plastic and Reconstructive Surgery, "Pedro Ernesto" University Hospital, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil. Dr Bazi is a Radiologist, Breast Division, Rio Imagem Center for Diagnostic Imaging of the State of Rio de Janeiro, Rio de Janeiro, Brazil. Dr Marques is an Assistant Professor, Graduate Program in Physiopathology and Surgical Sciences, Department of General Surgery, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Claudio Cardoso de Castro
- Dr Roxo is a PhD Student, Graduate Program in Physiopathology and Surgical Sciences, and Drs Nahas, de Castro, and Aboudib are Associate Professors, Division of Plastic and Reconstructive Surgery, "Pedro Ernesto" University Hospital, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil. Dr Bazi is a Radiologist, Breast Division, Rio Imagem Center for Diagnostic Imaging of the State of Rio de Janeiro, Rio de Janeiro, Brazil. Dr Marques is an Assistant Professor, Graduate Program in Physiopathology and Surgical Sciences, Department of General Surgery, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Jose Horacio Aboudib
- Dr Roxo is a PhD Student, Graduate Program in Physiopathology and Surgical Sciences, and Drs Nahas, de Castro, and Aboudib are Associate Professors, Division of Plastic and Reconstructive Surgery, "Pedro Ernesto" University Hospital, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil. Dr Bazi is a Radiologist, Breast Division, Rio Imagem Center for Diagnostic Imaging of the State of Rio de Janeiro, Rio de Janeiro, Brazil. Dr Marques is an Assistant Professor, Graduate Program in Physiopathology and Surgical Sciences, Department of General Surgery, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Ruy Garcia Marques
- Dr Roxo is a PhD Student, Graduate Program in Physiopathology and Surgical Sciences, and Drs Nahas, de Castro, and Aboudib are Associate Professors, Division of Plastic and Reconstructive Surgery, "Pedro Ernesto" University Hospital, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil. Dr Bazi is a Radiologist, Breast Division, Rio Imagem Center for Diagnostic Imaging of the State of Rio de Janeiro, Rio de Janeiro, Brazil. Dr Marques is an Assistant Professor, Graduate Program in Physiopathology and Surgical Sciences, Department of General Surgery, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| |
Collapse
|
18
|
Stanwell P, Gluch L. Lipid and Metabolite Deregulation in BRCA1 and BRCA2 Genetic Mutations. Radiology 2015; 277:614-5. [PMID: 26492029 DOI: 10.1148/radiol.2015151153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Peter Stanwell
- Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia *
| | - Laurence Gluch
- Strathfield Breast Centre, Strathfield, NSW, Australia †
| |
Collapse
|
19
|
Cho GY, Moy L, Kim SG, Klautau Leite AP, Baete SH, Babb JS, Sodickson DK, Sigmund EE. Comparison of contrast enhancement and diffusion-weighted magnetic resonance imaging in healthy and cancerous breast tissue. Eur J Radiol 2015. [PMID: 26220915 DOI: 10.1016/j.ejrad.2015.06.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To measure background parenchymal enhancement (BPE) and compare with other contrast enhancement values and diffusion-weighted MRI parameters in healthy and cancerous breast tissue at the clinical level. MATERIALS AND METHODS This HIPAA-compliant, IRB approved retrospective study enrolled 77 patients (38 patients with breast cancer - mean age 51.8 ± 10.0 years; 39 high-risk patients for screening evaluation - mean age 46.3 ± 11.7 years), who underwent contrast-enhanced 3T breast MRI. Contrast enhanced MRI and diffusion-weighted imaging were performed to quantify BPE, lesion contrast enhancement, and apparent diffusion coefficient (ADC) metrics in fibroglandular tissue (FGT) and lesions. RESULTS BPE did not correlate with ADC values. Mean BPE for the lesion-bearing patients was higher (43.9%) compared to that of the high-risk screening patients (28.3%, p=0.004). Significant correlation (r=0.37, p<0.05) was found between BPE and lesion contrast enhancement. CONCLUSION No significant association was observed between parenchymal or lesion enhancement with conventional apparent diffusion metrics, suggesting that proliferative processes are not co-regulated in cancerous and parenchymal tissue.
Collapse
Affiliation(s)
- Gene Young Cho
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, USA; Sackler Institute of Graduate Biomedical Sciences, New York University School of Medicine, New York, NY 10016, USA; Center for Advanced Imaging Innovation and Research (CAI(2)R), Department of Radiology, New York University School of Medicine, New York, NY 10016, USA.
| | - Linda Moy
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, USA; Center for Advanced Imaging Innovation and Research (CAI(2)R), Department of Radiology, New York University School of Medicine, New York, NY 10016, USA; New York University Langone Medical Center - Cancer Institute, New York, NY 10016, USA
| | - Sungheon G Kim
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, USA; Center for Advanced Imaging Innovation and Research (CAI(2)R), Department of Radiology, New York University School of Medicine, New York, NY 10016, USA
| | | | - Steven H Baete
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, USA; Center for Advanced Imaging Innovation and Research (CAI(2)R), Department of Radiology, New York University School of Medicine, New York, NY 10016, USA
| | - James S Babb
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, USA; Center for Advanced Imaging Innovation and Research (CAI(2)R), Department of Radiology, New York University School of Medicine, New York, NY 10016, USA
| | - Daniel K Sodickson
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, USA; Center for Advanced Imaging Innovation and Research (CAI(2)R), Department of Radiology, New York University School of Medicine, New York, NY 10016, USA
| | - Eric E Sigmund
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, USA; Center for Advanced Imaging Innovation and Research (CAI(2)R), Department of Radiology, New York University School of Medicine, New York, NY 10016, USA
| |
Collapse
|
20
|
Shin S, Ko ES, Kim RB, Han BK, Nam SJ, Shin JH, Hahn SY. Effect of menstrual cycle and menopausal status on apparent diffusion coefficient values and detectability of invasive ductal carcinoma on diffusion-weighted MRI. Breast Cancer Res Treat 2015; 149:751-9. [PMID: 25638396 DOI: 10.1007/s10549-015-3278-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 01/18/2015] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to determine whether the apparent diffusion coefficient (ADC) and tumor detectability based on diffusion-weighted imaging (DWI) are affected by the menstrual cycle or menopausal status in breast cancer patients. Institutional review board approval was obtained, and the requirement for informed consent was waived. A total of 124 women with invasive ductal carcinoma not otherwise specified (IDC NOS) who underwent breast MRI with DWI were included in this study. Two radiologists retrospectively measured the ADCs of tumor and contralateral normal glandular tissue and scored the tumor detectability. The ADCs and detectability were compared to menstrual cycle and menopausal status, based on patient questionnaires. ADCs of tumors and contralateral tissue were significantly lower in postmenopausal women than in premenopausal women (P = 0.006 and P < 0.001, respectively). Tumor detectability did not differ significantly between the premenopausal and postmenopausal groups (P = 0.454). Normalized ADCs were not significantly lower in postmenopausal women compared to premenopausal women (P = 0.880). There was no statistically significant difference in the absolute, contralateral, and normalized ADCs (P = 0.091, 0.809, and 0.299, respectively), and the tumor detectability (P = 0.680) according to the menstrual cycle. Although ADCs of the IDC and normal glandular tissue in postmenopausal women were significantly lower than those in premenopausal women, the menstrual cycle did not affect tumor detectability and ADCs of IDC.
Collapse
Affiliation(s)
- Suyoung Shin
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea
| | | | | | | | | | | | | |
Collapse
|
21
|
Zhao Q, Wei H, He Y, Ren Q, Zhou C. Evaluation of ultrasound and glucose synergy effect on the optical clearing and light penetration for human colon tissue using SD-OCT. JOURNAL OF BIOPHOTONICS 2014; 7:938-947. [PMID: 24458608 DOI: 10.1002/jbio.201300141] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Revised: 11/18/2013] [Accepted: 12/02/2013] [Indexed: 06/03/2023]
Abstract
Topical application optical clearing agents (OCAs) can effectively enhance the tissue optical clearing on the human colon tissue, which has been demonstrated in our previous studies. Nevertheless, the strong light scattering still limits the diffusion rate of OCAs and penetration depth of light into the tissue. In this study, in order to further increase the diffusion of the OCA of glucose into tissue, we employ a method to improve the glucose permeability and light penetration with ultrasound (sonophoretic delivery, SP) and glucose (G) synergy on human normal and cancerous colon tissues in vitro, which was measured and quantified with spectral-domain optical coherence tomography (SD-OCT) technology. To evaluate the effect of ultrasound mediation, the percentages of OCT signal enhancement (PSE) and 1/e light-penetration depth were calculated for G alone and ultrasound-G treatments. The PSE was calculated at approximately 313 μm from the sample tissue surface. For normal and cancerous colon tissues the PSE were about 91.1 ± 10.6% and 65.3% ± 12.3% with 30% G/SP, but for the 30% G alone treatment it was about 78.6 ± 11.2% and 54.5% ± 9.3%, respectively. The max value of 1/e light-penetration depth for normal colon tissue was 0.47 ± 0.02 mm with 30% G alone and 0.60 ± 0.05 mm (p < 0.05)with 30% G/SP synergy. However, for the cancerous colon tissue the max value was 0.45 ± 0.01 mm and 0.57 ± 0.03 mm (p < 0.05), respectively. The obtained permeability coefficients showed a significant enhancement with ultrasound mediation. The mean permeability coefficients of 30% G/SP in normal and cancerous colon tissues were (6.3 ± 0.16) × 10(-6) cm/s and (12.1 ± 0.34) × 10(-6) cm/s (p < 0.05), respectively. These preliminary experiments showed that ultrasound can effectively enhance the tissue optical clearing and glucose diffusion rate as well as increase the light-penetration depth into biotissues.
Collapse
Affiliation(s)
- Qingliang Zhao
- School of Biomedical Engineering, Shanghai Jiao Tong University, No. 800 Dongchuan Road, Shanghai 200240, China
| | | | | | | | | |
Collapse
|
22
|
Nissan N, Furman-Haran E, Shapiro-Feinberg M, Grobgeld D, Degani H. Diffusion-tensor MR imaging of the breast: hormonal regulation. Radiology 2014; 271:672-80. [PMID: 24533873 DOI: 10.1148/radiol.14132084] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE To investigate the parameters obtained with magnetic resonance (MR) diffusion-tensor imaging (DTI) of the breast throughout the menstrual cycle phases, during lactation, and after menopause, with and without hormone replacement therapy (HRT). MATERIALS AND METHODS All protocols were approved by the internal review board, and signed informed consent was obtained from all participants. Forty-five healthy volunteers underwent imaging by using T2-weighted and DTI MR sequences at 3 T. Premenopausal volunteers (n = 16) underwent imaging weekly, four times during one menstrual cycle. Postmenopausal volunteers (n = 19) and lactating volunteers (n = 10) underwent imaging once. The principal diffusion coefficients (λ1, λ2, and λ3), apparent diffusion coefficient (ADC), fractional anisotropy (FA), and maximal anisotropy (λ1-λ3) were calculated pixel by pixel for the fibroglandular tissue in the entire breast. RESULTS In all premenopausal volunteers, the DTI parameters exhibited high repeatability, remaining almost equal along the menstrual cycle, with a low mean within-subject coefficient of variance of λ1, λ2, λ3, and ADC (1%-2% for all) and FA (5%), as well as a high intraclass correlation of 0.92-0.98. The diffusion coefficients were significantly lower (a) in the group without HRT use as compared with the group with HRT use (P < .01) and premenopausal volunteers (P < .01) and (b) in the lactating volunteers as compared with the premenopausal volunteers (P < .005). No significant differences in DTI parameters were found between premenopausal volunteers free of oral contraceptives and those who used oral contraceptives (P = .28-0.82) and between premenopausal volunteers and postmenopausal volunteers who used HRT (P = .31-0.93). CONCLUSION DTI parameters are not sensitive to menstrual cycle changes, while menopause, long-term HRT, and presence of milk in lactating women affected the DTI parameters. Therefore, the timing for performing breast DTI is not restricted throughout the menstrual cycle, whereas the modulations in diffusion parameters due to HRT and lactation should be taken into account in DTI evaluation.
Collapse
Affiliation(s)
- Noam Nissan
- From the Department of Biological Regulation (N.N., D.G., H.D.) and Unit of Biological Services (E.F.H.), Weizmann Institute of Science, PO Box 26, Rehovot 76100, Israel; and Department of Radiology, Meir Medical Center, Kfar Saba, Israel (M.S.F.)
| | | | | | | | | |
Collapse
|
23
|
Tagliafico A, Tagliafico G, Houssami N. Differences in breast density assessment using mammography, tomosynthesis and MRI and their implications for practice. Br J Radiol 2013; 86:20130528. [PMID: 24167184 DOI: 10.1259/bjr.20130528] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- A Tagliafico
- Department of Experimental Medicine, University of Genoa, Genoa, Italy
| | | | | |
Collapse
|
24
|
Partridge SC, McDonald ES. Diffusion weighted magnetic resonance imaging of the breast: protocol optimization, interpretation, and clinical applications. Magn Reson Imaging Clin N Am 2013; 21:601-24. [PMID: 23928248 DOI: 10.1016/j.mric.2013.04.007] [Citation(s) in RCA: 123] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Diffusion-weighted magnetic resonance (MR) imaging (DWI) has shown promise for improving the positive predictive value of breast MR imaging for detection of breast cancer, evaluating tumor response to neoadjuvant chemotherapy, and as a noncontrast alternative to MR imaging in screening for breast cancer. However, data quality varies widely. Before implementing DWI into clinical practice, one must understand the pertinent technical considerations and current evidence regarding clinical applications of breast DWI. This article provides an overview of basic principles of DWI, optimization of breast DWI protocols, imaging features of benign and malignant breast lesions, promising clinical applications, and potential future directions.
Collapse
Affiliation(s)
- Savannah C Partridge
- Department of Radiology, Seattle Cancer Care Alliance, University of Washington School of Medicine, Seattle, WA 98109-1023, USA.
| | | |
Collapse
|
25
|
In response to Cuce et al. Menopause 2013; 20:241-2. [PMID: 23340261 DOI: 10.1097/gme.0b013e318280a499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
26
|
Comparative estimation of percentage breast tissue density for digital mammography, digital breast tomosynthesis, and magnetic resonance imaging. Breast Cancer Res Treat 2013; 138:311-7. [PMID: 23338763 DOI: 10.1007/s10549-013-2419-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Accepted: 01/12/2013] [Indexed: 10/27/2022]
|