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Müller-Franzes G, Khader F, Tayebi Arasteh S, Huck L, Bode M, Han T, Lemainque T, Kather JN, Nebelung S, Kuhl C, Truhn D. Intraindividual Comparison of Different Methods for Automated BPE Assessment at Breast MRI: A Call for Standardization. Radiology 2024; 312:e232304. [PMID: 39012249 DOI: 10.1148/radiol.232304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/17/2024]
Abstract
Background The level of background parenchymal enhancement (BPE) at breast MRI provides predictive and prognostic information and can have diagnostic implications. However, there is a lack of standardization regarding BPE assessment. Purpose To investigate how well results of quantitative BPE assessment methods correlate among themselves and with assessments made by radiologists experienced in breast MRI. Materials and Methods In this pseudoprospective analysis of 5773 breast MRI examinations from 3207 patients (mean age, 60 years ± 10 [SD]), the level of BPE was prospectively categorized according to the Breast Imaging Reporting and Data System by radiologists experienced in breast MRI. For automated extraction of BPE, fibroglandular tissue (FGT) was segmented in an automated pipeline. Four different published methods for automated quantitative BPE extractions were used: two methods (A and B) based on enhancement intensity and two methods (C and D) based on the volume of enhanced FGT. The results from all methods were correlated, and agreement was investigated in comparison with the respective radiologist-based categorization. For surrogate validation of BPE assessment, how accurately the methods distinguished premenopausal women with (n = 50) versus without (n = 896) antihormonal treatment was determined. Results Intensity-based methods (A and B) exhibited a correlation with radiologist-based categorization of 0.56 ± 0.01 and 0.55 ± 0.01, respectively, and volume-based methods (C and D) had a correlation of 0.52 ± 0.01 and 0.50 ± 0.01 (P < .001). There were notable correlation differences (P < .001) between the BPE determined with the four methods. Among the four quantitation methods, method D offered the highest accuracy for distinguishing women with versus without antihormonal therapy (P = .01). Conclusion Results of different methods for quantitative BPE assessment agree only moderately among themselves or with visual categories reported by experienced radiologists; intensity-based methods correlate more closely with radiologists' ratings than volume-based methods. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Mann in this issue.
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Affiliation(s)
- Gustav Müller-Franzes
- From the Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstr 30, 52074 Aachen, Germany (G.M.F., F.K., S.T.A., L.H., M.B., T.H., T.L., S.N., C.K., D.T.); National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany (J.N.K.); Department of Medical Oncology, Heidelberg University Hospital, Heidelberg, Germany (J.N.K.); Else Kroener Fresenius Center for Digital Health, Technical University Dresden, Dresden, Germany (J.N.K.); and Department of Medicine I, University Hospital Dresden, Dresden, Germany (J.N.K.)
| | - Firas Khader
- From the Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstr 30, 52074 Aachen, Germany (G.M.F., F.K., S.T.A., L.H., M.B., T.H., T.L., S.N., C.K., D.T.); National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany (J.N.K.); Department of Medical Oncology, Heidelberg University Hospital, Heidelberg, Germany (J.N.K.); Else Kroener Fresenius Center for Digital Health, Technical University Dresden, Dresden, Germany (J.N.K.); and Department of Medicine I, University Hospital Dresden, Dresden, Germany (J.N.K.)
| | - Soroosh Tayebi Arasteh
- From the Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstr 30, 52074 Aachen, Germany (G.M.F., F.K., S.T.A., L.H., M.B., T.H., T.L., S.N., C.K., D.T.); National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany (J.N.K.); Department of Medical Oncology, Heidelberg University Hospital, Heidelberg, Germany (J.N.K.); Else Kroener Fresenius Center for Digital Health, Technical University Dresden, Dresden, Germany (J.N.K.); and Department of Medicine I, University Hospital Dresden, Dresden, Germany (J.N.K.)
| | - Luisa Huck
- From the Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstr 30, 52074 Aachen, Germany (G.M.F., F.K., S.T.A., L.H., M.B., T.H., T.L., S.N., C.K., D.T.); National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany (J.N.K.); Department of Medical Oncology, Heidelberg University Hospital, Heidelberg, Germany (J.N.K.); Else Kroener Fresenius Center for Digital Health, Technical University Dresden, Dresden, Germany (J.N.K.); and Department of Medicine I, University Hospital Dresden, Dresden, Germany (J.N.K.)
| | - Maike Bode
- From the Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstr 30, 52074 Aachen, Germany (G.M.F., F.K., S.T.A., L.H., M.B., T.H., T.L., S.N., C.K., D.T.); National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany (J.N.K.); Department of Medical Oncology, Heidelberg University Hospital, Heidelberg, Germany (J.N.K.); Else Kroener Fresenius Center for Digital Health, Technical University Dresden, Dresden, Germany (J.N.K.); and Department of Medicine I, University Hospital Dresden, Dresden, Germany (J.N.K.)
| | - Tianyu Han
- From the Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstr 30, 52074 Aachen, Germany (G.M.F., F.K., S.T.A., L.H., M.B., T.H., T.L., S.N., C.K., D.T.); National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany (J.N.K.); Department of Medical Oncology, Heidelberg University Hospital, Heidelberg, Germany (J.N.K.); Else Kroener Fresenius Center for Digital Health, Technical University Dresden, Dresden, Germany (J.N.K.); and Department of Medicine I, University Hospital Dresden, Dresden, Germany (J.N.K.)
| | - Teresa Lemainque
- From the Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstr 30, 52074 Aachen, Germany (G.M.F., F.K., S.T.A., L.H., M.B., T.H., T.L., S.N., C.K., D.T.); National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany (J.N.K.); Department of Medical Oncology, Heidelberg University Hospital, Heidelberg, Germany (J.N.K.); Else Kroener Fresenius Center for Digital Health, Technical University Dresden, Dresden, Germany (J.N.K.); and Department of Medicine I, University Hospital Dresden, Dresden, Germany (J.N.K.)
| | - Jakob Nikolas Kather
- From the Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstr 30, 52074 Aachen, Germany (G.M.F., F.K., S.T.A., L.H., M.B., T.H., T.L., S.N., C.K., D.T.); National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany (J.N.K.); Department of Medical Oncology, Heidelberg University Hospital, Heidelberg, Germany (J.N.K.); Else Kroener Fresenius Center for Digital Health, Technical University Dresden, Dresden, Germany (J.N.K.); and Department of Medicine I, University Hospital Dresden, Dresden, Germany (J.N.K.)
| | - Sven Nebelung
- From the Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstr 30, 52074 Aachen, Germany (G.M.F., F.K., S.T.A., L.H., M.B., T.H., T.L., S.N., C.K., D.T.); National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany (J.N.K.); Department of Medical Oncology, Heidelberg University Hospital, Heidelberg, Germany (J.N.K.); Else Kroener Fresenius Center for Digital Health, Technical University Dresden, Dresden, Germany (J.N.K.); and Department of Medicine I, University Hospital Dresden, Dresden, Germany (J.N.K.)
| | - Christiane Kuhl
- From the Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstr 30, 52074 Aachen, Germany (G.M.F., F.K., S.T.A., L.H., M.B., T.H., T.L., S.N., C.K., D.T.); National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany (J.N.K.); Department of Medical Oncology, Heidelberg University Hospital, Heidelberg, Germany (J.N.K.); Else Kroener Fresenius Center for Digital Health, Technical University Dresden, Dresden, Germany (J.N.K.); and Department of Medicine I, University Hospital Dresden, Dresden, Germany (J.N.K.)
| | - Daniel Truhn
- From the Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstr 30, 52074 Aachen, Germany (G.M.F., F.K., S.T.A., L.H., M.B., T.H., T.L., S.N., C.K., D.T.); National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany (J.N.K.); Department of Medical Oncology, Heidelberg University Hospital, Heidelberg, Germany (J.N.K.); Else Kroener Fresenius Center for Digital Health, Technical University Dresden, Dresden, Germany (J.N.K.); and Department of Medicine I, University Hospital Dresden, Dresden, Germany (J.N.K.)
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2
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Völzke H, Schössow J, Schmidt CO, Jürgens C, Richter A, Werner A, Werner N, Radke D, Teumer A, Ittermann T, Schauer B, Henck V, Friedrich N, Hannemann A, Winter T, Nauck M, Dörr M, Bahls M, Felix SB, Stubbe B, Ewert R, Frost F, Lerch MM, Grabe HJ, Bülow R, Otto M, Hosten N, Rathmann W, Schminke U, Großjohann R, Tost F, Homuth G, Völker U, Weiss S, Holtfreter S, Bröker BM, Zimmermann K, Kaderali L, Winnefeld M, Kristof B, Berger K, Samietz S, Schwahn C, Holtfreter B, Biffar R, Kindler S, Wittfeld K, Hoffmann W, Kocher T. Cohort Profile Update: The Study of Health in Pomerania (SHIP). Int J Epidemiol 2022; 51:e372-e383. [PMID: 35348705 DOI: 10.1093/ije/dyac034] [Citation(s) in RCA: 70] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 02/25/2022] [Indexed: 12/16/2022] Open
Affiliation(s)
- Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Janka Schössow
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | | | - Clemens Jürgens
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Adrian Richter
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - André Werner
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Nicole Werner
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Dörte Radke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Till Ittermann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Birgit Schauer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Vivien Henck
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Nele Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Anke Hannemann
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.,Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Theresa Winter
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Matthias Nauck
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.,Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Marcus Dörr
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.,Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Martin Bahls
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.,Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Stephan B Felix
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.,Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Beate Stubbe
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Ralf Ewert
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Fabian Frost
- Department of Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Markus M Lerch
- Department of Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Hans J Grabe
- Clinic of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.,German Centre for Neurodegenerative Diseases, Site Rostock/Greifswald, Greifswald, Greifswald, Germany
| | - Robin Bülow
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.,Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Markus Otto
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Norbert Hosten
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Wolfgang Rathmann
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Greifswald, Germany
| | - Ulf Schminke
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Rico Großjohann
- Clinic of Ophthalmology, University Medicine Greifswald, Greifswald, Germany
| | - Frank Tost
- Clinic of Ophthalmology, University Medicine Greifswald, Greifswald, Germany
| | - Georg Homuth
- Interfaculty Institute of Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Uwe Völker
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.,Interfaculty Institute of Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Stefan Weiss
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.,Interfaculty Institute of Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Silva Holtfreter
- Department of Immunology, University Medicine Greifswald, Greifswald, Germany
| | - Barbara M Bröker
- Department of Immunology, University Medicine Greifswald, Greifswald, Germany
| | - Kathrin Zimmermann
- Friedrich Loeffler Institute for Medical Microbiology, University Medicine Greifswald, Greifswald, Germany
| | - Lars Kaderali
- Institute for Bioinformatics, University Medicine Greifswald, Greifswald, Germany
| | | | | | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Munster, Munster, Germany
| | - Stefanie Samietz
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - Christian Schwahn
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Reiner Biffar
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - Stefan Kindler
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, University Medicine Greifswald, Greifswald, Germany
| | - Katharina Wittfeld
- Clinic of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.,German Centre for Neurodegenerative Diseases, Site Rostock/Greifswald, Greifswald, Greifswald, Germany
| | - Wolfgang Hoffmann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany.,German Centre for Neurodegenerative Diseases, Site Rostock/Greifswald, Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
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3
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Hosten N, Bülow R, Völzke H, Domin M, Schmidt CO, Teumer A, Ittermann T, Nauck M, Felix S, Dörr M, Markus MRP, Völker U, Daboul A, Schwahn C, Holtfreter B, Mundt T, Krey KF, Kindler S, Mksoud M, Samietz S, Biffar R, Hoffmann W, Kocher T, Chenot JF, Stahl A, Tost F, Friedrich N, Zylla S, Hannemann A, Lotze M, Kühn JP, Hegenscheid K, Rosenberg C, Wassilew G, Frenzel S, Wittfeld K, Grabe HJ, Kromrey ML. SHIP-MR and Radiology: 12 Years of Whole-Body Magnetic Resonance Imaging in a Single Center. Healthcare (Basel) 2021; 10:33. [PMID: 35052197 PMCID: PMC8775435 DOI: 10.3390/healthcare10010033] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/17/2021] [Accepted: 12/20/2021] [Indexed: 12/16/2022] Open
Abstract
The Study of Health in Pomerania (SHIP), a population-based study from a rural state in northeastern Germany with a relatively poor life expectancy, supplemented its comprehensive examination program in 2008 with whole-body MR imaging at 1.5 T (SHIP-MR). We reviewed more than 100 publications that used the SHIP-MR data and analyzed which sequences already produced fruitful scientific outputs and which manuscripts have been referenced frequently. Upon reviewing the publications about imaging sequences, those that used T1-weighted structured imaging of the brain and a gradient-echo sequence for R2* mapping obtained the highest scientific output; regarding specific body parts examined, most scientific publications focused on MR sequences involving the brain and the (upper) abdomen. We conclude that population-based MR imaging in cohort studies should define more precise goals when allocating imaging time. In addition, quality control measures might include recording the number and impact of published work, preferably on a bi-annual basis and starting 2 years after initiation of the study. Structured teaching courses may enhance the desired output in areas that appear underrepresented.
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Affiliation(s)
- Norbert Hosten
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, 17475 Greifswald, Germany; (N.H.); (R.B.); (M.D.); (K.H.); (C.R.)
| | - Robin Bülow
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, 17475 Greifswald, Germany; (N.H.); (R.B.); (M.D.); (K.H.); (C.R.)
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, 17475 Greifswald, Germany; (H.V.); (C.O.S.); (A.T.); (T.I.); (W.H.); (J.-F.C.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 10785 Berlin, Germany; (M.N.); (S.F.); (M.D.); (M.R.P.M.); (U.V.); (N.F.); (S.Z.); (A.H.)
| | - Martin Domin
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, 17475 Greifswald, Germany; (N.H.); (R.B.); (M.D.); (K.H.); (C.R.)
| | - Carsten Oliver Schmidt
- Institute for Community Medicine, University Medicine Greifswald, 17475 Greifswald, Germany; (H.V.); (C.O.S.); (A.T.); (T.I.); (W.H.); (J.-F.C.)
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, 17475 Greifswald, Germany; (H.V.); (C.O.S.); (A.T.); (T.I.); (W.H.); (J.-F.C.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 10785 Berlin, Germany; (M.N.); (S.F.); (M.D.); (M.R.P.M.); (U.V.); (N.F.); (S.Z.); (A.H.)
| | - Till Ittermann
- Institute for Community Medicine, University Medicine Greifswald, 17475 Greifswald, Germany; (H.V.); (C.O.S.); (A.T.); (T.I.); (W.H.); (J.-F.C.)
| | - Matthias Nauck
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 10785 Berlin, Germany; (M.N.); (S.F.); (M.D.); (M.R.P.M.); (U.V.); (N.F.); (S.Z.); (A.H.)
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Stephan Felix
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 10785 Berlin, Germany; (M.N.); (S.F.); (M.D.); (M.R.P.M.); (U.V.); (N.F.); (S.Z.); (A.H.)
- Department of Internal Medicine B, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Marcus Dörr
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 10785 Berlin, Germany; (M.N.); (S.F.); (M.D.); (M.R.P.M.); (U.V.); (N.F.); (S.Z.); (A.H.)
- Department of Internal Medicine B, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Marcello Ricardo Paulista Markus
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 10785 Berlin, Germany; (M.N.); (S.F.); (M.D.); (M.R.P.M.); (U.V.); (N.F.); (S.Z.); (A.H.)
- Department of Internal Medicine B, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Uwe Völker
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 10785 Berlin, Germany; (M.N.); (S.F.); (M.D.); (M.R.P.M.); (U.V.); (N.F.); (S.Z.); (A.H.)
- Interfaculty Institute of Genetics and Functional Genomics, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Amro Daboul
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University Medicine Greifswald, 17475 Greifswald, Germany; (A.D.); (C.S.); (T.M.); (S.S.); (R.B.)
| | - Christian Schwahn
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University Medicine Greifswald, 17475 Greifswald, Germany; (A.D.); (C.S.); (T.M.); (S.S.); (R.B.)
| | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, 17475 Greifswald, Germany; (B.H.); (T.K.)
| | - Torsten Mundt
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University Medicine Greifswald, 17475 Greifswald, Germany; (A.D.); (C.S.); (T.M.); (S.S.); (R.B.)
| | - Karl-Friedrich Krey
- Department of Orthodontics, University Medicine Greifswald, 17475 Greifswald, Germany;
| | - Stefan Kindler
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, University Medicine Greifswald, 17475 Greifswald, Germany; (S.K.); (M.M.)
| | - Maria Mksoud
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, University Medicine Greifswald, 17475 Greifswald, Germany; (S.K.); (M.M.)
| | - Stefanie Samietz
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University Medicine Greifswald, 17475 Greifswald, Germany; (A.D.); (C.S.); (T.M.); (S.S.); (R.B.)
| | - Reiner Biffar
- Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University Medicine Greifswald, 17475 Greifswald, Germany; (A.D.); (C.S.); (T.M.); (S.S.); (R.B.)
| | - Wolfgang Hoffmann
- Institute for Community Medicine, University Medicine Greifswald, 17475 Greifswald, Germany; (H.V.); (C.O.S.); (A.T.); (T.I.); (W.H.); (J.-F.C.)
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 10785 Berlin, Germany; (M.N.); (S.F.); (M.D.); (M.R.P.M.); (U.V.); (N.F.); (S.Z.); (A.H.)
- German Centre for Neurodegenerative Diseases (DZNE), Partner Site Rostock/Greifswald, 17489 Greifswald, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, 17475 Greifswald, Germany; (B.H.); (T.K.)
| | - Jean-Francois Chenot
- Institute for Community Medicine, University Medicine Greifswald, 17475 Greifswald, Germany; (H.V.); (C.O.S.); (A.T.); (T.I.); (W.H.); (J.-F.C.)
| | - Andreas Stahl
- Clinic of Ophthalmology, University Medicine Greifswald, 17475 Greifswald, Germany; (A.S.); (F.T.)
| | - Frank Tost
- Clinic of Ophthalmology, University Medicine Greifswald, 17475 Greifswald, Germany; (A.S.); (F.T.)
| | - Nele Friedrich
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 10785 Berlin, Germany; (M.N.); (S.F.); (M.D.); (M.R.P.M.); (U.V.); (N.F.); (S.Z.); (A.H.)
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Stephanie Zylla
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 10785 Berlin, Germany; (M.N.); (S.F.); (M.D.); (M.R.P.M.); (U.V.); (N.F.); (S.Z.); (A.H.)
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Anke Hannemann
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 10785 Berlin, Germany; (M.N.); (S.F.); (M.D.); (M.R.P.M.); (U.V.); (N.F.); (S.Z.); (A.H.)
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Martin Lotze
- Functional Imaging Unit, Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, 17475 Greifswald, Germany;
| | - Jens-Peter Kühn
- Institute and Policlinic of Diagnostic and Interventional Radiology, Medical University, Carl-Gustav Carus, 01307 Dresden, Germany;
| | - Katrin Hegenscheid
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, 17475 Greifswald, Germany; (N.H.); (R.B.); (M.D.); (K.H.); (C.R.)
| | - Christian Rosenberg
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, 17475 Greifswald, Germany; (N.H.); (R.B.); (M.D.); (K.H.); (C.R.)
| | - Georgi Wassilew
- Clinic of Orthopedics, University Medicine Greifswald, 17475 Greifswald, Germany;
| | - Stefan Frenzel
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, 17475 Greifswald, Germany; (S.F.); (K.W.); (H.J.G.)
| | - Katharina Wittfeld
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, 17475 Greifswald, Germany; (S.F.); (K.W.); (H.J.G.)
- German Center of Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Site Greifswald, 17489 Greifswald, Germany
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, 17475 Greifswald, Germany; (S.F.); (K.W.); (H.J.G.)
- German Center of Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Site Greifswald, 17489 Greifswald, Germany
| | - Marie-Luise Kromrey
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, 17475 Greifswald, Germany; (N.H.); (R.B.); (M.D.); (K.H.); (C.R.)
- Correspondence:
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de Kermadec E, Thomassin I, Daraï E, Kolanska K, Chabbert-Buffet N. [Impact of the menstrual cycle on the quality of interpretation of the MRI result in the follow-up of women at genetic risk for breast]. ACTA ACUST UNITED AC 2021; 49:923-929. [PMID: 33771738 DOI: 10.1016/j.gofs.2021.03.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Breast MRI is used as a reference for screening breast cancer among women with a genetic high risk. Its sensitivity and specificity might decrease because of the background parenchymal enhancement. Therefore, it is recommended to plan the MRI between the 7th and the 14th day of the menstrual cycle despite of the burden of this organization. Our aim was to evaluate the interpretation (performance) of the MRI performance when it was done out of this period. METHODS We analyzed the MRI done in the Tenon Hospital among patients with a genetic high risk, without a history of breast cancer, between 2006 and 2016. We analyzed the rate of enhancement hindering the interpretation (EH) - that is to say grade III and IV -, the rate of additional explorations (MRI and biopsy), and the occurrence of interval events in 2 groups according to the programming of the examination: appropriate programming (D7-D14) and inappropriate programming (outside this period). RESULTS In total, 126 MRI were analyzed, done in a population of 62 women with a genetic predisposition to Breast Cancer (BRCA 1 or 2: 91%, others: 9%), median age was 34.5 years old. 84 were in appropriate programming and 42 were in an inappropriate one. The rate of EH was comparable between the two groups (respectively 31% and 35.7%, P=1), as well as the rate of additional explorations (respectively 31% and 45%, P=0.11). CONCLUSION Our results suggest that the programming of screening MRI could be simplified among patients with a genetic predisposition of breast cancer.
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Affiliation(s)
- E de Kermadec
- Service de gynécologie obstétrique médecine de la reproduction, centre de suivi des femmes à risque de cancer, Sorbonne Université site TENON, AP-HP, Paris, France; Réseau sein a risque, AP-HP, Paris, France
| | - I Thomassin
- Réseau sein a risque, AP-HP, Paris, France; Service de radiologie, centre d'imagerie de la femme, Sorbonne Université site TENON, AP-HP, Paris, France
| | - E Daraï
- Service de gynécologie obstétrique médecine de la reproduction, centre de suivi des femmes à risque de cancer, Sorbonne Université site TENON, AP-HP, Paris, France; Réseau sein a risque, AP-HP, Paris, France
| | - K Kolanska
- Service de gynécologie obstétrique médecine de la reproduction, centre de suivi des femmes à risque de cancer, Sorbonne Université site TENON, AP-HP, Paris, France; Réseau sein a risque, AP-HP, Paris, France
| | - N Chabbert-Buffet
- Service de gynécologie obstétrique médecine de la reproduction, centre de suivi des femmes à risque de cancer, Sorbonne Université site TENON, AP-HP, Paris, France; Réseau sein a risque, AP-HP, Paris, France.
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5
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Hu Y, Zhan C, Yang Z, Zhang X, Zhang H, Liu W, Xia L, Ai T. Accelerating acquisition of readout-segmented echo planar imaging with a simultaneous multi-slice (SMS) technique for diagnosing breast lesions. Eur Radiol 2020; 31:2667-2676. [PMID: 33146797 DOI: 10.1007/s00330-020-07393-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/09/2020] [Accepted: 10/08/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To investigate the feasibility and effectiveness of SMS rs-EPI for evaluating breast lesions. METHODS This prospective study was approved by IRB. Ninety-six patients had 102 histopathologically verified lesions (80 malignant and 22 benign) that were evaluated. Conventional rs-EPI and SMS rs-EPI data were acquired on a 3T scanner. Mean kurtosis (MK), mean diffusion (MD), and apparent diffusion coefficient (ADC) values were quantitatively calculated for each lesion on both sequences. Images were qualitatively and quantitatively analyzed with respect to image sharpness, geometric distortion, lesion conspicuity, anatomic structure, overall image quality, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). Student's t test, Pearson correlation, receiver operating characteristic curve, Wilcoxon rank sum test, and paired-sample t tests were used for statistical analysis. RESULTS Compared to conventional rs-EPI, the acquisition time of SMS rs-EPI was markedly reduced (2:17 min vs 4:27 min). Pearson's correlations showed excellent linear relationships for each parameter between conventional rs-EPI and SMS rs-EPI (MK, r = 0.908; MD, r = 0.938; and ADC, r = 0.975; p < 0.01 for all). Furthermore, SMS rs-EPI had similar diagnostic performance compared with conventional rs-EPI. SMS rs-EPI had comparable visual image quality as conventional rs-EPI, with excellent inter-reader reliability (ICC = 0.851-0.940). No differences existed between conventional rs-EPI and SMS rs-EPI for either SNR or CNR (p > 0.05). CONCLUSIONS Applying the SMS technique can significantly reduce the acquisition time and produce similar diagnostic accuracy while generating comparable image quality as the conventional rs-EPI. KEY POINTS • SMS rs-EPI reduces scan time from 4:27 min to 2:17 min compared with conventional rs-EPI. • SMS rs-EPI has a comparable diagnostic performance to conventional rs-EPI in the differentiation between malignant and benign breast lesions. • SMS rs-EPI demonstrates comparable image quality to conventional rs-EPI with shorter scan time.
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Affiliation(s)
- Yiqi Hu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Chenao Zhan
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Zhenlu Yang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Xiaoyong Zhang
- MR Collaborations, Siemens Healthcare, Shenzhen, 518000, China
| | - Huiting Zhang
- MR Scientific Marketing, Siemens Healthcare, Wuhan, 430030, Hubei, China
| | - Wei Liu
- Siemens Shenzhen Magnetic Resonance, Shenzhen, 518000, China
| | - Liming Xia
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Tao Ai
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
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van der Velden BH, van Rijssel MJ, Lena B, Philippens ME, Loo CE, Ragusi MA, Elias SG, Sutton EJ, Morris EA, Bartels LW, Gilhuijs KG. Harmonization of Quantitative Parenchymal Enhancement in T 1 -Weighted Breast MRI. J Magn Reson Imaging 2020; 52:1374-1382. [PMID: 32491246 PMCID: PMC7687185 DOI: 10.1002/jmri.27244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/19/2020] [Accepted: 05/20/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Differences in imaging parameters influence computer-extracted parenchymal enhancement measures from breast MRI. PURPOSE To investigate the effect of differences in dynamic contrast-enhanced MRI acquisition parameter settings on quantitative parenchymal enhancement of the breast, and to evaluate harmonization of contrast-enhancement values with respect to flip angle and repetition time. STUDY TYPE Retrospective. PHANTOM/POPULATIONS We modeled parenchymal enhancement using simulations, a phantom, and two cohorts (N = 398 and N = 302) from independent cancer centers. SEQUENCE FIELD/STRENGTH 1.5T dynamic contrast-enhanced T1 -weighted spoiled gradient echo MRI. Vendors: Philips, Siemens, General Electric Medical Systems. ASSESSMENT We assessed harmonization of parenchymal enhancement in simulations and phantom by varying the MR parameters that influence the amount of T1 -weighting: flip angle (8°-25°) and repetition time (4-12 msec). We calculated the median and interquartile range (IQR) of the enhancement values before and after harmonization. In vivo, we assessed overlap of quantitative parenchymal enhancement in the cohorts before and after harmonization using kernel density estimations. Cohort 1 was scanned with flip angle 20° and repetition time 8 msec; cohort 2 with flip angle 10° and repetition time 6 msec. STATISTICAL TESTS Paired Wilcoxon signed-rank-test of bootstrapped kernel density estimations. RESULTS Before harmonization, simulated enhancement values had a median (IQR) of 0.46 (0.34-0.49). After harmonization, the IQR was reduced: median (IQR): 0.44 (0.44-0.45). In the phantom, the IQR also decreased, median (IQR): 0.96 (0.59-1.22) before harmonization, 0.96 (0.91-1.02) after harmonization. Harmonization yielded significantly (P < 0.001) better overlap in parenchymal enhancement between the cohorts: median (IQR) was 0.46 (0.37-0.58) for cohort 1 vs. 0.37 (0.30-0.44) for cohort 2 before harmonization (57% overlap); and 0.35 (0.28-0.43) vs. .0.37 (0.30-0.44) after harmonization (85% overlap). DATA CONCLUSION The proposed practical harmonization method enables an accurate comparison between patients scanned with differences in imaging parameters. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY STAGE: 4.
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Affiliation(s)
- Bas H.M. van der Velden
- Image Sciences InstituteUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
| | - Michael J. van Rijssel
- Image Sciences InstituteUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
| | - Beatrice Lena
- Image Sciences InstituteUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
| | - Marielle E.P. Philippens
- Department of RadiotherapyUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
| | - Claudette E. Loo
- Department of RadiologyThe Netherlands Cancer Institute – Antoni van Leeuwenhoek HospitalAmsterdamThe Netherlands
| | - Max A.A. Ragusi
- Image Sciences InstituteUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
| | - Sjoerd G. Elias
- Julius Center for Health Sciences and Primary CareUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
| | - Elizabeth J. Sutton
- Department of RadiologyMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Elizabeth A. Morris
- Department of RadiologyMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Lambertus W. Bartels
- Image Sciences InstituteUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
| | - Kenneth G.A. Gilhuijs
- Image Sciences InstituteUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
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van Rijssel MJ, Pluim JPW, Chan HSM, van den Wildenberg L, Schmitz AMT, Luijten PR, Gilhuijs KGA, Klomp DWJ. Correcting time-intensity curves in dynamic contrast-enhanced breast MRI for inhomogeneous excitation fields at 7T. Magn Reson Med 2019; 84:1000-1010. [PMID: 31880346 PMCID: PMC7217168 DOI: 10.1002/mrm.28147] [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: 08/12/2019] [Revised: 12/05/2019] [Accepted: 12/06/2019] [Indexed: 12/13/2022]
Abstract
Purpose Inhomogeneous excitation at ultrahigh field strengths (7T and above) compromises the reliability of quantified dynamic contrast‐enhanced breast MRI. This can hamper the introduction of ultrahigh field MRI into the clinic. Compensation for this non‐uniformity effect can consist of both hardware improvements and post‐acquisition corrections. This paper investigated the correctable radiofrequency transmit (B1+) range post‐acquisition in both simulations and patient data for 7T MRI. Methods Simulations were conducted to determine the minimum B1+ level at which corrections were still beneficial because of noise amplification. Two correction strategies leading to differences in noise amplification were tested. The effect of the corrections on a 7T patient data set (N = 38) with a wide range of B1+ levels was investigated in terms of time‐intensity curve types as well as washin, washout and peak enhancement values. Results In simulations assuming a common amount of T1 saturation, the lowest B1+ level at which the SNR of the corrected images was at least that of the original precontrast image was 43% of the nominal angle. After correction, time‐intensity curve types changed in 24% of included patients, and the distribution of curve types corresponded better to the distribution found in literature. Additionally, the overlap between the distributions of washin, washout, and peak enhancement values for grade 1 and grade 2 tumors was slightly reduced. Conclusion Although the correctable range varies with the amount of T1 saturation, post‐acquisition correction for inhomogeneous excitation was feasible down to B1+ levels of 43% of the nominal angle in vivo.
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Affiliation(s)
| | - Josien P W Pluim
- Center for Image Sciences, UMC Utrecht, Utrecht, The Netherlands.,Department of Biomedical Engineering, Technische Universiteit Eindhoven, Eindhoven, The Netherlands
| | - Hui-Shan M Chan
- Center for Image Sciences, UMC Utrecht, Utrecht, The Netherlands
| | | | | | - Peter R Luijten
- Center for Image Sciences, UMC Utrecht, Utrecht, The Netherlands
| | | | - Dennis W J Klomp
- Center for Image Sciences, UMC Utrecht, Utrecht, The Netherlands
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Ultrasmall bimodal nanomolecules enhanced tumor angiogenesis contrast with endothelial cell targeting and molecular pharmacokinetics. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2019; 15:252-263. [DOI: 10.1016/j.nano.2018.10.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 10/01/2018] [Accepted: 10/05/2018] [Indexed: 11/20/2022]
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9
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Ha R, Mango V, Al-Khalili R, Mema E, Friedlander L, Desperito E, Wynn RT. Evaluation of association between degree of background parenchymal enhancement on MRI and breast cancer subtype. Clin Imaging 2018; 51:307-310. [PMID: 29945057 DOI: 10.1016/j.clinimag.2018.05.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 04/30/2018] [Accepted: 05/04/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE Evaluate possible association between BPE and breast cancer tumor type/prognostic markers. METHODS IRB approved retrospective study from 1/2010-1/2014 identified 328 patients who had breast MRI and available clinical/pathology data. BPE was categorized according to BI-RADS. The association between BPE and breast cancer molecular subtype/prognostic factors was evaluated. RESULTS No significant association was present between high BPE and the following: HER2+ tumors, basal tumors, tumors with axillary nodal disease, high nuclear grade tumors, high Ki-67 index tumors or larger tumors. CONCLUSION Patients with high BPE may be at increased risk for breast cancer but not necessarily for those cancer subtypes with a poor prognosis.
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Affiliation(s)
- Richard Ha
- Columbia University Medical Center, Breast Imaging Section, Department of Radiology, 622 West 168th Street, PB-1-301, New York, NY 10032, United States.
| | - Victoria Mango
- Memorial Sloan Kettering Cancer Center, Department of Radiology, 300 East 66th Street, New York, NY 10065, United States
| | - Rend Al-Khalili
- Department of Radiology, Georgetown University School of Medicine, CCC Building, 3800 Reservoir Road, N.W., Washington, DC 20007-2113, United states
| | - Eralda Mema
- Columbia University Medical Center, Department of Radiology, 622 West 168th Street, PB-1-301, New York, NY 10032, United States
| | - Lauren Friedlander
- Columbia University Medical Center, Department of Radiology, 622 West 168th Street, PB-1-301, New York, NY 10032, United States
| | - Elise Desperito
- Columbia University Medical Center, Department of Radiology, 622 West 168th Street, PB-1-301, New York, NY 10032, United States
| | - Ralph T Wynn
- Columbia University Medical Center, Department of Radiology, 622 West 168th Street, PB-1-301, New York, NY 10032, United States
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10
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Machida Y, Shimauchi A, Kuroki Y, Tozaki M, Kato Y, Hoshi K, Fukuma E. Single focus on breast magnetic resonance imaging: diagnosis based on kinetic pattern and patient age. Acta Radiol 2017; 58:652-659. [PMID: 27664278 DOI: 10.1177/0284185116668212] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background Because of its small size, a focus in breast magnetic resonance imaging (MRI) must be evaluated on the basis of characteristics other than morphologic features. Patient-related factors including patient age, in conjunction with lesion-related factors, could be useful for decision-making. Purpose To assess the probability of malignant foci based on both lesion- and patient-related factors, and to propose a relevant decision-making method. Material and Methods Foci in our breast MRI database dating from April 2006 to June 2013 were retrospectively identified and analyzed. A Fisher's exact test or a Mann-Whitney U test were performed for univariate analyses, and factors that showed a significant association with outcome in the univariate analyses were subjected to multivariate analysis using a logistic regression model. A decision tree was then drawn using the significant predictors confirmed by multivariate analysis. Results In total, 184 foci (168 benign, 16 malignant) in 184 patients were analyzed in our study. The presence of a washout pattern and older age were found to be significant predictors of malignancy ( P < 0.0001; odds ratio [OR], 17.8; P = 0.021; OR, 1.1, respectively). The main decisive node on the decision tree was the presence of a washout pattern, followed by whether the patient's age was >63 years. Conclusion An enhancing focus showing a washout pattern, especially in older patients, may warrant immediate biopsy rather than short-interval follow-up.
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Affiliation(s)
- Youichi Machida
- Kameda Kyobashi Clinic, Tokyo, Japan
- Kameda Medical Center, Chiba, Japan
| | | | - Yoshifumi Kuroki
- Kameda Kyobashi Clinic, Tokyo, Japan
- Sagara Hospital Affiliated Breast Center, Kagoshima City, Japan
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Öztürk M, Polat AV, Süllü Y, Tomak L, Polat AK. Background Parenchymal Enhancement and Fibroglandular Tissue Proportion on Breast MRI: Correlation with Hormone Receptor Expression and Molecular Subtypes of Breast Cancer. THE JOURNAL OF BREAST HEALTH 2017; 13:27-33. [PMID: 28331765 DOI: 10.5152/tjbh.2016.3247] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 10/21/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To assess the relationship between background parenchymal enhancement (BPE) and fibroglandular tissue (FGT) proportion on breast magnetic resonance imaging (MRI) and hormone receptor expression and molecular subtypes in invasive breast cancer. MATERIALS AND METHODS This retrospective study enrolled 75 breast cancer patients who underwent breast MRI before treatment. T1-weighted images were reviewed to determine the FGT proportion, and contrast-enhanced fat-suppressed T1-weighted images were reviewed to determine BPE. Estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2-neu (HER2) status, and molecular subtypes of the tumors were compared with the BPE and FGT proportions. RESULTS Women with high BPE tended to have increased rate of ER and PR positive tumors (p=0.018 and p=0.013). FGT proportion was associated with ER positivity (p=0.009), but no significant differences between FGT proportion and PR positivity were found (p=0.256). There was no significant difference between HER2 status and any of the imaging features (p=0.453 and p=0.922). For premenopausal women, both FGT proportion and BPE were associated with molecular subtypes (p=0.025 and p=0.042). FGT proportion was also associated with BPE (p<0.001). CONCLUSION In women with invasive breast cancer, both high FGT containing breasts and high BPE breasts tended to have ER positive tumors.
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Affiliation(s)
- Mesut Öztürk
- Department of Radiology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Ahmet Veysel Polat
- Department of Radiology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Yurdanur Süllü
- Department of Pathology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Leman Tomak
- Department of Medical Biostatistics, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Ayfer Kamalı Polat
- Department of General Surgery, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
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Bignotti B, Signori A, Valdora F, Rossi F, Calabrese M, Durando M, Mariscotto G, Tagliafico A. Evaluation of background parenchymal enhancement on breast MRI: a systematic review. Br J Radiol 2016; 90:20160542. [PMID: 27925480 DOI: 10.1259/bjr.20160542] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To perform a systematic review of the methods used for background parenchymal enhancement (BPE) evaluation on breast MRI. METHODS Studies dealing with BPE assessment on breast MRI were retrieved from major medical libraries independently by four reviewers up to 6 October 2015. The keywords used for database searching are "background parenchymal enhancement", "parenchymal enhancement", "MRI" and "breast". The studies were included if qualitative and/or quantitative methods for BPE assessment were described. RESULTS Of the 420 studies identified, a total of 52 articles were included in the systematic review. 28 studies performed only a qualitative assessment of BPE, 13 studies performed only a quantitative assessment and 11 studies performed both qualitative and quantitative assessments. A wide heterogeneity was found in the MRI sequences and in the quantitative methods used for BPE assessment. CONCLUSION A wide variability exists in the quantitative evaluation of BPE on breast MRI. More studies focused on a reliable and comparable method for quantitative BPE assessment are needed. Advances in knowledge: More studies focused on a quantitative BPE assessment are needed.
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Affiliation(s)
- Bianca Bignotti
- 2 Department of Health Sciences, Institute of Statistics, University of Genoa, Genoa, Italy
| | - Alessio Signori
- 3 Department of Experimental Medicine, Institute of Anatomy, University of Genoa, Genoa, Italy
| | | | - Federica Rossi
- 1 Department of Health Sciences, University of Genova, Genoa, Italy
| | - Massimo Calabrese
- 5 IRCCS AOU San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
| | - Manuela Durando
- 6 Department of Diagnostic Imaging and Radiotherapy, AOU Città della Salute e della Scienza of Turin, Breast Imaging Service, Division of Radiology, University of Turin, Turin, Italy
| | - Giovanna Mariscotto
- 6 Department of Diagnostic Imaging and Radiotherapy, AOU Città della Salute e della Scienza of Turin, Breast Imaging Service, Division of Radiology, University of Turin, Turin, Italy
| | - Alberto Tagliafico
- 3 Department of Experimental Medicine, Institute of Anatomy, University of Genoa, Genoa, Italy.,5 IRCCS AOU San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy
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13
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Krug B, Hellmich M, Ulhaas A, Krämer S, Rhiem K, Zarghooni V, Püsken M, Schwabe H, Grinstein O, Markiefka B, Maintz D. Vacuum-assisted breast biopsies (VAB) carried out on an open 1.0T MR imager: Influence of patient and target characteristics on the procedural and clinical results. Eur J Radiol 2016; 85:1157-66. [PMID: 27161066 DOI: 10.1016/j.ejrad.2016.02.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 02/25/2016] [Accepted: 02/29/2016] [Indexed: 01/12/2023]
Abstract
PURPOSE The study was conducted in order to assess the clinical impact of MRI-guided vacuum-assisted breast biopsies carried out using an open 1.0T open MRI-system. MATERIAL AND METHODS The clinical, imaging, interventional and histological data of all 132 patients with a first MRI-guided vacuum-assisted breast biopsy carried out between 07/2005 and 03/2012at the Radiological Department were extracted from the clinical files. The clinical outcome of patients with benign histological findings was assessed based on the clinical files and queries of the local gynecologists in charge. In the 103 interventional image data sets available target localization and target size were evaluated by two board-certified senior radiologists. Clinical data, lesion characteristics and interventional results were evaluated statistically using subgroup analyses. RESULTS 131 of 132 MRI-guided breast biopsies (99.2%) were carried out successfully. The median interventional duration was 30min (25%-percentile 25min, 75%-percentile 35min, maximum 75min). Minor complications occurred in 12 interventions of the 131 (9.2%). The histological work-up of the biopsy specimen showed benign results in 98 of 131 interventions (74.8%), lesions with uncertain biological potential in 5 biopsies (3.8%) and malignant findings in 28 biopsies (21.4%). There were 2 false negative histological findings. Neither the patient age nor the medical history nor the anticipated risk of developing breast cancer had an impact on the success rates and the complication rates. In the 103 interventions with available image data sets the maximum target lesion diameters were 1-5mm in 16 lesions (15.5%), 6-10mm in 41 lesions (39.8%) and 11-15mm in 29 lesions (28.2%). There was a positive correlation between the maximum diameters and the rate of malignancy of the target lesions (p=0.020) as well as a trend towards longer interventional procedure durations in smaller target lesions (p=0.183). CONCLUSION MRI-guided vacuum-assisted breast biopsy for suspicious breast lesions is a clinically safe and feasible method even in small target lesions when using an open high-field MRI-system.
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Affiliation(s)
- Barbara Krug
- Dept. of Diagnostical and Interventional Radiology, University Hospital of Cologne, Germany.
| | - Martin Hellmich
- Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Germany
| | - Angela Ulhaas
- Breast Center and Dept. of Obstetrics and Gynecology, University Hospital of Cologne, Germany
| | - Stefan Krämer
- Breast Center and Dept. of Obstetrics and Gynecology, University Hospital of Cologne, Germany
| | - Kerstin Rhiem
- Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology (CIO) and Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne and University Hospital of Cologne, Germany
| | - Verena Zarghooni
- Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology (CIO) and Center for Molecular Medicine Cologne (CMMC), Medical Faculty, University of Cologne and University Hospital of Cologne, Germany
| | - Michael Püsken
- Dept. of Diagnostical and Interventional Radiology, University Hospital of Cologne, Germany
| | - Hendrik Schwabe
- Dept. of Diagnostical Radiology, Helios Hospital, Siegburg, Germany
| | - Olga Grinstein
- Dept. of Diagnostical and Interventional Radiology, University Hospital of Cologne, Germany
| | | | - David Maintz
- Dept. of Diagnostical and Interventional Radiology, University Hospital of Cologne, Germany
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Diffusion tensor imaging in the normal breast: influences of fibroglandular tissue composition and background parenchymal enhancement. Clin Imaging 2015; 40:506-11. [PMID: 27133695 DOI: 10.1016/j.clinimag.2015.12.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 12/01/2015] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To evaluate effects of fibroglandular tissue (FGT) composition and background parenchymal enhancement (BPE) on diffusion tensor imaging (DTI) parameters in normal breast tissue. METHODS DTI analysis was performed on 35 breasts with regions of interest drawn to include only normal tissue. Breasts were dichotomized by FGT composition and by BPE; DTI parameters were compared. RESULTS The λ1 principal diffusion coefficient was lower in breasts with moderate/marked BPE versus those with minimal/mild BPE (P=.039). All other parameters were unaffected. CONCLUSION λ1 is sensitive to differences in BPE within normal breast tissue that should be taken into account in DTI evaluation.
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Impact of clinical and lesion characteristics on the results of MR-guided wire localizations of the breast using an open 1.0-T MRI system. Invest Radiol 2014; 48:445-51. [PMID: 23538885 DOI: 10.1097/rli.0b013e3182856a91] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Preoperative magnetic resonance (MR)-guided wire localizations are warranted in patients with suspicious focal breast lesions on MR mammographic findings without equivalent in x-ray mammography and ultrasonography. The study was performed to assess the impact of clinical parameters, tumor size, and target localization on the procedural characteristics in magnetic resonance imaging (MRI)-guided wire localizations of breast lesions using an open 1.0-T open MR system. MATERIAL AND METHODS The clinical, radiological, and histological characteristics of all 347 patients and all 394 interventional procedures performed in a 6-year interval were extracted from the clinical files. Two board-certified senior radiologists evaluated the impact of target localization and the size on the interventional results in the available 302 image data sets. Patient characteristics, lesion characteristics, and interventional results were statistically correlated in subgroup analyses. RESULTS A total of 387 of the 394 MR-guided wire localizations (98.2%) were technically successful. In 7 cases (2.3%), the intervention was aborted because the suspicious finding of the diagnostic MR mammography could not be visualized during the intervention. Minor complications occurred in 13 interventions (3.3%). The histological workup of the operative specimen showed benign results in 226 of the 394 interventions (57.4%) and malignant findings in 154 wire localizations (39.1%). The mean (SD) length of the interventional procedure time defined as the time interval between the start of the first and of the last MRI sequence as documented in the electronic MRI data sets was 24.6 (8.4) minutes. Patient age, medical history, and the anticipated risk for developing breast cancer and a simultaneous known carcinoma did not affect the technical success and complication rates and the interventional procedure time. A total of 60 targets (19.5%) were located in the retromamillary zone, 89 targets (28.9%) in the peripheral zone, and 1 target (0.3%) near the chest wall. The maximum diameter was 1 to 5 mm in 64 lesions (21.2%), 6 to 10 mm in 136 lesions (45.0%), 11 to 15 mm in 56 lesions (18.6%), and 16 mm or greater in 46 lesions (15.2%). A total of 23 of the 100 histologically proven invasive carcinomas had a maximum MRI diameter of 1 to 5 mm (23.0%) and 38 (38.0%) of 6 to 10 mm. CONCLUSIONS Magnetic resonance-guided wire localizations of suspicious breast lesions using an open high-field MR system are a clinically safe and feasible method even in small target lesions and anatomical regions that are usually considered difficult to access.
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Millet I, Curros-Doyon F, Molinari N, Bouic-Pages E, Prat X, Alili C, Taourel P. Invasive breast carcinoma: influence of prognosis and patient-related factors on kinetic MR imaging characteristics. Radiology 2013; 270:57-66. [PMID: 24029641 DOI: 10.1148/radiol.13122758] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To retrospectively compare the kinetic magnetic resonance (MR) imaging characteristics of invasive breast carcinomas with both prognostic tumoral and patient-related parameters. MATERIALS AND METHODS This HIPAA-compliant retrospective study was approved by the institutional review board, and informed consent was waived. From January 2008 to January 2011, 273 consecutive women (mean age, 55 years; range, 23-83 years) with invasive breast cancers who had undergone MR imaging were selected. The kinetic curves were retrospectively classified according to the Breast Imaging Reporting and Data System lexicon. Initial enhancement and maximal enhancement percentages, time to peak enhancement, and the signal enhancement ratio were calculated for each lesion. Kinetic characteristics were compared according to tumoral parameters (size, pathologic type, grade, hormone receptor status, and c-erbB-2 status) and patient parameters (menopausal status, personal history of breast carcinoma) by means of univariate and then multivariate analysis by using false-discovery-rate statistics. RESULTS Lesions in menopausal patients exhibited less suspicious quantitative and qualitative characteristics than lesions in nonmenopausal patients. There was an independent association between the kinetic characteristics and menopausal status, with an odds ratio of 2.94 for the lack of rapid initial contrast material uptake and of 2.38 for the lack of washout in menopausal patients as compared with nonmenopausal patients. The odds ratio was 4.00 for not having rapid initial contrast material uptake in patients with a personal history of ipsilateral breast cancer. CONCLUSION Kinetic data in invasive breast cancer are associated with the patient's menopausal status, with a typical kinetic pattern of malignancy being less common in menopausal patients.
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Affiliation(s)
- Ingrid Millet
- From the Department of Imaging, Hospital Lapeyronie (I.M., F.C., E.B., X.P., C.A., P.T.), and Department of Statistics (N.M.), Centre Hospitalo-Universitaire Montpellier, 371 Avenue du Doyen Gaston Giraud, Montpellier 34295, France; and CIC INSERM 1001, University of Montpellier I, Montpellier, France (I.M., P.T.)
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