Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Ultrafast Dynamic Contrast-Enhanced Breast MRI: Lesion Conspicuity and Size Assessment according to Background Parenchymal Enhancement

  • Soo-Yeon Kim (Department of Radiology, Seoul National University Hospital) ;
  • Nariya Cho (Department of Radiology, Seoul National University Hospital) ;
  • Yunhee Choi (Medical Research Collaborating Center, Seoul National University Hospital) ;
  • Sung Ui Shin (Department of Radiology, Seoul National University Hospital) ;
  • Eun Sil Kim (Department of Radiology, Seoul National University Hospital) ;
  • Su Hyun Lee (Department of Radiology, Seoul National University Hospital) ;
  • Jung Min Chang (Department of Radiology, Seoul National University Hospital) ;
  • Woo Kyung Moon (Department of Radiology, Seoul National University Hospital)
  • Received : 2019.08.02
  • Accepted : 2020.01.13
  • Published : 2020.05.01
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Abstract

Objective: To evaluate the clinical utility of ultrafast dynamic contrast-enhanced (DCE)-MRI compared to conventional DCE-MRI by studying lesion conspicuity and size according to the level of background parenchymal enhancement (BPE). Materials and Methods: This study included 360 women (median age, 54 years; range, 26-82 years) with 361 who had undergone breast MRI, including both ultrafast and conventional DCE-MRI before surgery, between January and December 2017. Conspicuity was evaluated using a five-point score. Size was measured as the single maximal diameter. The Wilcoxon signed-rank test was used to compare median conspicuity score. To identify factors associated with conspicuity, multivariable logistic regression was performed. Absolute agreement between size at MRI and histopathologic examination was assessed using the intraclass correlation coefficient (ICC). Results: The median conspicuity scores were 5 at both scans, but the interquartile ranges were significantly different (5-5 at ultrafast vs. 4-5 at conventional, p < 0.001). Premenopausal status (odds ratio [OR] = 2.2, p = 0.048), non-mass enhancement (OR = 4.1, p = 0.001), moderate to marked BPE (OR = 7.5, p < 0.001), and shorter time to enhancement (OR = 0.9, p = 0.043) were independently associated with better conspicuity at ultrafast scans. Tumor size agreement between MRI and histopathologic examination was similar for both scans (ICC = 0.66 for ultrafast vs. 0.63 for conventional). Conclusion: Ultrafast DCE-MRI could improve lesion conspicuity compared to conventional DCE-MRI, especially in women with premenopausal status, non-mass enhancement, moderate to marked BPE or short time to enhancement.

Keywords

Acknowledgement

This study has received funding by grant (no.04-2017-0470) from the Seoul National University Hospital Research Fund.

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