Korean J Radiol.  2020 Apr;21(5):561-571. 10.3348/kjr.2019.0567.

Ultrafast Dynamic Contrast-Enhanced Breast MRI:Lesion Conspicuity and Size Assessment according toBackground Parenchymal Enhancement

• Kim SY
• Cho N
• Choi Y
• Shin SU
• Kim ES
• Lee SH
• Chang JM
• Moon WK

• KMID: 2500038
• DOI: http://doi.org/10.3348/kjr.2019.0567

Abstract

Objective
To evaluate the clinical utility of ultrafast dynamic contrast-enhanced (DCE)-MRI compared to conventional DCEMRI 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.

Keyword

Ultrafast breast dynamic contrast-enhanced MRI; Lesion conspicuity; Lesion size; Background parenchymal enhancement; Breast cancer