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Sample records for dynamic breast mri

  1. Dynamic MRI of the breast.

    Science.gov (United States)

    Ercolani, P; Valeri, G; Amici, F

    1998-05-01

    To describe the rationale, the technical requirements and the examination technique of dynamic magnetic resonance studies of the breast and to assess the role of this method in the clinical diagnostic protocol. We reviewed the relative literature and compared the results with our personal experience. The earliest reports on the possibility of differentiating carcinoma from benign tissue with magnetic resonance imaging came from Germany, where in 1986 Heywang and coworkers used T1-weighted spin-echo sequences before and after i.v. Gd-DTPA administration with an imaging time of approximately 5 mins and 5 mm slice thickness. With advances in magnetic resonance technology, Heywang Koebrunner adopted a static three-dimensional fast low-angle shot technique permitting advantages of three-dimensional imaging and permit dynamic studies (values over 95%. The time/signal intensity curves revealed the rapid and strong enhancement of malignancies, the gradual and strong enhancement of the only fibroadenoma studied, and the gradual and mild contrast uptake of benign dysplasia. In 1992, in nearly 1000 dynamic examinations, Kaiser and Reiser reported 98.3% sensitivity, 97.0% specificity, 82.1% predictive value and 97.2% accuracy. The combination of rapid acquisition with techniques that preserve high spatial resolution may improve specificity by allowing the study of lesion morphology as well as of enhancement patterns. A whole-breast imaging technique has been reported which permits acquisition times < 15 s by partial sampling of the central k-space region superimposed on high-resolution three-dimensional images. Dynamic magnetic resonance imaging of the breast is currently an important step of the clinical protocol of breast diseases, but there is no established study protocol yet.

  2. Dynamic MRI study for breast tumors

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    Seki, Tsuneaki (Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine)

    1990-10-01

    Application of MRI for diagnosis of breast tumors was retrospectively examined in 103 consecutive cases. Contrast enhancement, mostly by dynamic study, was performed in 83 cases using Gd-DTPA and 0.5 T superconductive apparatus. Results were compared to those of mammography and sonography. On dynamic study, carcinoma showed abrupt rise of signal intensity with clear-cut peak formation in early phase, while benign fibroadenoma showed slow rise of signal intensity and prolonged enhancement without peak formation. In 12 of 33 carcinomas (33%), peripheral ring enhancement was noted reflecting vascular stroma of histologic sections. All fibroadenomas showed homogenous enhancement without peripheral ring. In MRI, sensitivity, specificity, and accuracy were 86%, 96%, 91%. In mammography 82%, 95%, 87% and in ultrasonography 91%, 95%, 93%. Although MRI should not be regarded as routine diagnostic procedure because of expense and limited availability, it may afford useful additional information when standard mammographic findings are not conclusive. (author).

  3. Typical atypical findings on dynamic MRI of the breast

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    Kurz, Kathinka D., E-mail: kurk@sus.no [Department of Radiology, Stavanger University Hospital, Postbox 8100, 4068 Stavanger (Norway); Roy, Sumit, E-mail: rosu@sus.no [Department of Radiology, Stavanger University Hospital, Postbox 8100, 4068 Stavanger (Norway); Moedder, Ulrich, E-mail: Moedder@uni-duesseldorf.de [Institute of Diagnostic Radiology, Duesseldorf University Hospital (Germany); Skaane, Per, E-mail: Per.Skaane@ulleval.no [Department of Radiology, Ullevaal University Hospital, University of Oslo (Norway); Saleh, Andreas, E-mail: saleh@uni-duesseldorf.de [Institute of Diagnostic Radiology, Duesseldorf University Hospital (Germany)

    2010-11-15

    Dynamic contrast enhanced magnetic resonance imaging (DCE MRI) of the breast has become an important tool to detect and characterize breast disease. The American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) provides a standardized vocabulary for describing the morphologic features and contrast kinetics of breast lesions. However, some lesions may show morphologic and dynamic MR features not consistent with their histologic nature resulting in incorrect categorization as malignant or benign. Another cause of diagnostic problems is artifacts. Thus correct interpretation of dynamic MRI of the breast demands knowledge of the most common pitfalls encountered in clinical practice. A pictorial overview of these is presented, with particular reference to the differentiation of malignant tumors from benign lesions.

  4. Dynamic MRI of breast fibroadenoma: pathologic correlation

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    Oh, Ki Keun; Hahm, Jin kyeung; Yoon, Pyong Ho; Jeong, Eun Kee [Yonsei University, College of Medicine, Seoul (Korea, Republic of)

    1995-09-15

    To analyze the dynamic MR imaging of breast fibroadenoma according to the histologic type for differentiation from breast carcinoma. Dynamic MR images of 26 lesions from 22 breasts in 19 patients showing atypical clinical features or film mammogram and ultrasound manifestations were performed. We analyzed the speed and the maximal amount of contrast enhancement and the patterns, such as shape, border, and internal signal intensity, among the histologic types during five minutes after contrast injection. The speed and maximal amount of contrast enhancement of fibroadenoma were in descending order of myxoid, sclerotic, glandular, and calcified types. Among these, the value of maximal amount of contrast enhancement of myxoid and sclerotic type were more than 700 NU, but only myxoid type was enhanced more than 700 NU within the first 1 minute after contrast injection, similar to the findings of carcinoma. In general, fibroadenoma showed the tendency of smooth surface(69%), well-defined border(88%) with safety rim, and internal homogeneous signal intensity(65%). However, sclerotic type of fibroadenoma had relatively high incidence of heterogeneous internal signal intensity(78%) after Gd-DTPA injection. Dynamic MR imaging of atypical breast fibroadenoma mimicking breast malignancy was very useful in differentiation it from carcinoma and had the benefit of classifying fibroadenoma according to its histologic types.

  5. Computerized Interpretation of Dynamic Breast MRI

    Science.gov (United States)

    2006-05-01

    planning , and treatment response monitoring. X-Ray mammography has shown considerable success in screening for the early detection of breast cancer; however...observer is highly accurate (8) Automatic tumor delineation is of clinical value, for example, in surgical planning or follow-up during neoad- juvant... Venta LA, Vyborny CJ. Automatic segmentation of breast lesions on ultrasound. Med Phys 2001; 28:1652–1659. 14. Madabhushi A, Metaxas DN. Combining low

  6. Dynamic contrast-enhanced MRI for monitoring response to neoadjuvant chemotherapy in breast cancer

    OpenAIRE

    Loo, C E

    2016-01-01

    The general aim of this thesis is to investigate the role of dynamic contrast-enhanced MRI in monitoring response of breast cancer during neoadjuvant chemotherapy. The role of MRI with respect to achieving personalized breast cancer treatment by improving response monitoring is examined. Our findings demonstrate the potential clinical relevance of contrast-enhanced MRI for monitoring response of breast cancer during and after neoadjuvant chemotherapy. We defined MRI criteria ( reduction < 25%...

  7. Vascular characterisation of triple negative breast carcinomas using dynamic MRI

    Energy Technology Data Exchange (ETDEWEB)

    Li, Sonia P.; Beresford, Mark J.; Ah-See, Mei-Lin W.; Makris, Andreas [Mount Vernon Cancer Centre, Academic Oncology Unit, Northwood, Middlesex (United Kingdom); Padhani, Anwar R.; Taylor, N.J.; Stirling, J.J. [Mount Vernon Hospital, Paul Strickland Scanner Centre, Northwood, Middlesex (United Kingdom); D' Arcy, James A.; Collins, David J. [Royal Marsden NHS Foundation Trust and Institute of Cancer Research, CR UK and EPSRC Cancer Imaging Centre, Sutton, Surrey (United Kingdom)

    2011-07-15

    Triple-negative (ER-/PR-/HER2-) breast carcinomas (TNBC) are aggressive tumours with underexplored imaging features. This study investigates whether their vascular characteristics as assessed by dynamic contrast-enhanced (DCE) and dynamic susceptibility contrast-enhanced (DSC) MRI are distinct from the prognostically more favourable ER+/PR+/HER2- cancers. Patients with primary breast cancer underwent MRI before neoadjuvant chemotherapy and were identified as ER-/PR-/HER2- or ER+/PR+/HER2- from core biopsy specimens. MRI parameters reflecting tissue perfusion, permeability, and extracellular leakage space were measured. Values for inflow transfer constant (K{sup trans}), outflow rate constant (k{sub ep}), leakage space (v{sub e}), area under the gadolinium curve (IAUGC{sub 60}), relative blood volume (rBV) and flow (rBF), and Mean Transit Time (MTT) were compared across receptor status and with known prognostic variables. Thirty seven patients were assessable in total (16 ER-/PR-/HER2-, 21 ER+/PR+/HER2-). Lower v{sub e} (p = 0.001), shorter MTT (p = 0.007) and higher k{sub ep} values (p = 0.044) were observed in TNBC. v{sub e} was lower across all T stages, node-negative (p = 0.004) and low-grade TNBC (p = 0.037). v{sub e} was the best predictor of triple negativity (ROC AUC 0.80). TNBC possess characteristic features on imaging, with lower extracellular space (higher cell density) and higher contrast agent wash-out rate (higher vascular permeability) suggesting a distinctive phenotype detectable by MRI. (orig.)

  8. Breast MRI scan

    Science.gov (United States)

    MRI - breast; Magnetic resonance imaging - breast; Breast cancer - MRI; Breast cancer screening - MRI ... radiologist) see some areas more clearly. During the MRI, the person who operates the machine will watch ...

  9. Dynamic contrast-enhanced MRI for monitoring response to neoadjuvant chemotherapy in breast cancer

    NARCIS (Netherlands)

    Loo, C.E.

    2016-01-01

    The general aim of this thesis is to investigate the role of dynamic contrast-enhanced MRI in monitoring response of breast cancer during neoadjuvant chemotherapy. The role of MRI with respect to achieving personalized breast cancer treatment by improving response monitoring is examined. Our finding

  10. Differentiation of breast cancer from fibroadenoma with dual-echo dynamic contrast-enhanced MRI.

    Directory of Open Access Journals (Sweden)

    Shiwei Wang

    Full Text Available Dynamic contrast-enhanced magnetic resonance imaging (DCE MRI of the breast is a routinely used imaging method which is highly sensitive for detecting breast malignancy. Specificity, though, remains suboptimal. Dynamic susceptibility contrast magnetic resonance imaging (DSC MRI, an alternative dynamic contrast imaging technique, evaluates perfusion-related parameters unique from DCE MRI. Previous work has shown that the combination of DSC MRI with DCE MRI can improve diagnostic specificity, though an additional administration of intravenous contrast is required. Dual-echo MRI can measure both T1W DCE MRI and T2*W DSC MRI parameters with a single contrast bolus, but has not been previously implemented in breast imaging. We have developed a dual-echo gradient-echo sequence to perform such simultaneous measurements in the breast, and use it to calculate the semi-quantitative T1W and T2*W related parameters such as peak enhancement ratio, time of maximal enhancement, regional blood flow, and regional blood volume in 20 malignant lesions and 10 benign fibroadenomas in 38 patients. Imaging parameters were compared to surgical or biopsy obtained tissue samples. Receiver operating characteristic (ROC curves and area under the ROC curves were calculated for each parameter and combination of parameters. The time of maximal enhancement derived from DCE MRI had a 90% sensitivity and 69% specificity for predicting malignancy. When combined with DSC MRI derived regional blood flow and volume parameters, sensitivity remained unchanged at 90% but specificity increased to 80%. In conclusion, we show that dual-echo MRI with a single administration of contrast agent can simultaneously measure both T1W and T2*W related perfusion and kinetic parameters in the breast and the combination of DCE MRI and DSC MRI parameters improves the diagnostic performance of breast MRI to differentiate breast cancer from benign fibroadenomas.

  11. Pharmacokinetic analysis of Gd-DTPA enhancement in dynamic three-dimensional MRI of breast lesions

    NARCIS (Netherlands)

    denBoer, JA; Hoenderop, RKKM; Smink, J; Dornseiffen, G; Koch, PWAA; Mulder, JH; Slump, CH; Volker, EDP; deVos, RAI

    1997-01-01

    The purpose of this study was to demonstrate that dynamic MRI covering both breasts can provide sensitivity for tumor detection as well as specificity and sensitivity for differentiation of tumor malignancy, Three-dimensional gradient echo scans were used covering both breasts. Before Gd-DTPA bolus

  12. [The actions of diffusion weighted imaging (DWI) and dynamic contrast enhanced MRI in differentiating breast tumors].

    Science.gov (United States)

    Luo, Yi; Yu, Jianqun; Chen, Dongdong; Xu, Zhongzi; Zeng, Hanjiang

    2013-12-01

    We studied the actions of diffusion weighted imaging (DWI) and dynamic contrast enhanced (DCE) magnetic resonance imaging (MRI) in differentiating breast tumors. From January 2010 to February 2012, we retrospectively analyzed data of 95 cases with breast tumor pathologically confirmed from DWI and DCE-MRI. We compared the ADC value, time-intensity curve (TIC) and DCE-MRI parameters between breast tumors, and calculated the sensitivity and specificity for differentiating breast tumors. The results were as follows: (1) On DWI, mean ADC value of malignant tumor was lower than that of benign tumor (P value of time to peak (Tpeak) and maximal enhancement ratio (SImax) were lower than that of benign tumor (all P < 0.05). As for TIC, type II and III were more frequently seen in malignant tumor than in benign tumor whereas type I was more common in benign tumor than in malignant tumor (all P < 0.05). For differentiating breast malignant tumors from benign neoplasm, DCE-MRI obtained a sensitivity of 89.7% and specificity of 70.3%. (3) For differentiating breast malignant tumors from benign neoplasm, ADC value together with TIC obtained a sensitivity of 79.3% and specificity of 78.4%. Malignant or benign breast tumors could have their own unique characteristics on DWI and DCE-MRI. These characteristics might be helpful for differentiating these tumors.

  13. Breast fibromatosis response to tamoxifen: dynamic MRI findings and review of the current treatment options.

    Science.gov (United States)

    Plaza, Michael J; Yepes, Monica

    2012-03-01

    Breast fibromatosis is a rare entity responsible for 0.2% of all solid breast tumors. It has been associated with scars, pregnancy, implants, and familial adenomatous polyposis. We present an interesting case of breast fibromatosis in a 29 year old woman which encroached upon her saline implant and subsequently filled its cavity once the implant was removed. The patient was put on tamoxifen therapy and at 14 month follow-up there was a significant decrease in the size of the mass. Dynamic MRI images are offered for review and current treatment options are discussed.

  14. The Added Diagnostic Value of Dynamic Contrast-Enhanced MRI at 3.0 T in Nonpalpable Breast Lesions

    Science.gov (United States)

    Merckel, Laura G.; Verkooijen, Helena M.; Peters, Nicky H. G. M.; Mann, Ritse M.; Veldhuis, Wouter B.; Storm, Remmert K.; Weits, Teun; Duvivier, Katya M.; van Dalen, Thijs; Mali, Willem P. Th. M.; Peeters, Petra H. M.; van den Bosch, Maurice A. A. J.

    2014-01-01

    Objective To investigate the added diagnostic value of 3.0 Tesla breast MRI over conventional breast imaging in the diagnosis of in situ and invasive breast cancer and to explore the role of routine versus expert reading. Materials and Methods We evaluated MRI scans of patients with nonpalpable BI-RADS 3–5 lesions who underwent dynamic contrast-enhanced 3.0 Tesla breast MRI. Initially, MRI scans were read by radiologists in a routine clinical setting. All histologically confirmed index lesions were re-evaluated by two dedicated breast radiologists. Sensitivity and specificity for the three MRI readings were determined, and the diagnostic value of breast MRI in addition to conventional imaging was assessed. Interobserver reliability between the three readings was evaluated. Results MRI examinations of 207 patients were analyzed. Seventy-eight of 207 (37.7%) patients had a malignant lesion, of which 33 (42.3%) patients had pure DCIS and 45 (57.7%) invasive breast cancer. Sensitivity of breast MRI was 66.7% during routine, and 89.3% and 94.7% during expert reading. Specificity was 77.5% in the routine setting, and 61.0% and 33.3% during expert reading. In the routine setting, MRI provided additional diagnostic information over clinical information and conventional imaging, as the Area Under the ROC Curve increased from 0.76 to 0.81. Expert MRI reading was associated with a stronger improvement of the AUC to 0.87. Interobserver reliability between the three MRI readings was fair and moderate. Conclusions 3.0 T breast MRI of nonpalpable breast lesions is of added diagnostic value for the diagnosis of in situ and invasive breast cancer. PMID:24713637

  15. The added diagnostic value of dynamic contrast-enhanced MRI at 3.0 T in nonpalpable breast lesions.

    Directory of Open Access Journals (Sweden)

    Laura G Merckel

    Full Text Available OBJECTIVE: To investigate the added diagnostic value of 3.0 Tesla breast MRI over conventional breast imaging in the diagnosis of in situ and invasive breast cancer and to explore the role of routine versus expert reading. MATERIALS AND METHODS: We evaluated MRI scans of patients with nonpalpable BI-RADS 3-5 lesions who underwent dynamic contrast-enhanced 3.0 Tesla breast MRI. Initially, MRI scans were read by radiologists in a routine clinical setting. All histologically confirmed index lesions were re-evaluated by two dedicated breast radiologists. Sensitivity and specificity for the three MRI readings were determined, and the diagnostic value of breast MRI in addition to conventional imaging was assessed. Interobserver reliability between the three readings was evaluated. RESULTS: MRI examinations of 207 patients were analyzed. Seventy-eight of 207 (37.7% patients had a malignant lesion, of which 33 (42.3% patients had pure DCIS and 45 (57.7% invasive breast cancer. Sensitivity of breast MRI was 66.7% during routine, and 89.3% and 94.7% during expert reading. Specificity was 77.5% in the routine setting, and 61.0% and 33.3% during expert reading. In the routine setting, MRI provided additional diagnostic information over clinical information and conventional imaging, as the Area Under the ROC Curve increased from 0.76 to 0.81. Expert MRI reading was associated with a stronger improvement of the AUC to 0.87. Interobserver reliability between the three MRI readings was fair and moderate. CONCLUSIONS: 3.0 T breast MRI of nonpalpable breast lesions is of added diagnostic value for the diagnosis of in situ and invasive breast cancer.

  16. Assessment of three different software systems in the evaluation of dynamic MRI of the breast

    Energy Technology Data Exchange (ETDEWEB)

    Kurz, K.D. [Department of Radiology, Stavanger University Hospital, Postbox 8100, Stavanger (Norway)], E-mail: kurk@sus.no; Steinhaus, D. [Institute of Daignostic Radiology, Duesseldorf University Hospital, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: Daniele.Steinhaus@med.uni-duesseldorf.de; Klar, V. [Institute of Daignostic Radiology, Duesseldorf University Hospital, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: verena.klar@uni-duesseldorf.de; Cohnen, M. [Institute of Daignostic Radiology, Duesseldorf University Hospital, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: cohnen@med.uni-duesseldorf.de; Wittsack, H.J. [Institute of Daignostic Radiology, Duesseldorf University Hospital, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: wittsack@uni-duesseldorf.de; Saleh, A. [Institute of Daignostic Radiology, Duesseldorf University Hospital, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: saleh@uni-duesseldorf.de; Moedder, U. [Institute of Daignostic Radiology, Duesseldorf University Hospital, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: moedder@med.uni-duesseldorf.de; Blondin, D. [Institute of Daignostic Radiology, Duesseldorf University Hospital, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: blondin@med.uni-duesseldorf.de

    2009-02-15

    Objective: The aim was to compare the diagnostic performance and handling of dynamic contrast-enhanced MRI of the breast with two commercial software solutions ('CADstream' and '3TP') and one self-developed software system ('Mammatool'). Materials and methods: Identical data sets of dynamic breast MRI from 21 patients were evaluated retrospectively with all three software systems. The exams were classified according to the BI-RADS classification. The number of lesions in the parametric mapping was compared to histology or follow-up of more than 2 years. In addition, 25 quality criteria were judged by 3 independent investigators with a score from 0 to 5. Statistical analysis was performed to document the quality ranking of the different software systems. Results: There were 9 invasive carcinomas, one pure DCIS, one papilloma, one radial scar, three histologically proven changes due to mastopathy, one adenosis and two fibroadenomas. Additionally two patients with enhancing parenchyma followed with MRI for more than 3 years and one scar after breast conserving therapy were included. All malignant lesions were classified as BI-RADS 4 or 5 using all software systems and showed significant enhancement in the parametric mapping. 'CADstream' showed the best score on subjective quality criteria. '3TP' showed the lowest number of false-positive results. 'Mammatool' produced the lowest number of benign tissues indicated with parametric overlay. Conclusion: All three software programs tested were adequate for sensitive and efficient assessment of dynamic MRI of the breast. Improvements in specificity may be achievable.

  17. Statistical comparison of dynamic contrast-enhanced MRI pharmacokinetic models in human breast cancer.

    Science.gov (United States)

    Li, Xia; Welch, E Brian; Chakravarthy, A Bapsi; Xu, Lei; Arlinghaus, Lori R; Farley, Jaime; Mayer, Ingrid A; Kelley, Mark C; Meszoely, Ingrid M; Means-Powell, Julie; Abramson, Vandana G; Grau, Ana M; Gore, John C; Yankeelov, Thomas E

    2012-07-01

    By fitting dynamic contrast-enhanced MRI data to an appropriate pharmacokinetic model, quantitative physiological parameters can be estimated. In this study, we compare four different models by applying four statistical measures to assess their ability to describe dynamic contrast-enhanced MRI data obtained in 28 human breast cancer patient sets: the chi-square test (χ(2)), Durbin-Watson statistic, Akaike information criterion, and Bayesian information criterion. The pharmacokinetic models include the fast exchange limit model with (FXL_v(p)) and without (FXL) a plasma component, and the fast and slow exchange regime models (FXR and SXR, respectively). The results show that the FXL_v(p) and FXR models yielded the smallest χ(2) in 45.64 and 47.53% of the voxels, respectively; they also had the smallest number of voxels showing serial correlation with 0.71 and 2.33%, respectively. The Akaike information criterion indicated that the FXL_v(p) and FXR models were preferred in 42.84 and 46.59% of the voxels, respectively. The Bayesian information criterion also indicated the FXL_v(p) and FXR models were preferred in 39.39 and 45.25% of the voxels, respectively. Thus, these four metrics indicate that the FXL_v(p) and the FXR models provide the most complete statistical description of dynamic contrast-enhanced MRI time courses for the patients selected in this study.

  18. Diagnositc value of 3D-gradient echo dynamic contrast enhanced MRI in breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Ik; Chung, Soo Young; Park, Hai Jung; Lee, Yul; Chung, Bong Wha; Shim, Jeong Won [Hallym Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-10-01

    To assess the usefulness of 3D-gradient echo dynamic contrast enhanced MRI (3D-DMRI) in the diagnosis of breast cancer and to determine the most useful parameter for this diagnosis. Using a 1.0T MR unit, (Magnetom, Siemens, Erlaugen, Germany), 3D-DMRI (TR/TE=3D30/12) with Gd-DTPA was performed in 38 cases of breast cancer, 22 of fibroadenoma, and in three normal volunteers. We retrospectively evaluated the findings according to the speed on dynamic study and maximal amount of contrast enhancement during the delayed phase;we calculated the contrast index and morphology of the cancers and compared diagnostic accuracy among these three diagnostic parameters. On conventional spin-echo T1-and T2-weighted images, there was no significant difference of signal intensity between benign fibroadenoma and breast carcinoma. Rapid contrast enhancement (within one minute) was noted in 35 breast cancer lesions (92.1%), but relatively low and slow contrast enhancement (after five minutes) was noted in three such lesions (7.9%). Gradual contrast enhancement was noted in 21 lesions of fibroadenoma(95.5%), but a moderate degree of rapid contrast enhancement (from three to five minutes) was noted in the other case (7.9%). of On the delayed enhanced phase of 3D-DMRI, the maximal amount of contrast enhancement showed no significant difference between fibroadenoma and cancer. On 3D-DMRI, an irregular, spiculated border, with high contrast enhancement was noted in all cases of breast cancer, in particular, irregular thick peripheral contrast enhancement with central necrosis was noted 11cases(28.9%). For the diagnosis of breast cancer, 3D-DMRI is a useful technique. Among the diagnostic criteria of speed, maximal amount of contrast enhancement and morphology, morphologic change after contrast enhancement study was the most useful diagnostic parameter.=20.

  19. Contrast kinetics of the malignant breast tumour - border versus centre enhancement on dynamic midfield MRI

    DEFF Research Database (Denmark)

    Marklund, M.; Torp-Pedersen, S.; Bentzon, N.;

    2008-01-01

    PURPOSE: To quantify the border versus centre enhancement of malignant breast tumours on dynamic magnetic resonance mammography. MATERIALS AND METHODS: Fifty-two women diagnosed with primary breast cancer underwent dynamic magnetic resonance mammography (Omniscan 0.2 mmol/kg bodyweight...... receptor negative tumours. CONCLUSION: The border/centre enhancement difference in malignant breast tumours is easily visualized on midfield dynamic magnetic resonance mammography. The dynamic behaviour is significantly correlated to histological features and receptor status of the tumours Udgivelsesdato...

  20. Correlation between dynamic contrast-enhanced MRI and histopathology in the measurement of tumor and breast volume and their ratio in breast cancer patients: a prospective study

    Institute of Scientific and Technical Information of China (English)

    LIU Qian; YE Jing-ming; XU Ling; DUAN Xue-ning; ZHAO Jian-xin; LIU Yin-hua

    2012-01-01

    Background Earlier studies have examined the association between the diameter of primary tumors measured by magnetic resonance imaging (MRI) and histopathology in breast cancer patients.However,the diameter does not completely describe the dimensions of the breast tumor or its volumetric proportion relative to the whole breast.The association between breast tumor volume/breast volume ratios measured by these two techniques has not been reported.Methods Seventy-three patients were recruited from female patients with primary breast tumors admitted to our center between January and December 2010.They were divided into two groups.Group A (n=46) underwent modified radical mastectomy (MRM),and Group B (n=27) underwent preoperative neoadjuvant chemotherapy before MRM.They were examined by dynamic-contrast enhanced MRI (DCE-MRI) to measure breast volumes (BVs),tumor volumes (TVs),and tumor volume/breast volume ratios (TV/BV).These measurements were compared with histopathology results after MRM,and the associations between MRI and pathology were analyzed by linear regression and Bland-Altman analysis.Results For Group A,the correlation coefficients for BVs,TVs,and TV/BV ratios measured by the two techniques were 0.938,0.921,and 0.897 (all P <0.001),respectively.For Group B,the correlation coefficients for BVs,TVs,and TV/BV ratios were 0.936,0.902,and 0.869 (all P<0.01),respectively.The results suggest statistically significant correlations between these parameters measured by the two techniques for both groups.Conclusion For these patients,BVs,TVs,and TV/BV ratios measured by DCE-MRI significantly correlated with those determined by histopathology.

  1. Neural network vector quantization improves the diagnostic quality of computer-aided diagnosis in dynamic breast MRI

    Science.gov (United States)

    Wismüller, Axel; Meyer-Baese, Anke; Leinsinger, Gerda L.; Lange, Oliver; Schlossbauer, Thomas; Reiser, Maximilian F.

    2007-03-01

    We quantitatively evaluate a novel neural network pattern recognition approach for characterization of diagnostically challenging breast lesions in contrast-enhanced dynamic breast MRI. Eighty-two women with 84 indeterminate mammographic lesions (BIRADS III-IV, 38/46 benign/malignant lesions confirmed by histopathology and follow-up, median lesion diameter 12mm) were examined by dynamic contrast-enhanced breast MRI. The temporal signal dynamics results in an intensity time-series for each voxel represented by a 6-dimensional feature vector. These vectors were clustered by minimal-free-energy Vector Quantization (VQ), which identifies groups of pixels with similar enhancement kinetics as prototypical time-series, so-called codebook vectors. For comparison, conventional analysis based on lesion-specific averaged signal-intensity time-courses was performed according to a standardized semi-quantitative evaluation score. For quantitative assessment of diagnostic accuracy, areas under ROC curves (AUC) were computed for both VQ and standard classification methods. VQ increased the diagnostic accuracy for classification between benign and malignant lesions, as confirmed by quantitative ROC analysis: VQ results (AUC=0.760) clearly outperformed the conventional evaluation of lesion-specific averaged time-series (AUC=0.693). Thus, the diagnostic benefit of neural network VQ for MR mammography analysis is quantitatively documented by ROC evaluation in a large data base of diagnostically challenging small focal breast lesions. VQ outperforms the conventional method w.r.t. diagnostic accuracy.

  2. The added diagnostic value of dynamic contrast-enhanced MRI at 3.0 T in nonpalpable breast lesions

    NARCIS (Netherlands)

    Merckel, L.G.; Verkooijen, H.M.; Peters, N.H.G.M.; Mann, R.M.; Veldhuis, W.B.; Storm, R.K.; Weits, T.; Duvivier, K.M.; Dalen, T. van; Mali, W.P.Th.; Peeters, P.H.M.; Bosch, Martijn van den

    2014-01-01

    To investigate the added diagnostic value of 3.0 Tesla breast MRI over conventional breast imaging in the diagnosis of in situ and invasive breast cancer and to explore the role of routine versus expert reading.We evaluated MRI scans of patients with nonpalpable BI-RADS 3-5 lesions who underwent dyn

  3. Value of dynamic enhanced MRI (DCE-MRI)in diagnosing the breast fibroadenoma and breast carcinoma%MRI动态增强扫描对乳腺纤维腺瘤和乳腺癌的诊断价值

    Institute of Scientific and Technical Information of China (English)

    梅莉; 郑建刚; 王开香; 许建兴; 刘良卿; 顾勇坚; 周鸿雁

    2013-01-01

    目的 探讨乳腺纤维腺瘤和乳腺癌的MRI动态增强表现,以期提高对乳腺疾病的诊断准确性.方法 回顾性分析30例经手术或穿刺病理证实的乳腺纤维腺瘤和乳腺癌患者的MRI资料,分析病灶的形态特征、动态增强特征,以及病灶的时间-信号强度曲线(TIC)表达.结果 30例患者共53个病灶,其中乳腺纤维腺瘤病灶38个,乳腺癌病灶15个.乳腺纤维腺瘤边界大多较清晰光整,且增强后强化均匀或不强化,TIC表达主要为Ⅰ型,占78.95%.乳腺癌的形态多表现为不规则或毛刺状,强化不均匀,TIC以Ⅲ型为主,占60.00%.二者在Ⅱ型TIC上有交叉.结论 MRI动态增强扫描可以提高病灶的检出率,能更好地鉴别乳腺癌和乳腺纤维腺瘤.%Objective To investigate the imaging appearance of breast fibroadenoma and breast carcinoma by the dynamic enhanced MRI(DCE - MRI), and improve the diagnostic accuracy of the breast diseases. Methods Imaging data of 30 patients with breast fibroadenoma and breast carcinoma proved by operation or biopsy were retrospectively analized. MR imaging features of morphology, dynamic enhancement pattern, and the time-signal intensity curve(TIC) were evaluated. Results Among the 30 patients with 53 breast lesions, 38 were having breast fibroadenoma, 15 breast carcinoma. Most breast fibroadenoma cases showed smooth and tidy borders, homogeneous enhancement or no enhancement. Type Ⅰ TIC were observed in most cases(78.95%). While most breast carcinoma showed irregular shape or speculated margin, and heterogeneous enhancement or rim enhancement. Type Ⅲ TIC curves were observed in most breast carcinoma (60.00%). Type Ⅱ TIC curves were found in both breast fibroadenoma and breast carcinoma. Conclusion DCE -MRI can improve the lesions' relevance ratio of breast diseases, and is helpful in diagnosing the difference between breast fibroadenoma and breast carcinoma.

  4. Joint estimation of shape and deformation for the detection of lesions in dynamic contrast-enhanced breast MRI

    Science.gov (United States)

    Hong, Byung-Woo

    2013-11-01

    We propose a mathematical framework for simultaneously delineating the boundary of object and estimating its temporal motion in the application of lesion detection in a dynamic contrast-enhanced (DCE) breast MRI sequence where both the appearance and the shape of region of interest is assumed to change in time. A unified energy functional for a joint segmentation and registration is proposed based on the assumption that the statistical properties of dynamic intensity curves within a region of interest are homogeneous. Our algorithm is designed to provide the morphological properties of the enhanced region and its dynamic intensity profiles, called kinetic signatures, in the analysis of DCE imagery since these features are considered as significant cues in understanding images. The proposed energy comprises a combination of a segmentation energy and a registration energy. The segmentation energy is developed based on a convex formulation being insensitive to the initialization. The registration energy is designed to compensate motion artifacts that are usually involved in the temporal imaging procedure. The major objective of this work is to provide a mathematical framework for a joint segmentation and registration on a dynamic sequence of images, and we demonstrate the mutual benefit of the estimation of temporal deformations for the registration step and the localization of regions of interest for the segmentation step. The effectiveness of the developed algorithm has been demonstrated on a number of clinical DCE breast MRI data in the application of breast lesion detection and the results show its potential to improve the accuracy and the efficiency in the diagnosis of breast cancer.

  5. A suspicious breast lesion detected by dynamic contrast-enhanced MRI and pathologically confirmed as capillary hemangioma: A case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Lian He; Li, Qing Chang; Xu, Hong Tao; Wang, Xin; Wang, En Hua [The First Affiliated Hospital and College of Basic Medical Sciences, China Medical University, Shenyang (China); Ma, Shuang [Dept. of Neurology, Sheng Jing Hospital of China Medical University, Shenyang (China)

    2013-12-15

    Breast capillary hemangioma is a type of benign vascular tumor which is rarely seen. Little is known about its presentation on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Here, we describe a case of suspicious breast lesion detected by DCE-MRI and pathologically confirmed as capillary hemangioma. Our case indicates that a small mass with a superficial location, clear boundary, and homogeneous enhancement on DCE-MRI indicates the possible diagnosis of hemangioma, whereby even the lesion presents a washout type curve.

  6. Quality assurance in MRI breast screening: comparing signal-to-noise ratio in dynamic contrast-enhanced imaging protocols

    Science.gov (United States)

    Kousi, Evanthia; Borri, Marco; Dean, Jamie; Panek, Rafal; Scurr, Erica; Leach, Martin O.; Schmidt, Maria A.

    2016-01-01

    MRI has been extensively used in breast cancer staging, management and high risk screening. Detection sensitivity is paramount in breast screening, but variations of signal-to-noise ratio (SNR) as a function of position are often overlooked. We propose and demonstrate practical methods to assess spatial SNR variations in dynamic contrast-enhanced (DCE) breast examinations and apply those methods to different protocols and systems. Four different protocols in three different MRI systems (1.5 and 3.0 T) with receiver coils of different design were employed on oil-filled test objects with and without uniformity filters. Twenty 3D datasets were acquired with each protocol; each dataset was acquired in under 60 s, thus complying with current breast DCE guidelines. In addition to the standard SNR calculated on a pixel-by-pixel basis, we propose other regional indices considering the mean and standard deviation of the signal over a small sub-region centred on each pixel. These regional indices include effects of the spatial variation of coil sensitivity and other structured artefacts. The proposed regional SNR indices demonstrate spatial variations in SNR as well as the presence of artefacts and sensitivity variations, which are otherwise difficult to quantify and might be overlooked in a clinical setting. Spatial variations in SNR depend on protocol choice and hardware characteristics. The use of uniformity filters was shown to lead to a rise of SNR values, altering the noise distribution. Correlation between noise in adjacent pixels was associated with data truncation along the phase encoding direction. Methods to characterise spatial SNR variations using regional information were demonstrated, with implications for quality assurance in breast screening and multi-centre trials.

  7. MRI evaluation of the contralateral breast in patients with recently diagnosed breast cancer

    OpenAIRE

    Sangeeta Taneja; Amarnath Jena; Syed. Mohd. Shuaib Zaidi; Anuj Khurana

    2012-01-01

    Introduction: Contralateral breast cancer can be synchronous and/or metachronous in patients with cancer of one breast. Detection of a synchronous breast cancer may affect patient management. Dynamic contrast-enhanced MRI of the breast (DCE-MRI) is a sensitive technique for detecting contralateral lesions occult on the other imaging modalities in women already diagnosed with cancer of one breast. Aim: The aim was to assess the incidence of mammographically occult synchronous contralateral bre...

  8. [Diagnostic value of quantitative pharmacokinetic parameters and relative quantitative pharmacokinetic parameters in breast lesions with dynamic contrast-enhanced MRI].

    Science.gov (United States)

    Sun, T T; Liu, W H; Zhang, Y Q; Li, L H; Wang, R; Ye, Y Y

    2017-08-01

    Objective: To explore the differential between the value of dynamic contrast-enhanced MRI quantitative pharmacokinetic parameters and relative pharmacokinetic quantitative parameters in breast lesions. Methods: Retrospective analysis of 255 patients(262 breast lesions) who was obtained by clinical palpation , ultrasound or full-field digital mammography , and then all lessions were pathologically confirmed in Zhongda Hospital, Southeast University from May 2012 to May 2016. A 3.0 T MRI scanner was used to obtain the quantitative MR pharmacokinetic parameters: volume transfer constant (K(trans)), exchange rate constant (k(ep))and extravascular extracellular volume fraction (V(e)). And measured the quantitative pharmacokinetic parameters of normal glands tissues which on the same side of the same level of the lesions; and then calculated the value of relative pharmacokinetic parameters: rK(rans)、rk(ep) and rV(e).To explore the diagnostic value of two pharmacokinetic parameters in differential diagnosis of benign and malignant breast lesions using receiver operating curves and model of logistic regression. Results: (1)There were significant differences between benign lesions and malignant lesions in K(trans) and k(ep) (t=15.489, 15.022, respectively, P0.05). The areas under the ROC curve(AUC)of K(trans), k(ep) and V(e) between malignant and benign lesions were 0.933, 0.948 and 0.387, the sensitivity of K(trans), k(ep) and V(e) were 77.1%, 85.0%, 51.0% , and the specificity of K(trans), k(ep) and V(e) were 96.3%, 93.6%, 60.8% for the differential diagnosis of breast lesions if taken the maximum Youden's index as cut-off. (2)There were significant differences between benign lesions and malignant lesions in rK(trans), rk(ep) and rV(e) (t=14.177, 11.726, 2.477, respectively, Pquantitative pharmacokinetic parameters and the prediction probability of relative quantitative pharmacokinetic parameters(Z=0.867, P=0.195). Conclusion: There was no significant difference between

  9. Predicting response before initiation of neoadjuvant chemotherapy in breast cancer using new methods for the analysis of dynamic contrast enhanced MRI (DCE MRI) data

    Science.gov (United States)

    DeGrandchamp, Joseph B.; Whisenant, Jennifer G.; Arlinghaus, Lori R.; Abramson, V. G.; Yankeelov, Thomas E.; Cárdenas-Rodríguez, Julio

    2016-03-01

    The pharmacokinetic parameters derived from dynamic contrast enhanced (DCE) MRI have shown promise as biomarkers for tumor response to therapy. However, standard methods of analyzing DCE MRI data (Tofts model) require high temporal resolution, high signal-to-noise ratio (SNR), and the Arterial Input Function (AIF). Such models produce reliable biomarkers of response only when a therapy has a large effect on the parameters. We recently reported a method that solves the limitations, the Linear Reference Region Model (LRRM). Similar to other reference region models, the LRRM needs no AIF. Additionally, the LRRM is more accurate and precise than standard methods at low SNR and slow temporal resolution, suggesting LRRM-derived biomarkers could be better predictors. Here, the LRRM, Non-linear Reference Region Model (NRRM), Linear Tofts model (LTM), and Non-linear Tofts Model (NLTM) were used to estimate the RKtrans between muscle and tumor (or the Ktrans for Tofts) and the tumor kep,TOI for 39 breast cancer patients who received neoadjuvant chemotherapy (NAC). These parameters and the receptor statuses of each patient were used to construct cross-validated predictive models to classify patients as complete pathological responders (pCR) or non-complete pathological responders (non-pCR) to NAC. Model performance was evaluated using area under the ROC curve (AUC). The AUC for receptor status alone was 0.62, while the best performance using predictors from the LRRM, NRRM, LTM, and NLTM were AUCs of 0.79, 0.55, 0.60, and 0.59 respectively. This suggests that the LRRM can be used to predict response to NAC in breast cancer.

  10. Diffusion-weighted imaging and dynamic contrast-enhanced MRI of experimental breast cancer bone metastases – A correlation study with histology

    Energy Technology Data Exchange (ETDEWEB)

    Merz, Maximilian [Department of Medical Physics in Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Department of Hematology, Oncology and Rheumatology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg (Germany); Seyler, Lisa; Bretschi, Maren; Semmler, Wolfhard [Department of Medical Physics in Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Bäuerle, Tobias, E-mail: tobias.baeuerle@uk-erlangen.de [Department of Medical Physics in Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Institute of Radiology, University Medical Center Erlangen, Palmsanlage 5, 90154 Erlangen (Germany)

    2015-04-15

    Purpose: To validate imaging parameters from diffusion-weighted imaging and dynamic contrast-enhanced MRI with immunohistology and to non-invasively assess microstructure of experimental breast cancer bone metastases. Materials and methods: Animals bearing breast cancer bone metastases were imaged in a clinical 1.5 T MRI scanner. HASTE sequences were performed to calculate apparent diffusion coefficients. Saturation recovery turbo FLASH sequences were conducted while infusing 0.1 mmol/l Gd–DTPA for dynamic contrast-enhanced MRI to quantify parameters amplitude A and exchange rate constant k{sub ep}. After imaging, bone metastases were analyzed immunohistologically. Results: We found correlations of the apparent diffusion coefficients from diffusion-weighted imaging with tumor cellularity as assessed with cell nuclei staining. Histological vessel maturity was correlated negatively with parameters A and k{sub ep} from dynamic contrast-enhanced MRI. Tumor size correlated inversely with cell density and vessel permeability as well as positively with mean vessel calibers. Parameters from the rim of bone metastases differed significantly from values of the center. Conclusion: In vivo diffusion-weighted imaging and dynamic contrast-enhanced MRI in experimental bone metastases provide information about tumor cellularity and vascularity and correlate well with immunohistology.

  11. MRI of the Breast

    Science.gov (United States)

    ... surgery pose no risk during MRI. However, a recently placed artificial joint may require the use of ... evaluation with additional views or a special imaging technique. A follow-up examination may also be necessary ...

  12. Breast MRI in high risk patients

    NARCIS (Netherlands)

    A.I.M. Obdeijn (Inge-Marie)

    2015-01-01

    markdownabstractAbstract In this thesis we address various indications of breast MRI, with the emphasis on the value of MRI in screening of women with high genetic risk for breast cancer, and especially in BRCA1 mutation carriers. We showed that in the era of up-to-date MRI expertise and digital

  13. Integration of DCE-MRI and DW-MRI Quantitative Parameters for Breast Lesion Classification

    Directory of Open Access Journals (Sweden)

    Roberta Fusco

    2015-01-01

    Full Text Available Objective. The purpose of our study was to evaluate the diagnostic value of an imaging protocol combining dynamic contrast-enhanced MRI (DCE-MRI and diffusion-weighted MRI (DW-MRI in patients with suspicious breast lesions. Materials and Methods. A total of 31 breast lesions (15 malignant and 16 benign proved by histological examination in 26 female patients were included in this study. For both DCE-MRI and DW-MRI model free and model based parameters were computed pixel by pixel on manually segmented ROIs. Statistical procedures included conventional linear analysis and more advanced techniques for classification of lesions in benign and malignant. Results. Our findings indicated no strong correlation between DCE-MRI and DW-MRI parameters. Results of classification analysis show that combining of DCE parameters or DW-MRI parameter, in comparison of single feature, does not yield a dramatic improvement of sensitivity and specificity of the two techniques alone. The best performance was obtained considering a full combination of all features. Moreover, the classification results combining all features are dominated by DCE-MRI features alone. Conclusion. The combination of DWI and DCE-MRI does not show a potential to dramatically increase the sensitivity and specificity of breast MRI. DCE-MRI alone gave the same performance as in combination with DW-MRI.

  14. Signal enhancement ratio (SER) quantified from breast DCE-MRI and breast cancer risk

    Science.gov (United States)

    Wu, Shandong; Kurland, Brenda F.; Berg, Wendie A.; Zuley, Margarita L.; Jankowitz, Rachel C.; Sumkin, Jules; Gur, David

    2015-03-01

    Breast magnetic resonance imaging (MRI) is recommended as an adjunct to mammography for women who are considered at elevated risk of developing breast cancer. As a key component of breast MRI, dynamic contrast-enhanced MRI (DCE-MRI) uses a contrast agent to provide high intensity contrast between breast tissues, making it sensitive to tissue composition and vascularity. Breast DCE-MRI characterizes certain physiologic properties of breast tissue that are potentially related to breast cancer risk. Studies have shown that increased background parenchymal enhancement (BPE), which is the contrast enhancement occurring in normal cancer-unaffected breast tissues in post-contrast sequences, predicts increased breast cancer risk. Signal enhancement ratio (SER) computed from pre-contrast and post-contrast sequences in DCE-MRI measures change in signal intensity due to contrast uptake over time and is a measure of contrast enhancement kinetics. SER quantified in breast tumor has been shown potential as a biomarker for characterizing tumor response to treatments. In this work we investigated the relationship between quantitative measures of SER and breast cancer risk. A pilot retrospective case-control study was performed using a cohort of 102 women, consisting of 51 women who had diagnosed with unilateral breast cancer and 51 matched controls (by age and MRI date) with a unilateral biopsy-proven benign lesion. SER was quantified using fully-automated computerized algorithms and three SER-derived quantitative volume measures were compared between the cancer cases and controls using logistic regression analysis. Our preliminary results showed that SER is associated with breast cancer risk, after adjustment for the Breast Imaging Reporting and Data System (BI-RADS)-based mammographic breast density measures. This pilot study indicated that SER has potential for use as a risk factor for breast cancer risk assessment in women at elevated risk of developing breast cancer.

  15. Breast MRI: guidelines from the European Society of Breast Imaging

    OpenAIRE

    Mann, R. M.; Kuhl, C. K.; Kinkel, K.; BOETES, C.

    2008-01-01

    The aim of breast MRI is to obtain a reliable evaluation of any lesion within the breast. It is currently always used as an adjunct to the standard diagnostic procedures of the breast, i.e., clinical examination, mammography and ultrasound. Whereas the sensitivity of breast MRI is usually very high, specificity—as in all breast imaging modalities—depends on many factors such as reader expertise, use of adequate techniques and composition of the patient cohorts. Since breast MRI will always yi...

  16. MRI evaluation of the contralateral breast in patients with recently diagnosed breast cancer

    Directory of Open Access Journals (Sweden)

    Sangeeta Taneja

    2012-01-01

    Full Text Available Introduction: Contralateral breast cancer can be synchronous and/or metachronous in patients with cancer of one breast. Detection of a synchronous breast cancer may affect patient management. Dynamic contrast-enhanced MRI of the breast (DCE-MRI is a sensitive technique for detecting contralateral lesions occult on the other imaging modalities in women already diagnosed with cancer of one breast. Aim: The aim was to assess the incidence of mammographically occult synchronous contralateral breast cancer in patients undergoing MRI mammography for the evaluation of a malignant breast lesion. Materials and Methods: A total of 294 patients with recently diagnosed breast cancer who underwent MRI of the breast were evaluated for lesions in the opposite breast. Results: The incidence of synchronous contralateral malignancy detected by preoperative MRI mammography done for evaluation of extent of disease was 4.1%. Conclusion: Preoperative breast MRI may detect clinically and mammographically occult synchronous contralateral cancer, and can help the patient avoid an additional second surgery or a second course of chemotherapy later; also, as theoretically these lesions are smaller, there may be a survival benefit as well.

  17. Cluster analysis of signal-intensity time course in dynamic breast MRI: does unsupervised vector quantization help to evaluate small mammographic lesions?

    Energy Technology Data Exchange (ETDEWEB)

    Leinsinger, Gerda; Schlossbauer, Thomas; Scherr, Michael; Lange, Oliver; Reiser, Maximilian; Wismueller, Axel [Institute for Clinical Radiology University of Munich, Munich (Germany)

    2006-05-15

    We examined whether neural network clustering could support the characterization of diagnostically challenging breast lesions in dynamic magnetic resonance imaging (MRI). We examined 88 patients with 92 breast lesions (51 malignant, 41 benign). Lesions were detected by mammography and classified Breast Imaging and Reporting Data System (BIRADS) III (median diameter 14 mm). MRI was performed with a dynamic T1-weighted gradient echo sequence (one precontrast and five postcontrast series). Lesions with an initial contrast enhancement {>=}50% were selected with semiautomatic segmentation. For conventional analysis, we calculated the mean initial signal increase and postinitial course of all voxels included in a lesion. Secondly, all voxels within the lesions were divided into four clusters using minimal-free-energy vector quantization (VQ). With conventional analysis, maximum accuracy in detecting breast cancer was 71%. With VQ, a maximum accuracy of 75% was observed. The slight improvement using VQ was mainly achieved by an increase of sensitivity, especially in invasive lobular carcinoma and ductal carcinoma in situ (DCIS). For lesion size, a high correlation between different observers was found (R{sup 2} = 0.98). VQ slightly improved the discrimination between malignant and benign indeterminate lesions (BIRADS III) in comparison with a standard evaluation method. (orig.)

  18. Contribution of diffusion-weighted imaging to dynamic contrast-enhanced MRI in the characterization of papillary breast lesions.

    Science.gov (United States)

    Yildiz, Seyma; Toprak, Huseyin; Ersoy, Yeliz Emine; Malya, Fatma Ümit; Bakan, Ayşe Ahsen; Aralaşmak, Ayşe; Gucin, Zuhal

    2017-08-01

    Papillary lesions have a broad spectrum of appearances on magnetic resonance imaging (MRI). The purpose of this study was to evaluate whether apparent diffusion coefficient (ADC) values of papillary lesions can be used to characterize lesion as benign or malignant. This retrospective study included 29 papillary lesions. Diagnostic values of dynamic contrast-enhanced MRI (DCE-MRI), DWI-ADC, and DCE-MRI plus DWI-ADC were separately calculated. The malignant papillary lesions (0.744×10(-3)  mm(2) /s) exhibited significantly lower mean ADC values than the benign lesions (1.339×10(-3)  mm(2) /s). Addition of DWI to standard DCE-MRI provided 100% sensitivity. We hypothesized that this combination may prevent unnecessary excisional biopsies. © 2017 Wiley Periodicals, Inc.

  19. A computer-aided diagnosis system for breast DCE-MRI at high spatiotemporal resolution

    NARCIS (Netherlands)

    Dalmis, M.U.; Gubern-Merida, A.; Vreemann, S.; Karssemeijer, N.; Mann, R.; Platel, B.

    2016-01-01

    PURPOSE: With novel MRI sequences, high spatiotemporal resolution has become available in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the breast. Since benign structures in the breast can show enhancement similar to malignancies in DCE-MRI, characterization of detected lesions

  20. Breast MRI in high risk patients

    OpenAIRE

    Obdeijn, Inge-Marie

    2015-01-01

    markdownabstractAbstract In this thesis we address various indications of breast MRI, with the emphasis on the value of MRI in screening of women with high genetic risk for breast cancer, and especially in BRCA1 mutation carriers. We showed that in the era of up-to-date MRI expertise and digital mammography the screening efficacy is improved. However, the additional value of mammography over MRI is little while at the same time BRCA carriers are more sensitive the risks of low dose radiation ...

  1. Identifying Triple-Negative Breast Cancer Using Background Parenchymal Enhancement Heterogeneity on Dynamic Contrast-Enhanced MRI: A Pilot Radiomics Study.

    Directory of Open Access Journals (Sweden)

    Jeff Wang

    Full Text Available To determine the added discriminative value of detailed quantitative characterization of background parenchymal enhancement in addition to the tumor itself on dynamic contrast-enhanced (DCE MRI at 3.0 Tesla in identifying "triple-negative" breast cancers.In this Institutional Review Board-approved retrospective study, DCE-MRI of 84 women presenting 88 invasive carcinomas were evaluated by a radiologist and analyzed using quantitative computer-aided techniques. Each tumor and its surrounding parenchyma were segmented semi-automatically in 3-D. A total of 85 imaging features were extracted from the two regions, including morphologic, densitometric, and statistical texture measures of enhancement. A small subset of optimal features was selected using an efficient sequential forward floating search algorithm. To distinguish triple-negative cancers from other subtypes, we built predictive models based on support vector machines. Their classification performance was assessed with the area under receiver operating characteristic curve (AUC using cross-validation.Imaging features based on the tumor region achieved an AUC of 0.782 in differentiating triple-negative cancers from others, in line with the current state of the art. When background parenchymal enhancement features were included, the AUC increased significantly to 0.878 (p<0.01. Similar improvements were seen in nearly all subtype classification tasks undertaken. Notably, amongst the most discriminating features for predicting triple-negative cancers were textures of background parenchymal enhancement.Considering the tumor as well as its surrounding parenchyma on DCE-MRI for radiomic image phenotyping provides useful information for identifying triple-negative breast cancers. Heterogeneity of background parenchymal enhancement, characterized by quantitative texture features on DCE-MRI, adds value to such differentiation models as they are strongly associated with the triple-negative subtype

  2. MRI of breast implant-related complications

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Seung Hae; Kook, Shin Ho; Kim, Jong Wook; Ahn, Sung Yul; Cha, Dong Sup; Whang, Kwi Whan; Pae, Won Kil; Park, Yong Lai; Lee, Young Uk; Park, Hae Won; Kim, Myung Sook [Kangbuk Samsung Hospital, Seoul (Korea, Republic of)

    1998-06-01

    The purpose of this study is to assess the usefulness of MRI in the preoperative diagnosis of breast implant-related complications. Thirty four breast implants in 17 patients were examined. Eight breasts had a history of repeated surgery due to rupture and in eight others, simultaneous interstitial silicone injection had been performed. MR images of the 34 implants were prospectively analyzed for implant-related complications, without prior clinical information, and the findings were compared with the results of surgery. MRI was an effective and useful method for the preoperative evaluation of implant-related complications; degree of contracture was successfully predicted. (author). 18 refs., 2 tabs., 5 figs.

  3. Study on diagnostic value and application of dynamic enhancement MRI for examination of breast tumors%动态增强MRI在乳腺肿瘤检查中的诊断价值及应用研究

    Institute of Scientific and Technical Information of China (English)

    纪寒翔; 杜青木; 于秀艳; 吴建锋

    2013-01-01

    Objective: To analyze the diagnostic value of dynamic enhancement MRI for examination of breast tumors, and explore its application value.Methods: A total of 145 patients with breast tumors who were treated in the hospital from March 2007 to March 2010 were analyzed retrospectively, conventional MRI plain scan was conducted at first, then dynamic enhancement MRI was conducted.The signs of MRI plain scan and dynamic enhancement MRI in the two groups were observed; Emax, Tmax, and Slopemax values of dynamic enhancement MRI for benign and malignant breast tumors were measured and compared.Results: The show rates of benign and malignant breast tumors with conventional MRI plain scan were 22.37% and 34.87% , respectively, which were statistically significantly lower than those with dynamic enhancement MRI (40.13% , 53.95% ) (P <0.05) ; Emax and Slopemax values of benign breast tumors were (76.84 ±50.55)% per second and (2.75 ±2.87)% per second, respectively, which were statistically significantly lower than those of malignant breast tumors (P<0.05) , Emax and Slopemax values of malignant breast tumors were (115.70 ±28.01)% per second and (6.39 ± 2.03 ) % per second, respectively; Tmax value of benign breast tumors was (422.03 ±119.45 ) seconds, which was statistically significantly higher than that of malignant breast tumors (P<0.05) , Tmax value of malignant breast tumors was (157.5 ± 490.91) seconds.Conclusion: The detection rates and accurate rate of dynamic enhancement MRI for breast tumors are very high, which can differentiate benign and malignant breast tumors, so it is a good choice among all diagnostic methods.%目的:分析动态增强MRI在乳腺肿瘤检查中的诊断价值,并探讨其对乳腺肿瘤的应用价值.方法:回顾性分析2007年3月~2010年3月期间收治的乳腺肿瘤患者145例,患者均先进行常规MRI平扫,再对患者进行动态增强MRI扫描.观察两组患者MRI平扫和动态增强MRI征象,测定并比较动态增

  4. Breast MRI : EUSOBI recommendations for women's information

    NARCIS (Netherlands)

    Mann, Ritse M.; Balleyguier, Corinne; Baltzer, Pascal A.; Bick, Ulrich; Colin, Catherine; Cornford, Eleanor; Evans, Andrew; Fallenberg, Eva; Forrai, Gabor; Fuchsjaeger, Michael H.; Gilbert, Fiona J.; Helbich, Thomas H.; Heywang-Koebrunner, Sylvia H.; Camps-Herrero, Julia; Kuhl, Christiane K.; Martincich, Laura; Pediconi, Federica; Panizza, Pietro; Pina, Luis J.; Pijnappel, Ruud M.; Pinker-Domenig, Katja; Skaane, Per; Sardanelli, Francesco

    2015-01-01

    This paper summarizes information about breast MRI to be provided to women and referring physicians. After listing contraindications, procedure details are described, stressing the need for correct scheduling and not moving during the examination. The structured report including BI-RADSA (R) categor

  5. Breast MRI: EUSOBI recommendations for women's information

    NARCIS (Netherlands)

    Mann, R.M.; Balleyguier, C.; Baltzer, P.A.; Bick, U.; Colin, C.; Cornford, E.; Evans, A.; Fallenberg, E.; Forrai, G.; Fuchsjager, M.H.; Gilbert, F.J.; Helbich, T.H.; Heywang-Kobrunner, S.H.; Camps-Herrero, J.; Kuhl, C.K.; Martincich, L.; Pediconi, F.; Panizza, P.; Pina, L.J.; Pijnappel, R.M.; Pinker-Domenig, K.; Skaane, P.; Sardanelli, F.; Imaging, w.l.r.b.E.D.-T.E.B.C.C. European Societ

    2015-01-01

    This paper summarizes information about breast MRI to be provided to women and referring physicians. After listing contraindications, procedure details are described, stressing the need for correct scheduling and not moving during the examination. The structured report including BI-RADS(R) categorie

  6. Dynamic Contrast Enhanced MRI in Patients With Advanced Breast or Pancreatic Cancer With Metastases to the Liver or Lung

    Science.gov (United States)

    2014-05-28

    Acinar Cell Adenocarcinoma of the Pancreas; Duct Cell Adenocarcinoma of the Pancreas; Liver Metastases; Lung Metastases; Recurrent Breast Cancer; Recurrent Pancreatic Cancer; Stage IV Breast Cancer; Stage IV Pancreatic Cancer

  7. Dynamic contrast-enhanced MRI in the differential diagnosis of benign and malignant breast disease%动态增强MRI在乳腺良恶性疾病鉴别诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    姚建飞

    2015-01-01

    Objective To explore the value of dynamic contrast-enhanced MRI in the differential diagnosis of benign and malignant breast diseases. Methods Retrospective analysis was conducted on MRI data of 70 cases (78 breasts) with breast lesions confirmed pathologically during the period of January 2012 to June 2014, including 46 breasts of carcinoma and 32 breasts of benign diseases. MRI signs and enhanced parameters of benign and malignant breast lesions were observed, and specificity, sensitivity and accuracy were compared between dynamic contrast-enhanced MRI scan and MRI plain scan in diagnosis of breast cancer. Results The average age of patients with benign lesions was significantly lower (t=8. 225, P0. 05). Emax of malignant breast lesions was significantly higher than benign tumors, but Tmax and Slopemax were significantly lower than benign lesions ( t value was 10. 286, 11. 445 and 7. 236, all P0.05);②乳腺恶性病变峰值增强率(Emax)显著高于良性肿块,峰值时间(Tmax)、最大强化速率(Slopemax)显著低于良性病变(t值分别为10.286、11.445、7.236,均P<0.05);③乳腺恶性病变SI-Time曲线廓清型、平台型、渐进型分别为38例、6例、2例,良性病变分别为0例、5例、27例,两组比较SI-Time曲线类型分布差异有统计学意义(χ2=10.381,P<0.05);④MRI动态增强扫描检查乳腺恶性病变灵敏度、特异度及准确率分别为100%、96.88%、98.72%,均高于 MRI 平扫的78.26%、78.13%、78.20%,比较差异有统计学意义(χ2值分别为7.382、8.164、8.237,均P<0.05)。结论乳腺良恶性疾病动态增强MRI扫描具有特异性表现,具有较高的鉴别诊断参考价值。

  8. Classification of small lesions in dynamic breast MRI: Eliminating the need for precise lesion segmentation through spatio-temporal analysis of contrast enhancement over time.

    Science.gov (United States)

    Nagarajan, Mahesh B; Huber, Markus B; Schlossbauer, Thomas; Leinsinger, Gerda; Krol, Andrzej; Wismüller, Axel

    2013-10-01

    Characterizing the dignity of breast lesions as benign or malignant is specifically difficult for small lesions; they don't exhibit typical characteristics of malignancy and are harder to segment since margins are harder to visualize. Previous attempts at using dynamic or morphologic criteria to classify small lesions (mean lesion diameter of about 1 cm) have not yielded satisfactory results. The goal of this work was to improve the classification performance in such small diagnostically challenging lesions while concurrently eliminating the need for precise lesion segmentation. To this end, we introduce a method for topological characterization of lesion enhancement patterns over time. Three Minkowski Functionals were extracted from all five post-contrast images of sixty annotated lesions on dynamic breast MRI exams. For each Minkowski Functional, topological features extracted from each post-contrast image of the lesions were combined into a high-dimensional texture feature vector. These feature vectors were classified in a machine learning task with support vector regression. For comparison, conventional Haralick texture features derived from gray-level co-occurrence matrices (GLCM) were also used. A new method for extracting thresholded GLCM features was also introduced and investigated here. The best classification performance was observed with Minkowski Functionals area and perimeter, thresholded GLCM features f8 and f9, and conventional GLCM features f4 and f6. However, both Minkowski Functionals and thresholded GLCM achieved such results without lesion segmentation while the performance of GLCM features significantly deteriorated when lesions were not segmented (p < 0.05). This suggests that such advanced spatio-temporal characterization can improve the classification performance achieved in such small lesions, while simultaneously eliminating the need for precise segmentation.

  9. 磁共振动态增强扫描血管图在乳腺癌诊断中的应用%Vascular maps with dynamic contrast-enhanced MRI for diagnosis of breast cancer

    Institute of Scientific and Technical Information of China (English)

    尹波; 刘莉; 施梦; 耿道颖; 李亚迪

    2009-01-01

    对52例乳腺病变患者进行MRI动态增强扫描.在MRI血管图上进行血管计数,计数评价分为0~3级.平均乳腺血管数目,乳腺恶性病变患侧为(3.8±2.0)条,良性病变患侧为(1.3±1.0)条,良恶性病变间差异有统计学意义(P<0.05).采用0~1级诊断为良性病灶,2~3级诊断为恶性病灶标准,特异度为79%,敏感度为83%.乳腺癌患侧乳腺血管数目明显增多,可为MRI诊断乳腺癌提供更多的信息.%Total 52 patients with breast lesions underwent dynamic contrast-enhanced breast MRI; and the breast vascularization was scored on the MRI vascular maps with a range of 0 to 3. The mean number of vessels per ipsilateral breast in malignant cases was higher than that of benign cases (3.8±2.0 vs. 1.3± 1.0; P=0.000). When the breast vascularity score 0-1 was defined as benign and 2-3 was defined as malignant, the sensitivity and specificity was 79% and 83%, respectively. Results indicate that dynamic contrast-enhanced breast MRI is of value in diagnosis of malignant breast lesions.

  10. Fat saturation in dynamic breast MRI at 3 Tesla: is the Dixon technique superior to spectral fat saturation? A visual grading characteristics study

    Energy Technology Data Exchange (ETDEWEB)

    Clauser, P. [University of Udine, Azienda Ospedaliero-Universitaria ' ' S.Maria della Misericordia' ' , Institute of Diagnostic Radiology, Udine (Italy); Medical University of Vienna, Department of Biomedical Imaging and Image-guided interventions, Division of Molecular and Gender Imaging, Vienna (Austria); Pinker, K.; Helbich, T.H.; Kapetas, P.; Bernathova, M.; Baltzer, P.A.T. [Medical University of Vienna, Department of Biomedical Imaging and Image-guided interventions, Division of Molecular and Gender Imaging, Vienna (Austria)

    2014-09-15

    To intra-individually compare the diagnostic image quality of Dixon and spectral fat suppression at 3 T. Fifty consecutive patients (mean age 55.1 years) undergoing 3 T breast MRI were recruited for this prospective study. The image protocol included pre-contrast and delayed post-contrast spectral and Dixon fat-suppressed T1w series. Two independent blinded readers compared spectral and Dixon fat-suppressed series by evaluating six ordinal (1 worst to 5 best) image quality criteria (image quality, delineation of anatomical structures, fat suppression in the breast and axilla, lesion delineation and internal enhancement). Breast density and size were assessed. Data analysis included Spearman's rank correlation coefficient and visual grading characteristics (VGC) analysis. Four examinations were excluded; 48 examinations in 46 patients were evaluated. In VGC analysis, the Dixon technique was superior regarding image quality criteria analysed (P < 0.01). Smaller breast size and lower breast density were significantly (P < 0.01) correlated with impaired spectral fat suppression quality. No such correlation was identified for the Dixon technique, which showed reconstruction-based water-fat mixups leading to insufficient image quality in 20.8 %. The Dixon technique outperformed spectral fat suppression in all evaluated criteria (P < 0.01). Non-diagnostic examinations can be avoided by fat and water image reconstruction. The superior image quality of the Dixon technique can improve breast MRI interpretation. (orig.)

  11. Breast MRI used as a problem-solving tool reliably excludes malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Spick, Claudio, E-mail: claudio.spick@meduniwien.ac.at [Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090 Vienna (Austria); Szolar, Dieter H.M.; Preidler, Klaus W.; Tillich, Manfred; Reittner, Pia [Diagnostikum Graz-Südwest, Weblinger Guertel 25, 8054 Graz (Austria); Baltzer, Pascal A., E-mail: pascal.baltzer@meduniwien.ac.at [Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090 Vienna (Austria)

    2015-01-15

    Highlights: • Breast MRI reliably excludes malignancy in conventional BI-RADS 0 cases (NPV: 100%). • Malignancy rate in the BI-RADS 0 population is substantial with 13.5%. • Breast MRI used as a problem-solving tool reliably excludes malignancy. - Abstract: Purpose: To evaluate the diagnostic performance of breast MRI if used as a problem-solving tool in BI-RADS 0 cases. Material and methods: In this IRB-approved, single-center study, 687 women underwent high-resolution-3D, dynamic contrast-enhanced breast magnetic resonance imaging (MRI) between January 2012 and December 2012. Of these, we analyzed 111 consecutive patients (mean age, 51 ± 12 years; range, 20–83 years) categorized as BI-RADS 0. Breast MRI findings were stratified by clinical presentations, conventional imaging findings, and breast density. MRI results were compared to the reference standard, defined as histopathology or an imaging follow-up of at least 1 year. Results: One hundred eleven patients with BI-RADS 0 conventional imaging findings revealed 30 (27%) mammographic masses, 57 (51.4%) mammographic architectural distortions, five (4.5%) mammographic microcalcifications, 17 (15.3%) ultrasound-only findings, and two palpable findings without imaging correlates. There were 15 true-positive, 85 true-negative, 11 false-positive, and zero false-negative breast MRI findings, resulting in a sensitivity, specificity, PPV, and NPV of 100% (15/15), 88.5% (85/96), 57.7% (15/26), and 100% (85/85), respectively. Breast density and reasons for referral had no significant influence on the diagnostic performance of breast MRI (p > 0.05). Conclusion: Breast MRI reliably excludes malignancy in conventional BI-RADS 0 cases resulting in a NPV of 100% (85/85) and a PPV of 57.7% (15/26)

  12. Male breast carcinoma and the use of MRI

    OpenAIRE

    Shaw, Aidan; Smith, Ben; Howlett, David

    2015-01-01

    MRI is well established in the diagnosis of female breast cancer, with an important role as a problem-solving tool in the postoperative breast and in implant evaluation. Little in the literature mentions the use of MRI in male breast cancer, with there is no clear role for its use at present. We present an unusual case of bilateral male breast carcinoma and demonstrate a similar enhancement pattern to that described in female breast cancer; we also suggest other potential applications of MRI ...

  13. MRI动态增强在乳腺癌诊断中的价值%Diagnostic Value of Dynamic Contrast-enhanced MRI in Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    刘亚婷; 范光明; 沈金丹; 谢弘; 张飘尘; 阮志兵; 聂红昉

    2016-01-01

    目的:分析乳腺良、恶性病变磁共振动态增强( DCE-MRI)检查的影像学特征,探讨DCE-MRI对乳腺癌的诊断价值。方法:经病理组织活检确诊的30例乳腺良性病灶患者(对照组)和30例乳腺癌患者(乳腺癌组),均进行DCE-MRI检查,观察2组患者乳腺病灶形态特征、强化模式和时间-信号曲线( TIC)类型。结果:对照组病灶形态以类圆形为主、边缘多光滑、增强后多为均匀强化,乳腺癌组病灶形态以分叶状为主、边缘多有毛刺、强化后多为不均匀强化,2组患者的所占比例比较差异有统计学意义(χ2=42.44、52.86、41.99,P<0.05);对照组病灶T1 C曲线主要为Ⅰ型,乳腺癌组主要为Ⅲ型曲线,2组患者的所占比例比较差异有统计学意义(χ2=43.45,P<0.05)。结论:DCE-MRI检查可提高乳腺癌诊断的准确性。%Objective:To ahalyze dyhamic cohtrast-ehhahced MRI( DCE-MRI )features of behigh ahd malighaht breast lesiohs,ahd explore the diaghosis value of DCE-MRI ih breast cahcer. Methods:DCE-MRI were performed ih 30 patiehts with breast behigh lesiohs( cohtrol group )ahd 30 patiehts with malighaht breast lesiohs( breast cahcer group),diaghosis were made ih all the objects by patho-logical biopsy;Morphological characteristics,ehhahcemeht mode ahd time ihtehsity curve( TIC)were compared ih the two group. Results:Ih the cohtrol group,the lesiohs were mostly rouhd,smooth ahd homogeheous ehhahcemeht;ih breast cahcer group,breast lesiohs were mostly lobulated with edge burr ahd uheveh ehhahcemeht,differehces betweeh the two groups were statistically sighificaht(χ2 =42. 44, 52. 86,41. 99,P <0. 05);Breast lesiohs of cohtrol group were maihly typeⅠof TIC,ahd those of breast cahcer group were maihly type Ⅲ of TIC,differehces betweeh the two groups were statistically sighificaht(χ2 =43 . 45 ,P <0 . 05 ). Conclusion:DCE-MRI cah improve the diaghosis accuracy of breast cahcer.

  14. Breast MRI: EUSOBI recommendations for women's information

    Energy Technology Data Exchange (ETDEWEB)

    Mann, Ritse M. [Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen (Netherlands); Balleyguier, Corinne [Gustave-Roussy Institute, Department of Radiology, Villejuif (France); Baltzer, Pascal A.; Helbich, Thomas H.; Pinker-Domenig, Katja [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Vienna (Austria); Bick, Ulrich; Fallenberg, Eva [Universitaetsmedizin Berlin, Clinic of Radiology, Charite, Berlin (Germany); Colin, Catherine [Centre Hospitalo-Universitaire Lyon Sud, Radiology Unit, Hospices Civils de Lyon, Pierre Benite Cedex (France); Cornford, Eleanor [Nottingham University Hospitals, Nottingham Breast Institute, Nottingham (United Kingdom); Evans, Andrew [Ninewells Hospital and Medical School, Dundee Cancer Centre, Clinical Research Centre, Dundee (United Kingdom); Forrai, Gabor [MHEK Teaching Hospital University Semmelweis, Budapest (Hungary); Fuchsjaeger, Michael H. [Medical University of Graz, Department of Radiology, Graz (Austria); Gilbert, Fiona J. [University of Cambridge, School of Clinical Medicine, Department of Radiology, Cambridge (United Kingdom); Heywang-Koebrunner, Sylvia H. [National Reference Centre Mammography, Munich, Munich (Germany); Camps-Herrero, Julia [Hospital de la Ribera, Department of Radiology, Alzira, Valencia (Spain); Kuhl, Christiane K. [University Hospital of Aachen, Rheinisch-Westfaelische Technische Hochschule, Aachen (Germany); Martincich, Laura [IRCCS-FPO, Radiology Unit, Candiolo, Turin (Italy); Pediconi, Federica [Sapienza University, Department of Radiological, Oncological and Pathological Sciences, Rome (Italy); Panizza, Pietro [Fondazione IRCCS Istituto Nazionale dei Tumori, Department of Radiology 1, Milan (Italy); Pina, Luis J. [Clinica Universidad de Navarra, Department of Radiology, Pamplona, Navarra (Spain); Pijnappel, Ruud M. [University Medical Centre Utrecht, Department of Imaging, Utrecht (Netherlands); Skaane, Per [Oslo University Hospital Ullevaal, University of Oslo, Department of Radiology, Oslo (Norway); Sardanelli, Francesco [Universita degli Studi di Milano, Radiology Unit, IRCCS Policlinico San Donato, Department of Biomedical Sciences for Health, San Donato Milanese, Milan (Italy); Collaboration: for the European Society of Breast Imaging (EUSOBI), with language review by Europa Donna-The European Breast Cancer Coalition

    2015-12-15

    This paper summarizes information about breast MRI to be provided to women and referring physicians. After listing contraindications, procedure details are described, stressing the need for correct scheduling and not moving during the examination. The structured report including BI-RADS registered categories and further actions after a breast MRI examination are discussed. Breast MRI is a very sensitive modality, significantly improving screening in high-risk women. It also has a role in clinical diagnosis, problem solving, and staging, impacting on patient management. However, it is not a perfect test, and occasionally breast cancers can be missed. Therefore, clinical and other imaging findings (from mammography/ultrasound) should also be considered. Conversely, MRI may detect lesions not visible on other imaging modalities turning out to be benign (false positives). These risks should be discussed with women before a breast MRI is requested/performed. Because breast MRI drawbacks depend upon the indication for the examination, basic information for the most important breast MRI indications is presented. Seventeen notes and five frequently asked questions formulated for use as direct communication to women are provided. The text was reviewed by Europa Donna-The European Breast Cancer Coalition to ensure that it can be easily understood by women undergoing MRI. (orig.)

  15. Correlative Study on MRI Morphologic Features,Pathology, and Molecular Biology of Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    Rong Chen; Shuigen Gong; Weiguo Zhang; Jinhua Chen; Shuangwu He; Baohua Liu; Zengpeng Li

    2005-01-01

    OBJECTIVE To investigate the correlation among MRI morphologic features,pathology, and molecular biology of breast cancer.METHORDS MRI was used to analyze the morphologic features of breast cancers of 78 patients before operation. The mastectomy specimens of the breast neoplasms were immunohistochemically stained, and the expression of the estrogen (ER), progesterone receptor (PR), C-erbB-2, P53, and the distribution of microvessel density (MVD) measured. The pathologic results were compared with the MRI features.RESULTS Among the 80 breast cancers, ER positive expression was positively correlated with the spicular contour of breast cancers (P<0.01),while showing a significant inverse correlation with the T-stage (P<0.05). CerbB-2 and P53 positive expression were positively correlated with the necrotic center of the cancers (P<0.05). The expression of PR was not significantly correlated with the spicular contour, obscure margin, necrotic center, and T-stage of these cancers (P>0.05). Among 41 breast cancers examined with dynamic contrast enhanced MR, there was a positive correlation between the spatial distribution of the contrast agent and MVD(P<0.01).CONCLUSION To a certain extent there is some correlation among the MRI morphologic features, pathology, and molecular biological factors in breast cancer. The biological behavior and prognosis of breast cancer can be assessed based on MRI features.

  16. Analysis of dynamic enhanced MRI performance characteristics of benign and malignant breast lesion%乳腺良恶性病变动态增强MRI表现特征分析

    Institute of Scientific and Technical Information of China (English)

    符益纲

    2014-01-01

    Objective:To compare and analyze the dynamic enhanced MRI performance characteristics of benign and malignant breast lesion.Methods:68 cases with breast lesion were selected as the research objects.42 cases were besnign breast lesion,and 26 cases were malignant breast lesion.The two groups were given dynamic enhanced MRI examination.The performance characteristics,T-SI types,early intensive rate and peak reinforcement rate of breast lesion of two groups were compared and analyzed in MRI examination.Results:The lesion morphology of the mammary gland malignant lesion group was irregular shape, and the lesion edge was mainly burr shape.The lesion morphology of the breast benign lesion group was regular shape,and the lesion edge was mainly smooth.The difference was statistically significant(P<0.05).T-SI in the breast benign lesion group was mainly Ⅰ type,and the mammary gland malignant lesion group was mainly Ⅲ type.The difference was statistically significant(P<0.05).MRI early intensive rate of the mammary gland malignant lesion group was higher than that of the breast benign lesion group(P<0.05).Conclusion:In the dynamic enhanced MRI examination,the contrast and summary of lesion morphology,T-SI types, early intensive rate and peak reinforcement rate of patients in the benign and malignant breast lesion can provide the reliable basis for the differential diagnosis of benign and malignant.%目的:对比分析乳腺良恶性病变动态增强 MRI 的表现特征。方法:收治乳腺病变患者68例,作为研究对象,乳腺良性病变42例,乳腺恶性病变26例。两组均行动态增强MRI检查,对比分析MRI检查下,两组乳腺病变的形态表现特征、T-SI分型及早期强化率和峰值强化率。结果:乳腺恶性病变组病变形态主要呈不规则状,病变边缘以毛刺状为主;而乳腺良性病变组病变形态主要呈规则状,病变边缘以光滑为主。两组比较,差异均具有统计学意义(P均<0

  17. US correlation for MRI-detected breast lesions in women with familial risk of breast cancer.

    NARCIS (Netherlands)

    Sim, L.S.; Hendriks, J.H.C.L.; Bult, P.; Fook-Chong, S.M.

    2005-01-01

    AIM: To examine the value of US correlation for MRI-detected breast lesions in women with familial risk of breast cancer. METHODS: From an initial dataset of 245 women with positive family history who had breast cancer surveillance involving mammography or MRI between November 1994 and February 2001

  18. Extra-mammary findings in breast MRI

    Energy Technology Data Exchange (ETDEWEB)

    Rinaldi, Pierluigi; Costantini, M.; Belli, P.; Giuliani, M.; Bufi, E.; Fubelli, R.; Distefano, D.; Romani, M.; Bonomo, L. [Catholic University - Policlinic A. Gemelli, Department of Bio-Imaging and Radiological Sciences, Rome (Italy)

    2011-11-15

    Incidental extra-mammary findings in breast Magnetic Resonance Imaging (MRI) may be benign in nature, but may also represent a metastasis or another important lesion. We aimed to analyse the prevalence and clinical relevance of these unexpected findings. A retrospective review of 1535 breast MRIs was conducted. Only axial sequences were reassessed. Confirmation examinations were obtained in all cases. 285 patients had a confirmed incidental finding, which were located in the liver (51.9%), lung (11.2%), bone (7%), mediastinal lymph nodes (4.2%) or consisted of pleural/pericardial effusion (15.4%). 20.4% of incidental findings were confirmed to be malignant. Positive predictive value for MRI to detect a metastatic lesion was high if located within the bone (89%), lymph nodes (83%) and lung (59%), while it was low if located within the liver (9%) or if it consisted of pleural/pericardial effusion (6%). The axial enhanced sequence showed superior sensitivity to unenhanced images in detecting metastatic lesions, especially if only smaller ({<=}10 mm.) lesions were considered. The prevalence of metastatic incidental extra-mammary findings is not negligible. Particular attention should be to incidental findings located within the lung, bone and mediastinal lymph nodes. (orig.)

  19. MRI of the breast: state of the art

    Energy Technology Data Exchange (ETDEWEB)

    Friedrich, M. [Abteilung Radiologie/Nuklearmedizin, Krankenhaus am Urban, Dieffenbachstrasse 1, D-10 967 Berlin (Germany)

    1998-06-02

    Contrast-enhanced MRI of the breast is probably the most sensitive method to detect breast pathology. It is best used to improve the sensitivity of mammography and sonography in selected patient groups with high breast cancer prevalence, where conventional methods are known to be less sensitive. Despite the high sensitivity of MRI, 5-12 % of invasive carcinomas are not recognized during MRI, because of lack of the typical criteria of carcinoma. MRI is probably inferior to mammography in detecting ductal in-situ carcinoma or very small carcinomas (< 3 mm), because the neo-angiogenesis induced by these small carcinomas is too faint to be detected by contrast-enhanced MRI. These tumours cannot be excluded by a normal MRI examination. MRI is non-specific as the distinction of benign and malignant breast lesions is unreliable. Only in selected cases (fat- or blood-containing lesions) may it improve the specificity of mammography and sonography. Mostly image-guided core biopsy is by far the most specific and least expensive method to establish a definitive diagnosis. For lesions exclusively detected by contrast-enhanced MRI, simple and reliable localisation devices are urgently needed. Presently accepted indications for MRI of the breast are: patients with silicone implants after mastectomy or augmentation mammoplasty (detection of recurrence/prothesis rupture/silicon leakage); patients whose breasts are difficult to evaluate by combined mammography and sonography, who have had breast conservation therapy (local recurrence), or who have proven carcinoma in one breast (multifocality/-centricity or contralateral breast carcinoma) or proven axillary lymph node metastases from an unknown primary tumor, especially when these are hormone receptor positive; patients with extensive postoperative scarring. In the future, genetically defined high breast cancer risk may become an indication. (orig.) With 11 figs., 2 tabs., 151 refs.

  20. Mammography combined with breast dynamic contrast-enhanced-magnetic resonance imaging for the diagnosis of early breast cancer

    Institute of Scientific and Technical Information of China (English)

    Yakun He; Guohui Xu; Jin Ren; Bin Feng; Xiaolei Dong; Hao Lu; Changjiu He

    2016-01-01

    Objective The aim of this study was to investigate the application of mammography combined with breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for the diagnosis of early breast cancer. Methods Mammography and DCE-MRI were performed for 120 patients with breast cancer (malignant, 102; benign; 18). Results The sensitivity of mammography for early diagnosis of breast cancer was 66.67%, specificity was 77.78%, and accuracy was 68.33%. The sensitivity of MRI for early diagnosis of breast cancer was 94.12%, specificity was 88.89%, and accuracy was 93.33%. However, the sensitivity of mammography combined with DCE-MRI volume imaging with enhanced water signal (VIEWS) scanning for early diagnosis of breast cancer was 97.06%, specificity was 94.44%, and accuracy was 96.67%. Conclusion Mammography combined with DCE-MRI increased the sensitivity, specificity, and accuracy of diagnosing early breast cancer.

  1. Breast MRI, digital mammography and breast tomosynthesis: comparison of three methods for early detection of breast cancer

    Directory of Open Access Journals (Sweden)

    Dragana Roganovic

    2015-11-01

    Full Text Available Breast cancer is the most common malignancy in women and early detection is important for its successful treatment. The aim of this study was to investigate the sensitivity and specificity of three methods for early detection of breast cancer: breast magnetic resonance imaging (MRI, digital mammography, and breast tomosynthesis in comparison to histopathology, as well as to investigate the intraindividual variability between these modalities.  We included 57 breast lesions, each detected by three diagnostic modalities: digital mammography, breast MRI, and breast tomosynthesis, and subsequently confirmed by histopathology. Breast Imaging-Reporting and Data System (BI-RADS was used for characterizing the lesions. One experienced radiologist interpreted all three diagnostic modalities. Twenty-nine of the breast lesions were malignant while 28 were benign. The sensitivity for digital mammography, breast MRI, and breast tomosynthesis, was 72.4%, 93.1%, and 100%, respectively; while the specificity was 46.4%, 60.7%, and 75%, respectively. Receiver operating characteristics (ROC curve analysis showed an overall diagnostic advantage of breast tomosynthesis over both breast MRI and digital mammography. The difference in performance between breast tomosynthesis and digital mammography was significant (p < 0.001, while the difference between breast tomosynthesis and breast MRI was not significant (p = 0.20. 

  2. Computerized breast parenchymal analysis on DCE-MRI

    Science.gov (United States)

    Li, Hui; Giger, Maryellen L.; Yuan, Yading; Jansen, Sanaz A.; Lan, Li; Bhooshan, Neha; Newstead, Gillian M.

    2009-02-01

    Breast density has been shown to be associated with the risk of developing breast cancer, and MRI has been recommended for high-risk women screening, however, it is still unknown how the breast parenchymal enhancement on DCE-MRI is associated with breast density and breast cancer risk. Ninety-two DCE-MRI exams of asymptomatic women with normal MR findings were included in this study. The 3D breast volume was automatically segmented using a volume-growing based algorithm. The extracted breast volume was classified into fibroglandular and fatty regions based on the discriminant analysis method. The parenchymal kinetic curves within the breast fibroglandular region were extracted and categorized by use of fuzzy c-means clustering, and various parenchymal kinetic characteristics were extracted from the most enhancing voxels. Correlation analysis between the computer-extracted percent dense measures and radiologist-noted BIRADS density ratings yielded a correlation coefficient of 0.76 (pBIRADS 3 and 4) were found to have more parenchymal enhancement at their peak time point (Ep) with an average Ep of 116.5% while those women with fatty breasts (BIRADS 1 and 2) demonstrated an average Ep of 62.0%. In conclusion, breast parenchymal enhancement may be associated with breast density and may be potential useful as an additional characteristic for assessing breast cancer risk.

  3. Quantitative breast MRI radiomics for cancer risk assessment and the monitoring of high-risk populations

    Science.gov (United States)

    Mendel, Kayla R.; Li, Hui; Giger, Maryellen L.

    2016-03-01

    Breast density is routinely assessed qualitatively in screening mammography. However, it is challenging to quantitatively determine a 3D density from a 2D image such as a mammogram. Furthermore, dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) is used more frequently in the screening of high-risk populations. The purpose of our study is to segment parenchyma and to quantitatively determine volumetric breast density on pre-contrast axial DCE-MRI images (i.e., non-contrast) using a semi-automated quantitative approach. In this study, we retroactively examined 3D DCE-MRI images taken for breast cancer screening of a high-risk population. We analyzed 66 cases with ages between 28 and 76 (mean 48.8, standard deviation 10.8). DCE-MRIs were obtained on a Philips 3.0 T scanner. Our semi-automated DCE-MRI algorithm includes: (a) segmentation of breast tissue from non-breast tissue using fuzzy cmeans clustering (b) separation of dense and fatty tissues using Otsu's method, and (c) calculation of volumetric density as the ratio of dense voxels to total breast voxels. We examined the relationship between pre-contrast DCE-MRI density and clinical BI-RADS density obtained from radiology reports, and obtained a statistically significant correlation [Spearman ρ-value of 0.66 (p < 0.0001)]. Our method within precision medicine may be useful for monitoring high-risk populations.

  4. 磁共振DCE和DWI联合评价中老年乳腺癌的临床意义%Value of apparent diffusion coefficient and dynamic enhanced MRI in the differential diagnosis of senile breast cancer

    Institute of Scientific and Technical Information of China (English)

    张丽萍

    2016-01-01

    目的:探讨表观弥散系数与动态增强MRI在鉴别诊断中老年乳腺癌中的价值。方法对疑有乳腺病变中老年患者56例进行双侧乳腺MRI平扫、弥散加权成像和动态增强扫描。结果 DCE-MRI形态学诊断乳腺病变的敏感度、特异度和准确性分别为73.68%、93.75%和82.86%,与手术或病理诊断比较Kappa=0.663;TIC类型诊断乳腺病变的敏感度、特异度和准确性分别为89.47%、68.75%和80.00%,与手术或病理诊断比较Kappa=0.597;当b值取1000s/mm2时,以ADC=1.222×10-3 mm2/s作为ADC诊断乳腺病变的阀值,ADC值诊断乳腺病变的敏感度、特异度和准确性分别为94.74%、81.25%和88.57%,与手术或病理诊断比较Kappa=0.773。结论 DCE-MRI形态学和ADC值诊断乳腺病变与手术病理诊断结果高度一致,其中ADC值诊断乳腺病变的价值略高于DCE-MRI形态学。%Objective To investigate the value of apparent diffusion coefficient and dynamic enhanced MRI in the differential diagnosis of senile breast cancer.Methods From March 2013 to February 2015, the patients suspected 56 with breast lesions, who needed to be further confirmed, underwent preoperative for bilateral breast MRI scan.Results The DCE-MRI morphologi-cal-the sensitivity of the diagnosis of breast lesions, specific degrees and accuracy were 73.68%, 93.75%and 73.68%respec-tively, compared with surgery or pathologic diagnosis of Kappa =0.663; TIC type the sensitivity of the diagnosis of breast le-sions, specific degrees and accuracy were 89.47%, 68.75%and 89.47%respectively, compared with surgery or pathologic di-agnosis of Kappa=0.597;When b=1 000 s/mm2 , with ADC=1.222 ×10-3 mm2/s as the threshold of ADC in the diagnosis of breast lesions, the sensitivity of the ADC values in the diagnosis of breast lesions, specific degrees and accuracy were 94.74%, 81.25%and 94.74% respectively, compared with surgery or pathologic

  5. Multi-atlas based segmentation of multiple organs in breast MRI

    Science.gov (United States)

    Liang, Xi; Sedai, Suman; Wang, Hongzhi; Liang, Sisi; Hashmi, Naveed; Mcneillie, Patrick; Hashoul, Sharbell

    2015-03-01

    Automatic segmentation of the breast, chest wall and heart is an important pre-processing step for automatic lesion detection of breast MR and dynamic contrast-enhanced MR studies. In this paper, we present a fully automatic segmentation procedure of multiple organs in breast MRI images using multi-atlas based methods. Our method starts by reducing the image inhomogeneity using anisotropic fusion method. We then build multiple atlases with labels of breast, chest wall and heart. These atlases are registered to a target image to obtain warped organ labels that are aligned to the target image. Given the warped organ labels, segmentation is performed via label fusion. In this paper, we evaluate various label fusion methods and compare their performance on segmenting multiple anatomical structures in breast MRI.

  6. Usefulness of MRI in detecting occult breast cancer associated with Paget's disease of the nipple-areolar complex.

    Science.gov (United States)

    Echevarria, J J; Lopez-Ruiz, J A; Martin, D; Imaz, I; Martin, M

    2004-12-01

    MRI allows for the detection of mammographically and clinically occult breast neoplasms. We analysed the ability of MRI to detect occult breast cancer in three patients with Paget's disease of the nipple-areolar complex, proven histologically. In all three cases we observed differences in the morphological and dynamic features of healthy and pathological nipples, and we also found enhancement foci in breast tissue, with suspicious kinetic and morphological characteristics, which in the case of two patients corresponded to ductal carcinoma in situ. The detection and location with MRI of underlying neoplastic foci may be of help in choosing the most reasonable and conservative treatment in these patients.

  7. The role of conventional and functional MRI in diagnosis of breast masses

    Directory of Open Access Journals (Sweden)

    Atef Hammad Teama

    2015-12-01

    Conclusion: DCE-MRI of the breast had a higher sensitivity for breast cancer detection and more accurate in delineation of the disease extension. The breast MRI with three parameters (DCE-MRI, DWI, and MRS increased the diagnostic accuracy of the breast cancer.

  8. Metabolomics of Breast Cancer Using High-Resolution Magic Angle Spinning Magnetic Resonance Spectroscopy: Correlations with 18F-FDG Positron Emission Tomography-Computed Tomography, Dynamic Contrast-Enhanced and Diffusion-Weighted Imaging MRI.

    Directory of Open Access Journals (Sweden)

    Haesung Yoon

    Full Text Available Our goal in this study was to find correlations between breast cancer metabolites and conventional quantitative imaging parameters using high-resolution magic angle spinning (HR-MAS magnetic resonance spectroscopy (MRS and to find breast cancer subgroups that show high correlations between metabolites and imaging parameters.Between August 2010 and December 2013, we included 53 female patients (mean age 49.6 years; age range 32-75 years with a total of 53 breast lesions assessed by the Breast Imaging Reporting and Data System. They were enrolled under the following criteria: breast lesions larger than 1 cm in diameter which 1 were suspicious for malignancy on mammography or ultrasound (US, 2 were pathologically confirmed to be breast cancer with US-guided core-needle biopsy (CNB 3 underwent 3 Tesla MRI with dynamic contrast-enhanced (DCE and diffusion-weighted imaging (DWI and positron emission tomography-computed tomography (PET-CT, and 4 had an attainable immunohistochemistry profile from CNB. We acquired spectral data by HR-MAS MRS with CNB specimens and expressed the data as relative metabolite concentrations. We compared the metabolites with the signal enhancement ratio (SER, maximum standardized FDG uptake value (SUV max, apparent diffusion coefficient (ADC, and histopathologic prognostic factors for correlation. We calculated Spearman correlations and performed a partial least squares-discriminant analysis (PLS-DA to further classify patient groups into subgroups to find correlation differences between HR-MAS spectroscopic values and conventional imaging parameters.In a multivariate analysis, the PLS-DA models built with HR-MAS MRS metabolic profiles showed visible discrimination between high and low SER, SUV, and ADC. In luminal subtype breast cancer, compared to all cases, high SER, ADV, and SUV were more closely clustered by visual assessment. Multiple metabolites were correlated with SER and SUV in all cases. Multiple metabolites

  9. Abbreviated MRI Protocols: Wave of the Future for Breast Cancer Screening.

    Science.gov (United States)

    Chhor, Chloe M; Mercado, Cecilia L

    2017-02-01

    The purpose of this article is to describe the use of abbreviated breast MRI protocols for improving access to screening for women at intermediate risk. Breast MRI is not a cost-effective modality for screening women at intermediate risk, including those with dense breast tissue as the only risk. Abbreviated breast MRI protocols have been proposed as a way of achieving efficiency and rapid throughput. Use of these abbreviated protocols may increase availability and provide women with greater access to breast MRI.

  10. Breast inflammation: indications for MRI and PET-CT.

    Science.gov (United States)

    de Bazelaire, C; Groheux, D; Chapellier, M; Sabatier, F; Scémama, A; Pluvinage, A; Albiter, M; de Kerviler, E

    2012-02-01

    Breast MRI should not be used for differential diagnosis between inflammatory breast cancer and acute mastitis (AM) prior to treatment. When mastitis symptoms persist after 10 to 15 days of well-managed medical treatment, MRI may be performed in addition to an ultrasound examination, a mammogram and to taking histological samples, in order to eliminate inflammatory breast cancer (IBC). For staging, MRI would seem to be useful in looking for a contralateral lesion, PET-CT for finding information about remote metastases and in certain centres, for information about the initial extension to local/regional lymph nodes, which would guide the fields of irradiation (since patients can become lymph node negative after neoadjuvant chemotherapy). MRI and PET-CT seems to be useful for early detection of patients responding poorly to neoadjuvant chemotherapy so that the latter may be rapidly modified. Copyright © 2011 Éditions française de radiologie. Published by Elsevier Masson SAS. All rights reserved.

  11. New method for predicting estrogen receptor status utilizing breast MRI texture kinetic analysis

    Science.gov (United States)

    Chaudhury, Baishali; Hall, Lawrence O.; Goldgof, Dmitry B.; Gatenby, Robert A.; Gillies, Robert; Drukteinis, Jennifer S.

    2014-03-01

    Magnetic Resonance Imaging (MRI) of breast cancer typically shows that tumors are heterogeneous with spatial variations in blood flow and cell density. Here, we examine the potential link between clinical tumor imaging and the underlying evolutionary dynamics behind heterogeneity in the cellular expression of estrogen receptors (ER) in breast cancer. We assume, in an evolutionary environment, that ER expression will only occur in the presence of significant concentrations of estrogen, which is delivered via the blood stream. Thus, we hypothesize, the expression of ER in breast cancer cells will correlate with blood flow on gadolinium enhanced breast MRI. To test this hypothesis, we performed quantitative analysis of blood flow on dynamic contrast enhanced MRI (DCE-MRI) and correlated it with the ER status of the tumor. Here we present our analytic methods, which utilize a novel algorithm to analyze 20 volumetric DCE-MRI breast cancer tumors. The algorithm generates post initial enhancement (PIE) maps from DCE-MRI and then performs texture features extraction from the PIE map, feature selection, and finally classification of tumors into ER positive and ER negative status. The combined gray level co-occurrence matrices, gray level run length matrices and local binary pattern histogram features allow quantification of breast tumor heterogeneity. The algorithm predicted ER expression with an accuracy of 85% using a Naive Bayes classifier in leave-one-out cross-validation. Hence, we conclude that our data supports the hypothesis that imaging characteristics can, through application of evolutionary principles, provide insights into the cellular and molecular properties of cancer cells.

  12. Quantitative DWI implemented after DCE-MRI yields increased specificity for BI-RADS 3 and 4 breast lesions

    NARCIS (Netherlands)

    Dijkstra, Hildebrand; Dorrius, Monique D; Wielema, Mirjam; Pijnappel, Ruud M; Oudkerk, Matthijs; Sijens, Paul E

    2016-01-01

    PURPOSE: To assess if specificity can be increased when semiautomated breast lesion analysis of quantitative diffusion-weighted imaging (DWI) is implemented after dynamic contrast-enhanced (DCE-) magnetic resonance imaging (MRI) in the workup of BI-RADS 3 and 4 breast lesions larger than 1 cm. MATER

  13. Preoperative indication for systemic therapy extended to patients with early-stage breast cancer using multiparametric 7-tesla breast MRI.

    Science.gov (United States)

    Schmitz, A M T; Veldhuis, W B; Menke-Pluijmers, M B E; van der Kemp, W J M; van der Velden, T A; Viergever, M A; Mali, W P T M; Kock, M C J M; Westenend, P J; Klomp, D W J; Gilhuijs, K G A

    2017-01-01

    To establish a preoperative decision model for accurate indication of systemic therapy in early-stage breast cancer using multiparametric MRI at 7-tesla field strength. Patients eligible for breast-conserving therapy were consecutively included. Patients underwent conventional diagnostic workup and one preoperative multiparametric 7-tesla breast MRI. The postoperative (gold standard) indication for systemic therapy was established from resected tumor and lymph-node tissue, based on 10-year risk-estimates of breast cancer mortality and relapse using Adjuvant! Online. Preoperative indication was estimated using similar guidelines, but from conventional diagnostic workup. Agreement was established between preoperative and postoperative indication, and MRI-characteristics used to improve agreement. MRI-characteristics included phospomonoester/phosphodiester (PME/PDE) ratio on 31-phosphorus spectroscopy (31P-MRS), apparent diffusion coefficients on diffusion-weighted imaging, and tumor size on dynamic contrast-enhanced (DCE)-MRI. A decision model was built to estimate the postoperative indication from preoperatively available data. We included 46 women (age: 43-74yrs) with 48 invasive carcinomas. Postoperatively, 20 patients (43%) had positive, and 26 patients (57%) negative indication for systemic therapy. Using conventional workup, positive preoperative indication agreed excellently with positive postoperative indication (N = 8/8; 100%). Negative preoperative indication was correct in only 26/38 (68%) patients. However, 31P-MRS score (p = 0.030) and tumor size (p = 0.002) were associated with the postoperative indication. The decision model shows that negative indication is correct in 21/22 (96%) patients when exempting tumors larger than 2.0cm on DCE-MRI or with PME>PDE ratios at 31P-MRS. Preoperatively, positive indication for systemic therapy is highly accurate. Negative indication is highly accurate (96%) for tumors sized ≤2,0cm on DCE-MRI and with PME

  14. 乳腺疾病的 MRI 诊断%MRI dia gnosis the breast diseases

    Institute of Scientific and Technical Information of China (English)

    杨正军; 郭周中; 赵双全

    2012-01-01

      Objective:To investigate the application value of MRI in the diagno sis of breast diseases.Methods: The clinical data of 126 cases of patients with breast disease confirmed by surgical biopsy was analyzed retrospectively.The MRI findings of breast lesions were analyzed.The MRI features of benign and malignant lesions were compared.Results 77 cases with benign lesions were eccentric strengthening, while 49 cases with malignant lesions being concentric strengthening. Besides,the contrast of both enhanced MRI and time intensity curve type between benign and malignant lesions,which had significant differences (P ﹤ 0.05,P ﹤ 0.01).Conclusions MRI imaging examination has a high clinical value in the differential diagnosis of benign and malignant breast lesions.%  目的探讨 MRI 对乳腺疾病的临床应用价值.方法回顾性分析126例经手术病理证实的乳腺疾病患者病例资料,分析乳腺病变的 MRI 检查结果,对比良、恶性病变的 MRI 特点.结果126例患者中,良性病变者77例为离心性强化,恶性病变者49例为向心性强化,且良恶性病变的 MRI 增强对比及时间强度曲线分型对比均具有显著性差异(P ﹤0.05,P ﹤0.01).结论 MRI 影像学检查技术在鉴别诊断乳腺良恶性病变时具有很高的临床价值.

  15. Counterview: Pre-operative breast MRI (magnetic resonance imaging) is not recommended for all patients with newly diagnosed breast cancer.

    Science.gov (United States)

    Solin, Lawrence J

    2010-02-01

    For the woman with a newly diagnosed early stage breast cancer, the routine use of pre-operative breast MRI (magnetic resonance imaging) is not indicated beyond conventional breast imaging (i.e., mammography with correlation ultrasound as indicated). There is no consistent evidence that a pre-operative breast MRI confers a benefit to the patient by improving clinical outcomes or surgical procedures. In a meta-analysis of studies reporting on the use of pre-operative breast MRI for the patient with an established index cancer, multifocal or multicentric disease was found on breast MRI in 16% of the patients, a rate substantially higher than the rate of local recurrence after breast conserving surgery plus definitive radiation treatment. In the largest retrospective study of patients treated with breast conserving surgery plus radiation, no gain was found for adding a breast MRI to conventional breast imaging. No randomized clinical trial has been designed to evaluate long term clinical outcomes associated with adding a pre-operative breast MRI. Adding pre-operative breast MRI can alter clinical management in ways that are potentially harmful to patients, for example, increased ipsilateral mastectomies, increased contralateral prophylactic mastectomies, increased work-ups, and delay to definitive surgery. In summary, the routine use of pre-operative breast MRI is not warranted for the typical patient with a newly diagnosed early stage breast cancer.

  16. MRI Background Parenchymal Enhancement Is Not Associated with Breast Cancer.

    Directory of Open Access Journals (Sweden)

    Barbara Bennani-Baiti

    Full Text Available Previously, a strong positive association between background parenchymal enhancement (BPE at magnetic resonance imaging (MRI and breast cancer was reported in high-risk populations. We sought to determine, whether this was also true for non-high-risk patients.540 consecutive patients underwent breast MRI for assessment of breast findings (BI-RADS 0-5, non-high-risk screening (no familial history of breast cancer, no known genetic mutation, no prior chest irradiation, or previous breast cancer diagnosis and subsequent histological work-up. For this IRB-approved study, BPE and fibroglandular tissue FGT were retrospectively assessed by two experienced radiologists according to the BI-RADS lexicon. Pearson correlation coefficients were calculated to explore associations between BPE, FGT, age and final diagnosis of breast cancer. Subsequently, multivariate logistic regression analysis, considering covariate colinearities, was performed, using final diagnosis as the target variable and BPE, FGT and age as covariates.Age showed a moderate negative correlation with FGT (r = -0.43, p<0.001 and a weak negative correlation with BPE (r = -0.28, p<0.001. FGT and BPE correlated moderately (r = 0.35, p<0.001. Final diagnosis of breast cancer displayed very weak negative correlations with FGT (r = -0.09, p = 0.046 and BPE (r = -0.156, p<0.001 and weak positive correlation with age (r = 0.353, p<0.001. On multivariate logistic regression analysis, the only independent covariate for prediction of breast cancer was age (OR 1.032, p<0.001.Based on our data, neither BPE nor FGT independently correlate with breast cancer risk in non-high-risk patients at MRI. Our model retained only age as an independent risk factor for breast cancer in this setting.

  17. Imaging Appearance and Clinical Impact of Preoperative Breast MRI in Pregnancy-Associated Breast Cancer.

    Science.gov (United States)

    Myers, Kelly S; Green, Lauren A; Lebron, Lizza; Morris, Elizabeth A

    2017-09-01

    The purpose of this study is to describe the imaging features of pregnancy-associated breast cancer (PABC) on breast MRI and to consider the impact of preoperative MRI on patient management. A retrospective review of medical records from January 1994 to May 2014 identified 183 women who presented with a new diagnosis of breast cancer during pregnancy or within 1 year postpartum. MR images were available for 53 of these patients, all of whom were included in the study. Clinical history and available breast images were reviewed. The clinical impact of preoperative breast MRI was also recorded. Of the 53 women, nine (17%) presented during pregnancy and 44 (83%) presented during the first year postpartum. The sensitivity of MRI was 98% (52/53). Among the 53 patients, the most common findings of PABC on MRI included a solitary mass (29 patients [55%]), nonmass enhancement (12 patients [23%]), and multiple masses (eight patients [15%]). For 12 patients (23%), MRI showed a pathologically proven larger tumor size or greater extent of disease than did mammography or ultrasound, with an additional eight patients (15%) having findings suspicious for greater extent of disease but having unavailable pathologic data. Breast MRI changed surgical management for 15 patients (28%), with four patients (8%) requiring a larger lumpectomy, seven (13%) no longer being considered candidates for lumpectomy, two (4%) having contralateral disease, and two (4%) having unsuspected metastasis. Breast MRI had a high sensitivity for PABC in our study population. MRI may play an important role in PABC because it changed the surgical management of 28% of patients.

  18. Computer-aided diagnosis for diagnostically challenging breast lesions in DCE-MRI based on image registration and integration of morphologic and dynamic characteristics

    Science.gov (United States)

    Retter, Felix; Plant, Claudia; Burgeth, Bernhard; Botella, Guillermo; Schlossbauer, Thomas; Meyer-Bäse, Anke

    2013-12-01

    Diagnostically challenging lesions comprise both foci (small lesions) and non-mass-like enhancing lesions and pose a challenge to current computer-aided diagnosis systems. Motion-based artifacts lead in dynamic contrast-enhanced breast magnetic resonance to diagnostic misinterpretation; therefore, motion compensation represents an important prerequisite to automatic lesion detection and diagnosis. In addition, the extraction of pertinent kinetic and morphologic features as lesion descriptors is an equally important task. In the present paper, we evaluate the performance of a computer-aided diagnosis system consisting of motion correction, lesion segmentation, and feature extraction and classification. We develop a new feature extractor, the radial Krawtchouk moment, which guarantees rotation invariance. Many novel feature extraction techniques are proposed and tested in conjunction with lesion detection. Our simulation results have shown that motion compensation combined with Minkowski functionals and Bayesian classifier can improve lesion detection and classification.

  19. Visualization of suspicious lesions in breast MRI based on intelligent neural systems

    Science.gov (United States)

    Twellmann, Thorsten; Lange, Oliver; Nattkemper, Tim Wilhelm; Meyer-Bäse, Anke

    2006-05-01

    Intelligent medical systems based on supervised and unsupervised artificial neural networks are applied to the automatic visualization and classification of suspicious lesions in breast MRI. These systems represent an important component of future sophisticated computer-aided diagnosis systems and enable the extraction of spatial and temporal features of dynamic MRI data stemming from patients with confirmed lesion diagnosis. By taking into account the heterogenity of the cancerous tissue, these techniques reveal the malignant, benign and normal kinetic signals and and provide a regional subclassification of pathological breast tissue. Intelligent medical systems are expected to have substantial implications in healthcare politics by contributing to the diagnosis of indeterminate breast lesions by non-invasive imaging.

  20. Breast density estimation from high spectral and spatial resolution MRI.

    Science.gov (United States)

    Li, Hui; Weiss, William A; Medved, Milica; Abe, Hiroyuki; Newstead, Gillian M; Karczmar, Gregory S; Giger, Maryellen L

    2016-10-01

    A three-dimensional breast density estimation method is presented for high spectral and spatial resolution (HiSS) MR imaging. Twenty-two patients were recruited (under an Institutional Review Board--approved Health Insurance Portability and Accountability Act-compliant protocol) for high-risk breast cancer screening. Each patient received standard-of-care clinical digital x-ray mammograms and MR scans, as well as HiSS scans. The algorithm for breast density estimation includes breast mask generating, breast skin removal, and breast percentage density calculation. The inter- and intra-user variabilities of the HiSS-based density estimation were determined using correlation analysis and limits of agreement. Correlation analysis was also performed between the HiSS-based density estimation and radiologists' breast imaging-reporting and data system (BI-RADS) density ratings. A correlation coefficient of 0.91 ([Formula: see text]) was obtained between left and right breast density estimations. An interclass correlation coefficient of 0.99 ([Formula: see text]) indicated high reliability for the inter-user variability of the HiSS-based breast density estimations. A moderate correlation coefficient of 0.55 ([Formula: see text]) was observed between HiSS-based breast density estimations and radiologists' BI-RADS. In summary, an objective density estimation method using HiSS spectral data from breast MRI was developed. The high reproducibility with low inter- and low intra-user variabilities shown in this preliminary study suggest that such a HiSS-based density metric may be potentially beneficial in programs requiring breast density such as in breast cancer risk assessment and monitoring effects of therapy.

  1. The importance of preoperative breast MRI for patients newly diagnosed with breast cancer.

    Science.gov (United States)

    Crowe, Joseph P; Patrick, Rebecca J; Rim, Alice

    2009-01-01

    The use of preoperative breast magnetic resonance imaging (bMRI) for patients newly diagnosed with breast cancer has been criticized for increasing the number of therapeutic mastectomies performed, as well as increasing the cost of treatment. The purpose of this report is to examine one surgeon's practice and to describe the MRI findings for patients with breast cancer to determine if those findings changed the therapeutic options for those patients in. Data were collected prospectively between August 2003 and January 2006 for patients newly diagnosed with breast cancer. Diagnoses were made by core biopsy or fine-needle aspiration; all lesions were intact at the time of MRI. Twenty-five percent of patients were found to have previously occult, but suspicious lesions on MRI that required additional diagnostic evaluation, including ultrasound, core biopsy, excisional biopsy, or any combination; for approximately half of these patients a separate cancer was confirmed. For most of these patients, the new lesion was ipsilateral and multicentric, and most required mastectomy. For the remaining 75% of patients, MRI confirmed the index lesion was the only area of concern, and appropriate surgical treatment was completed. Preoperative bMRI for patients newly diagnosed with breast cancer identified previously occult and separate tumors in 13% of patients, resulting in surgical treatment change for many.

  2. Fibroadenoma of the axillary accessory breast: diagnostic value of dynamic magnetic resonance imaging.

    Science.gov (United States)

    Sawa, Munehisa; Kawai, Nobuyuki; Sato, Morio; Takeuchi, Taizo; Tamaki, Takeshi; Oura, Shoji

    2010-10-01

    Accessory breast is synonymous with polymastia or supernumerary breast tissue. An accessory breast without a nipple or areola is rare. We report a case of fibroadenoma of an accessory breast with no nipple or areola in a 41-year-old woman who presented with a right axillary mass associated with five small nodules in the normally situated breast. Magnetic resonance imaging (MRI) showed the accessory breast surrounding the tumor. We ignored the presence of the component surrounding the mass and made a preoperative diagnosis of an axillary mass of possible metastases from multiple breast cancers or breast cancer of unknown origin associated with multiple breast fibroadenomas. From a retrospective view, based on the histological results, MRI and dynamic MRI demonstrated a tiny component of breast-like tissue surrounding the axillary mass and an enhancement pattern typical of fibroadenoma for the axillary mass. For the later diagnosis of the axillary mass, the interpretation of whether the component of breast tissue surrounding the axillary mass was present is crucial. If the component exists, a tumor that originated from the accessory breast should be foremost in the differential diagnosis. Dynamic MRI appears to contribute to the diagnosis of fibroadenoma of an accessory breast before biopsy or surgical resection.

  3. Increasing cancer detection yield of breast MRI using a new CAD scheme of mammograms

    Science.gov (United States)

    Tan, Maxine; Aghaei, Faranak; Hollingsworth, Alan B.; Stough, Rebecca G.; Liu, Hong; Zheng, Bin

    2016-03-01

    Although breast MRI is the most sensitive imaging modality to detect early breast cancer, its cancer detection yield in breast cancer screening is quite low (women) to date. The purpose of this preliminary study is to test the potential of developing and applying a new computer-aided detection (CAD) scheme of digital mammograms to identify women at high risk of harboring mammography-occult breast cancers, which can be detected by breast MRI. For this purpose, we retrospectively assembled a dataset involving 30 women who had both mammography and breast MRI screening examinations. All mammograms were interpreted as negative, while 5 cancers were detected using breast MRI. We developed a CAD scheme of mammograms, which include a new quantitative mammographic image feature analysis based risk model, to stratify women into two groups with high and low risk of harboring mammography-occult cancer. Among 30 women, 9 were classified into the high risk group by CAD scheme, which included all 5 women who had cancer detected by breast MRI. All 21 low risk women remained negative on the breast MRI examinations. The cancer detection yield of breast MRI applying to this dataset substantially increased from 16.7% (5/30) to 55.6% (5/9), while eliminating 84% (21/25) unnecessary breast MRI screenings. The study demonstrated the potential of applying a new CAD scheme to significantly increase cancer detection yield of breast MRI, while simultaneously reducing the number of negative MRIs in breast cancer screening.

  4. Tumor-to-breast volume ratio as measured on MRI: a possible predictor of breast-conserving surgery versus mastectomy.

    Science.gov (United States)

    Faermann, Renata; Sperber, Fani; Schneebaum, Schlomo; Barsuk, Daphna

    2014-02-01

    The surgical approach to breast cancer changed dramatically in the past 20 years. The surgical objective today is to remove the tumor, ensuring negative margins and good cosmetic results, and preserving the breast when possible. Magnetic resonance imaging of the breast has become an essential imaging tool prior to surgery, diagnosing additional tumors and assessing tumor extent. Tumor-to-breast volume ratio, an important predictor of breast conservation, can be measured with MRI and may change the surgical decision. To measure the tumor-to-breast volume ratio using MRI in order to assess whether there is a correlation between this ratio and the type of surgery selected (breast-conserving or mastectomy). The volumes of the tumor and the breast and the tumor-to-breast volume ratio were retrospectively calculated using preoperative breast MRI in 76 patients who underwent breast-conserving surgery or mastectomy. Breast-conserving surgery (lumpectomy) was performed in 64 patients and mastectomy in 12. The average tumor-to-breast volume ratio was 0.06 (6%) in the lumpectomy group and 0.30 (30%) in the mastectomy group (P < 0.0001). The tumor-to-breast volume ratio correlated with the type of surgery. As measured on MRI, this ratio is an accurate means of determining the type of surgery best suited for a given patient. It is recommended that MRI-determined tumor-to-breast volume ratio become part of the surgical planning protocol for patients diagnosed with breast cancer.

  5. Preoperative axillary lymph node evaluation in breast cancer patients by breast magnetic resonance imaging (MRI): Can breast MRI exclude advanced nodal disease?

    Energy Technology Data Exchange (ETDEWEB)

    Hyun, Su Jeong [Yonsei University College of Medicine, Department of Radiology, Breast Cancer Clinic, Severance Hospital, Research Institute of Radiological Science, Seoul (Korea, Republic of); Hallym University Medical Center, Department of Radiology, Kangnam Sacred Heart Hospital, Seoul (Korea, Republic of); Kim, Eun-Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Kim, Min Jung [Yonsei University College of Medicine, Department of Radiology, Breast Cancer Clinic, Severance Hospital, Research Institute of Radiological Science, Seoul (Korea, Republic of)

    2016-11-15

    To evaluate the diagnostic performance of breast magnetic resonance imaging (MRI) in preoperative evaluation of axillary lymph node metastasis (ALNM) in breast cancer patients and to assess whether breast MRI can be used to exclude advanced nodal disease. A total of 425 patients were included in this study and breast MRI findings were retrospectively reviewed. The diagnostic performance of breast MRI for diagnosis of ALNM was evaluated in all patients, patients with neoadjuvant chemotherapy (NAC), and those without NAC (no-NAC). We evaluated whether negative MRI findings (cN0) can exclude advanced nodal disease (pN2-pN3) using the negative predictive value (NPV) in each group. The sensitivity and NPV of breast MRI in evaluation of ALNM was 51.3 % (60/117) and 83.3 % (284/341), respectively. For cN0 cases on MRI, pN2-pN3 manifested in 1.8 % (6/341) of the overall patients, 0.4 % (1/257) of the no-NAC group, and 6 % (5/84) of the NAC group. The NPV of negative MRI findings for exclusion of pN2-pN3 was higher for the no-NAC group than for the NAC group (99.6 % vs. 94.0 %, p = 0.039). Negative MRI findings (cN0) can exclude the presence of advanced nodal disease with an NPV of 99.6 % in the no-NAC group. (orig.)

  6. Eigentumors for prediction of treatment failure in patients with early-stage breast cancer using dynamic contrast-enhanced MRI: a feasibility study

    Science.gov (United States)

    Chan, H. M.; van der Velden, B. H. M.; E Loo, C.; Gilhuijs, K. G. A.

    2017-08-01

    We present a radiomics model to discriminate between patients at low risk and those at high risk of treatment failure at long-term follow-up based on eigentumors: principal components computed from volumes encompassing tumors in washin and washout images of pre-treatment dynamic contrast-enhanced (DCE-) MR images. Eigentumors were computed from the images of 563 patients from the MARGINS study. Subsequently, a least absolute shrinkage selection operator (LASSO) selected candidates from the components that contained 90% of the variance of the data. The model for prediction of survival after treatment (median follow-up time 86 months) was based on logistic regression. Receiver operating characteristic (ROC) analysis was applied and area-under-the-curve (AUC) values were computed as measures of training and cross-validated performances. The discriminating potential of the model was confirmed using Kaplan-Meier survival curves and log-rank tests. From the 322 principal components that explained 90% of the variance of the data, the LASSO selected 28 components. The ROC curves of the model yielded AUC values of 0.88, 0.77 and 0.73, for the training, leave-one-out cross-validated and bootstrapped performances, respectively. The bootstrapped Kaplan-Meier survival curves confirmed significant separation for all tumors (P  treatment eigentumors for use in prediction of treatment failure of breast cancer.

  7. Breast MRI in pregnancy-associated breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Shin Jung; Shin, Sang Soo [Dept. of of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of); Lim, Hyo Soon; Baek, Jang Mi; Seon, Hyun Ju; Heo, Suk Hee; Kim, Jin Woong; Park, Min Ho [Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Hwasun (Korea, Republic of)

    2017-03-15

    The purpose of this study was to evaluate the usefulness of MR imaging and to describe the MR imaging findings of pregnancy-associated breast cancer. From 2006 to 2013, MR images of 23 patients with pregnancy-associated breast cancer were retrospectively evaluated. MR images were reviewed to evaluate lesion detection and imaging findings of pregnancy-associated breast cancer. MR images were analyzed by using the Breast Imaging Reporting and Data System and an additional MR-detected lesion with no mammographic or sonographic abnormality was determined. MR imaging depicted breast cancer in all patients, even in marked background parenchymal enhancement. Pregnancy-associated breast cancer was seen as a mass in 20 patients and as non-mass enhancement with segmental distribution in 3 patients. The most common features of the masses were irregular shape (85%), non-circumscribed margin (85%), and heterogeneous enhancement (60%). An additional site of cancer was detected with MR imaging in 5 patients (21.7%) and the type of surgery was changed. Pregnancy-associated breast cancer was usually seen as an irregular mass with heterogeneous enhancement on MR images. Although these findings were not specific, MR imaging was useful in evaluating the disease extent of pregnancy-associated breast cancer.

  8. Lesion morphology on breast MRI affects targeted ultrasound correlation rate

    Energy Technology Data Exchange (ETDEWEB)

    Hollowell, Lauren; Price, Elissa; Arasu, Vignesh; Wisner, Dorota; Hylton, Nola; Joe, Bonnie [UCSF, San Francisco, CA (United States)

    2015-05-01

    Suspicious lesions on breast MRI are often initially evaluated using targeted ultrasound. However, workup varies. Data on the rate of correlate detection by morphology [mass, non-mass enhancement (NME), or focus] would be useful for developing practice guidelines. Breast MRI examinations from 1 January 2008 to 31 December 2010 were reviewed. BI-RADS 4 or 5 lesions on MRI evaluated with targeted ultrasound where definitive diagnosis was obtained were included. Statistical analysis was performed on aggregate data and at the lesion level. A total of 204 lesions were included in the study. A statistically significant difference in ultrasound correlate identification by morphology was found; a correlate was found in 49.3 % of masses, 15 % of NME, and 42.3 % of foci (p = 0.0006). Additional analysis within each morphology demonstrated significantly greater rate of malignancy in masses with an ultrasound correlate than masses without a correlate (p = 0.0062), while the rate of malignancy in NME and foci did not differ with ultrasound correlation. Morphology of a suspicious lesion on breast MRI affects the probability of identifying an ultrasound correlate. As sonographic correlates are found in nearly half of masses and foci, targeted ultrasound should be the initial step in their workup. (orig.)

  9. A fully automated system for quantification of background parenchymal enhancement in breast DCE-MRI

    Science.gov (United States)

    Ufuk Dalmiş, Mehmet; Gubern-Mérida, Albert; Borelli, Cristina; Vreemann, Suzan; Mann, Ritse M.; Karssemeijer, Nico

    2016-03-01

    Background parenchymal enhancement (BPE) observed in breast dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) has been identified as an important biomarker associated with risk for developing breast cancer. In this study, we present a fully automated framework for quantification of BPE. We initially segmented fibroglandular tissue (FGT) of the breasts using an improved version of an existing method. Subsequently, we computed BPEabs (volume of the enhancing tissue), BPErf (BPEabs divided by FGT volume) and BPErb (BPEabs divided by breast volume), using different relative enhancement threshold values between 1% and 100%. To evaluate and compare the previous and improved FGT segmentation methods, we used 20 breast DCE-MRI scans and we computed Dice similarity coefficient (DSC) values with respect to manual segmentations. For evaluation of the BPE quantification, we used a dataset of 95 breast DCE-MRI scans. Two radiologists, in individual reading sessions, visually analyzed the dataset and categorized each breast into minimal, mild, moderate and marked BPE. To measure the correlation between automated BPE values to the radiologists' assessments, we converted these values into ordinal categories and we used Spearman's rho as a measure of correlation. According to our results, the new segmentation method obtained an average DSC of 0.81 0.09, which was significantly higher (p<0.001) compared to the previous method (0.76 0.10). The highest correlation values between automated BPE categories and radiologists' assessments were obtained with the BPErf measurement (r=0.55, r=0.49, p<0.001 for both), while the correlation between the scores given by the two radiologists was 0.82 (p<0.001). The presented framework can be used to systematically investigate the correlation between BPE and risk in large screening cohorts.

  10. Pathologic Findings in MRI-Guided Needle Core Biopsies of the Breast in Patients with Newly Diagnosed Breast Cancer

    OpenAIRE

    Siziopikou, K. P.; P. Jokich; Cobleigh, M.

    2011-01-01

    The role of MRI in the management of breast carcinoma is rapidly evolving from its initial use for specific indications only to a more widespread use on all women with newly diagnosed early stage breast cancer. However, there are many concerns that such widespread use is premature since detailed correlation of MRI findings with the underlying histopathology of the breast lesions is still evolving and clear evidence for improvements in management and overall prognosis of breast cancer patients...

  11. MRI in diagnosis of pathological complete response in breast cancer patients after neoadjuvant chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Li, Yan-Ling; Zhang, Xiao-Peng; Li, Jie; Cao, Kun; Cui, Yong; Li, Xiao-Ting; Sun, Ying-Shi, E-mail: sys@bjcancer.org

    2015-02-15

    Graphical abstract: After NAC, the original tumor area still had residual enhancement which may be misdiagnosed to be residual tumor with the current standard. Under the new standards it can effectively be correctly identified as pCR. And the pathological analysis ensured the diagnosis of pCR after surgery. - Highlights: • The confirmation of complete pathological response (pCR) after Neo-adjuvant chemotherapy (NAC) of breast cancer patients can contribute to an optimal choice of surgical procedure. • The present study selected out effective indicators for diagnosis of pCR by MRI using non-pCR cases as the control. • The study established an appropriate diagnostic program to maximize the accuracy of detecting pCR by MRI. - Abstract: Objective: To select effective indicators for diagnosis of pathological complete response (pCR) by MRI and to establish an appropriate diagnostic program to maximize the accuracy of pCR detection by MRI. Materials and methods: Twenty-one pCR patients and 22 non-pCR randomly selected patients receiving neoadjuvant chemotherapy (NAC) and subsequent surgery were recruited for the study. All patients underwent breast MRIs both before and after chemotherapy. Changes in diameter, area and dynamic variables between the first and final MRI were compared between the two groups. Logistic and ROC analysis were performed to select effective indicators for predicting pCR on MRI. Results: Eleven out of 43 patients had no residual enhanced areas on MRI, and the sensitivity and specificity for predicting pCR on MRI under the current criterion was 52.38% and 100%, respectively. Logistic regression analysis revealed that changes in diameter, SI{sub peak} and area were effective in predicting pCR by MRI. The latter two parameters had a greater impact on diagnosis than the diameter change. Two new independent criteria were established to predict pCR on MRI: (1) a reduction of ≥78% in area; and (2) a combination of a reduction of ≥27% in SI

  12. An anatomically oriented breast model for MRI

    Science.gov (United States)

    Kutra, Dominik; Bergtholdt, Martin; Sabczynski, Jörg; Dössel, Olaf; Buelow, Thomas

    2015-03-01

    Breast cancer is the most common cancer in women in the western world. In the breast cancer care-cycle, MRIis e.g. employed in lesion characterization and therapy assessment. Reading of a single three dimensional image or comparing a multitude of such images in a time series is a time consuming task. Radiological reporting is done manually by translating the spatial position of a finding in an image to a generic representation in the form of a breast diagram, outlining quadrants or clock positions. Currently, registration algorithms are employed to aid with the reading and interpretation of longitudinal studies by providing positional correspondence. To aid with the reporting of findings, knowledge about the breast anatomy has to be introduced to translate from patient specific positions to a generic representation. In our approach we fit a geometric primitive, the semi-super-ellipsoid to patient data. Anatomical knowledge is incorporated by fixing the tip of the super-ellipsoid to the mammilla position and constraining its center-point to a reference plane defined by landmarks on the sternum. A coordinate system is then constructed by linearly scaling the fitted super-ellipsoid, defining a unique set of parameters to each point in the image volume. By fitting such a coordinate system to a different image of the same patient, positional correspondence can be generated. We have validated our method on eight pairs of baseline and follow-up scans (16 breasts) that were acquired for the assessment of neo-adjuvant chemotherapy. On average, the location predicted and the actual location of manually set landmarks are within a distance of 5.6 mm. Our proposed method allows for automatic reporting simply by uniformly dividing the super-ellipsoid around its main axis.

  13. A Case Report of Breast Sparganosis in a Patient with Ipsilateral Breast Cancer: MRI and Ultrasonographic Findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yoo Jin; Bae, Young Tae; Kim, Jee Yeon [Pusan National University Hospital, Pusan National University School of Medicine, Busan (Korea, Republic of); Choo, Ki Seok [Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan (Korea, Republic of)

    2010-12-15

    Sparganosis of the breast is a quite rare parasitic infection of humans and presents as soft tissue masses that mimic breast malignancy or benign tumor, such as fibroadenoma. We present here a case of histologically confirmed breast sparganosis in the upper inner quadrant of the right breast with coexisting breast cancer in the ipsilateral breast upper outer quadrant. Ultrasonography of breast sparganosis showed a well defined, tubular hypoechoic mass with discrete multilayered wall and tubule-in tubule appearance, surrounded by heterogenous hyperechoic areas in the subcutaneous fat layer of the breast. MRI revealed an elongated tubular structure with persistent and progressive enhancement. This is the second report concerned with the MRI and ultrasonographic findings of breast sparganosis and the first report of breast sparganosis in a patient with ipsilateral breast cancer

  14. A Novel Approach to Contrast-Enhanced Breast Magnetic Resonance Imaging for Screening: High-Resolution Ultrafast Dynamic Imaging

    NARCIS (Netherlands)

    Mann, R.M.; Mus, R.D.M.; Zelst, J. van; Geppert, C.; Karssemeijer, N.; Platel, B.

    2014-01-01

    The use of breast magnetic resonance imaging (MRI) as screening tool has been stalled by high examination costs. Scan protocols have lengthened to optimize specificity. Modern view-sharing sequences now enable ultrafast dynamic whole-breast MRI, allowing much shorter and more cost-effective procedur

  15. Fat suppression techniques for obtaining high resolution dynamic contrast enhanced bilateral breast MR images at 7 tesla

    DEFF Research Database (Denmark)

    van der Velden, Tijl A; Schmitz, Alexander M Th; Gilhuijs, Kenneth G A

    2016-01-01

    OBJECTIVES: To compare water selective excitation (WSE) and Dixon fat suppression in the context of high-resolution dynamic contrast enhanced MRI of the breast at 7 tesla. METHODS: Ten healthy volunteers and one patient with a malignant breast lesion were scanned at 7 tesla. The MRI protocol...

  16. Radiologic Findings of Ductal Carcinoma in Situ Arising Within a Juvenile Fibroadenoma: Mammographic, Sonographic and Dynamic Contrast-Enhanced Breast MRI Features

    OpenAIRE

    Park, Eun Kyung; Cho, Kyu Ran; Seo, Bo Kyoung; Woo, Ok Hee; Lee, Jeong Hyeon; Song, Sung Eun; Bae, Jeong Won

    2015-01-01

    Juvenile fibroadenoma is an uncommon histologic variant of fibroadenoma that frequently shows a remarkable and rapid growth. The development of a carcinoma within a fibroadenoma, either in situ or invasive, is a rare condition. We encountered a 36-year-old woman with a palpable mass in the right breast. The radiologic findings were indicative of a fibroadenoma in the breast. Sonographic guided biopsy using a 14G core needle revealed the presence of ductal carcinoma in situ (DCIS) within the j...

  17. Selection of Spatiotemporal Features in Breast MRI to Differentiate between Malignant and Benign Small Lesions Using Computer-Aided Diagnosis

    Directory of Open Access Journals (Sweden)

    F. Steinbruecker

    2012-01-01

    Full Text Available Automated detection and diagnosis of small lesions in breast MRI represents a challenge for the traditional computer-aided diagnosis (CAD systems. The goal of the present research was to compare and determine the optimal feature sets describing the morphology and the enhancement kinetic features for a set of small lesions and to determine their diagnostic performance. For each of the small lesions, we extracted morphological and dynamical features describing both global and local shape, and kinetics behavior. In this paper, we compare the performance of each extracted feature set for the differential diagnosis of enhancing lesions in breast MRI. Based on several simulation results, we determined the optimal feature number and tested different classification techniques. The results suggest that the computerized analysis system based on spatiotemporal features has the potential to increase the diagnostic accuracy of MRI mammography for small lesions and can be used as a basis for computer-aided diagnosis of breast cancer with MR mammography.

  18. Blind compressive sensing dynamic MRI.

    Science.gov (United States)

    Lingala, Sajan Goud; Jacob, Mathews

    2013-06-01

    We propose a novel blind compressive sensing (BCS) frame work to recover dynamic magnetic resonance images from undersampled measurements. This scheme models the dynamic signal as a sparse linear combination of temporal basis functions, chosen from a large dictionary. In contrast to classical compressed sensing, the BCS scheme simultaneously estimates the dictionary and the sparse coefficients from the undersampled measurements. Apart from the sparsity of the coefficients, the key difference of the BCS scheme with current low rank methods is the nonorthogonal nature of the dictionary basis functions. Since the number of degrees-of-freedom of the BCS model is smaller than that of the low-rank methods, it provides improved reconstructions at high acceleration rates. We formulate the reconstruction as a constrained optimization problem; the objective function is the linear combination of a data consistency term and sparsity promoting l1 prior of the coefficients. The Frobenius norm dictionary constraint is used to avoid scale ambiguity. We introduce a simple and efficient majorize-minimize algorithm, which decouples the original criterion into three simpler subproblems. An alternating minimization strategy is used, where we cycle through the minimization of three simpler problems. This algorithm is seen to be considerably faster than approaches that alternates between sparse coding and dictionary estimation, as well as the extension of K-SVD dictionary learning scheme. The use of the l1 penalty and Frobenius norm dictionary constraint enables the attenuation of insignificant basis functions compared to the l0 norm and column norm constraint assumed in most dictionary learning algorithms; this is especially important since the number of basis functions that can be reliably estimated is restricted by the available measurements. We also observe that the proposed scheme is more robust to local minima compared to K-SVD method, which relies on greedy sparse coding. Our

  19. Abbreviated MRI protocols for detecting breast cancer in women with dense breasts

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Shung Qing; Huang, Min; Shen, Yu Ying; Liu, Chen Lu; Xu, Chuan Xiao [The Affiliated Suzhou Hospital, Nanjing Medical University, Suzhou (China)

    2017-06-15

    To evaluate the validity of two abbreviated protocols (AP) of MRI in breast cancer screening of dense breast tissue. This was a retrospective study in 356 participants with dense breast tissue and negative mammography results. The study was approved by the Nanjing Medical University Ethics Committee. Patients were imaged with a full diagnostic protocol (FDP) of MRI. Two APs (AP-1 consisting of the first post-contrast subtracted [FAST] and maximum-intensity projection [MIP] images, and AP-2 consisting of AP-1 combined with diffusion-weighted imaging [DWI]) and FDP images were analyzed separately, and the sensitivities and specificities of breast cancer detection were calculated. Of the 356 women, 67 lesions were detected in 67 women (18.8%) by standard MR protocol, and histological examination revealed 14 malignant lesions and 53 benign lesions. The average interpretation time of AP-1 and AP-2 were 37 seconds and 54 seconds, respectively, while the average interpretation time of the FDP was 3 minutes and 25 seconds. The sensitivities of the AP-1, AP-2, and FDP were 92.9, 100, and 100%, respectively, and the specificities of the three MR protocols were 86.5, 95.0, and 96.8%, respectively. There was no significant difference among the three MR protocols in the diagnosis of breast cancer (p > 0.05). However, the specificity of AP-1 was significantly lower than that of AP-2 (p = 0.031) and FDP (p = 0.035), while there was no difference between AP-2 and FDP (p > 0.05). The AP may be efficient in the breast cancer screening of dense breast tissue. FAST and MIP images combined with DWI of MRI are helpful to improve the specificity of breast cancer detection.

  20. MRI features of intraductal papilloma of the breast: sheep in wolf's clothing?

    Energy Technology Data Exchange (ETDEWEB)

    Kurz, Kathinka D; Roy, Sumit (Dept. of Radiology, Stavanger Univ. Hospital, Stavanger (Norway)), e-mail: kurk@sus.no; Saleh, Andreas (Inst. of Diagnostic Radiology, Duesseldorf Univ. Hospital, Duesseldorf (Germany)); Diallo-Danebrock, Raihana (Inst. of Pathology, Duesseldorf Univ. Hospital, Duesseldorf (Germany)); Skaane, Per (Dept. of Radiology, Ullevaal Univ. Hospital, Univ. of Oslo, Oslo (Norway))

    2011-04-15

    Background: Intraductal papillomas often present as small, smooth masses, dilated ducts or microcalcifications at mammography and as smooth, hypoechoic masses at sonography. At magnetic resonance imaging (MRI), intraductal papillomas often present as small smooth masses, however, often with strong enhancement with type 2 or 3 time intensity curves. The result of the MR analysis is therefore not infrequently inconclusive in order to characterize the mass as benign or malignant. Purpose: To characterize the appearance of intraductal papillomas of the breast at MRI, and determine whether the application of diagnostic rules described in literature could contribute to correctly classifying the lesions as benign. Material and Methods: Twenty patients with histologically proven intraductal papillomas were included. Two radiologists independently reviewed the MR images of the breast. The BI-RADS nomenclature was used to describe morphology and contrast-enhancement kinetics. Interobserver agreement in the interpretation of the MR images by the two investigators was performed. Kappa coefficient was calculated as index for the level of agreement. Subsequently, three sets of diagnostic rules, including the Goettinger score described by Fischer and the interpretation flowcharts according to Kinkel and to Tozaki were applied to characterize whether a biopsy should be recommended or not. Results: All papillomas presented as masses on dynamic contrast-enhanced MRI. Only five papillomas showed a round, oval, or lobulated shape combined with smooth margins and continuous rise of the time intensity curve. Using the Goettinger score, biopsy would be recommended in 16 patients. Based on the interpretation flowcharts of Kinkel and of Tozaki, an additional 13 and 10 papillomas, respectively, were correctly classified as benign. Dilated ducts were visible in 10 patients. The interobserver agreement was good or excellent for all included variables. Conclusion: Including systematic analysis

  1. 乳腺疾病的MRI研究进展%Advances in breast diseases MRI

    Institute of Scientific and Technical Information of China (English)

    黄娟; 田军章; 江桂华

    2011-01-01

    MRI has excellent soft tissue resolution,and this technology is more and more widely used in breast disease diagnosis in recent years.Blood supply and perfusion through the microvascular network of tumor can be imaged noninvasively by dynamic contrast-enhanced MRI and perfusion-weighted imaging.Diffusion-weighted imaging and magnetic resonance spectroscopy can provide molecular information of breast lesions.Magnetic resonance ductography provides a new technology for detecting intraductal breast lesions.With MRI technology maturing and the rapid development of software and hardware,MRI shows its unique advantages in breast lesions characterization.%MRI具有极佳的软组织分辨率,近年来,该技术越来越广泛的应用于乳腺疾病的诊断.乳腺动态增强成像和灌注加权成像可从不同角度反映乳腺组织及病灶的血供灌注情况,弥散加权成像和磁共振波谱分析则从分子水平提供乳腺病变组织信息,磁共振乳腺导管成像为导管内病变提供了新的影像诊断方法.随着MRI技术的成熟、软硬件的迅速发展,MRI在乳腺疾病的检出和诊断方面显示出其独到的优势.

  2. Predicting local recurrence following breast-conserving treatment: parenchymal signal enhancement ratio (SER) around the tumor on preoperative MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Young; Cho, Nariya; Koo, Hye Ryoung; Yun, Bo La; Bae, Min Sun; Moon, Woo Kyung [Dept. of Radiology, Seoul National Univ. Coll. of Medicine, Seoul National Univ. Hospital, Seoul (Korea, Republic of)], e-mail: river7774@gmail.com; Chie, Eui Kyu [Dept. of Radiation Oncology, Seoul National Univ. Coll. of Medicine, Seoul National Univ. Hospital, Seoul (Korea, Republic of)

    2013-09-15

    Background: The level of background parenchymal enhancement around tumor is known to be associated with breast cancer risk. However, there is no study investigating predictive power of parenchymal signal enhancement ratio (SER) around tumor for ipsilateral breast tumor recurrence (IBTR). Purpose: To investigate whether the breast parenchymal SER around the tumor on preoperative dynamic contrast-enhanced magnetic resonance imaging (MRI) is associated with subsequent IBTR in breast cancer patients who had undergone breast-conserving treatment. Material and Methods: Nineteen consecutive women (mean age, 44 years; range, 34-63 years) with breast cancer who developed IBTR following breast-conserving treatment and 114 control women matched for age, as well as T and N stages were included. We compared the clinicopathologic features of the two groups including nuclear grade, histologic grade, hormonal receptor status, human epidermal growth factor receptor-2 (HER-2) status, lymphovascular invasion, negative margin width, use of adjuvant therapy, and parenchymal SER around the tumor on preoperative DCE-MRI. The SER was measured on a slice showing the largest dimension of the tumor. Multivariate conditional logistic regression analysis was used to identify independent factors associated with IBTR. Results: In univariate analysis, ER negativity (odds ratio [OR] = 4.7; P = 0.040), PR negativity (OR = 4.0; P = 0.013), HER-2 positivity (OR = 3.6; P = 0.026), and a parenchymal SER greater than 0.53 (OR = 23.3; P = 0.011) were associated with IBTR. In multivariate analysis, ER negativity (OR = 3.8; P = 0.015) and a parenchymal SER greater than 0.53 (OR = 13.2; P = 0.040) on preoperative MRI were independent factors associated with IBTR. Conclusion: In addition to ER negativity, a higher parenchymal SER on preoperative MRI was an independent factor associated with subsequent IBTR in patients with breast cancer who had undergone breast-conserving treatment.

  3. Association of Different MRI BIRADS Descriptors With Malignancy in Non Mass-Like Breast Lesions.

    Science.gov (United States)

    Gity, Masoumeh; Ghazi Moghadam, Koosha; Jalali, Amir Hossein; Shakiba, Madjid

    2014-12-01

    Several studies on the diagnostic efficacy of MRI has not real consensus for the accuracy of MRI characteristics in non mass like breast lesions, and the number of malignant lesions in different studies is insufficient. In this study we aimed to analyze the diagnostic role of MRI BIRADS features for diagnosis of malignancy in non mass like breast lesions. All patients with positive findings (BIRADS 3, 4, 5), which had either biopsy proved pathology or follow-up MRI data at least for 12 months were included in the study. Finally, 213 breasts MRI that showed non mass like enhancing lesions among our patients were assessed in study. One experienced breast radiologist who was unaware of any clinical information or the histopathologic diagnosis evaluated all images retrospectively. The morphologic parameters evaluated consisted of distribution modifiers and pattern of internal enhancement. The kinetic enhancement parameters were assessed as showing washout, plateau, or persistent patterns. In the enhancement kinetic analysis, thew most worrisome curve type in each lesion was considered for interpretation, if it was more than 2% enhancement. We have evaluated the visual findings by comparison of the signal intensity on the first and third dynamic series. Data for the study were extracted from the breast MRI database and analyzed using SPSS version 16 statistical software. Totally 188 patients had 213 non mass like lesions. Mean age of the patients was 44.9 ± 8.3 years (24-63). Totally 46 of lesions were malignant (21.6%). The most common BIRADS score was 4 (116; 54.5%). The most prevalent feature of distribution, internal enhancement and curve type were focal (59.2%), clumped (27.2%) and washout (34.3%). Distribution of different subgroups of MR BIRADS features was different among benign and malignant lesions (All Pvalues BIRADS (4,5) for diagnosis of malignancy was 100%. Specificity of segmental or ductal linear distribution in diagnosis of malignancy was 81

  4. Early Prediction and Evaluation of Breast Cancer Response to Neoadjuvant Chemotherapy Using Quantitative DCE-MRI

    Directory of Open Access Journals (Sweden)

    Alina Tudorica

    2016-02-01

    Full Text Available The purpose is to compare quantitative dynamic contrast-enhanced (DCE magnetic resonance imaging (MRI metrics with imaging tumor size for early prediction of breast cancer response to neoadjuvant chemotherapy (NACT and evaluation of residual cancer burden (RCB. Twenty-eight patients with 29 primary breast tumors underwent DCE-MRI exams before, after one cycle of, at midpoint of, and after NACT. MRI tumor size in the longest diameter (LD was measured according to the RECIST (Response Evaluation Criteria In Solid Tumors guidelines. Pharmacokinetic analyses of DCE-MRI data were performed with the standard Tofts and Shutter-Speed models (TM and SSM. After one NACT cycle the percent changes of DCE-MRI parameters Ktrans (contrast agent plasma/interstitium transfer rate constant, ve (extravascular and extracellular volume fraction, kep (intravasation rate constant, and SSM-unique τi (mean intracellular water lifetime are good to excellent early predictors of pathologic complete response (pCR vs. non-pCR, with univariate logistic regression C statistics value in the range of 0.804 to 0.967. ve values after one cycle and at NACT midpoint are also good predictors of response, with C ranging 0.845 to 0.897. However, RECIST LD changes are poor predictors with C = 0.609 and 0.673, respectively. Post-NACT Ktrans, τi, and RECIST LD show statistically significant (P < .05 correlations with RCB. The performances of TM and SSM analyses for early prediction of response and RCB evaluation are comparable. In conclusion, quantitative DCE-MRI parameters are superior to imaging tumor size for early prediction of therapy response. Both TM and SSM analyses are effective for therapy response evaluation. However, the τi parameter derived only with SSM analysis allows the unique opportunity to potentially quantify therapy-induced changes in tumor energetic metabolism.

  5. DWI in breast MRI: Role of ADC value to determine diagnosis between recurrent tumor and surgical scar in operated patients

    Energy Technology Data Exchange (ETDEWEB)

    Rinaldi, Pierluigi, E-mail: pierluigi.rinaldi@rm.unicatt.i [Department of Bio-Imaging and Radiological Sciences, Catholic University - Policlinic A. Gemelli, L.go A. Gemelli 8, 00168 Rome (Italy); Giuliani, Michela, E-mail: micgiuli@yahoo.i [Department of Bio-Imaging and Radiological Sciences, Catholic University - Policlinic A. Gemelli, L.go A. Gemelli 8, 00168 Rome (Italy); Belli, Paolo, E-mail: pbelli@rm.unicatt.i [Department of Bio-Imaging and Radiological Sciences, Catholic University - Policlinic A. Gemelli, L.go A. Gemelli 8, 00168 Rome (Italy); Costantini, Melania, E-mail: mcostantini@rm.unicatt.i [Department of Bio-Imaging and Radiological Sciences, Catholic University - Policlinic A. Gemelli, L.go A. Gemelli 8, 00168 Rome (Italy); Romani, Maurizio, E-mail: mromani@rm.unicatt.i [Department of Bio-Imaging and Radiological Sciences, Catholic University - Policlinic A. Gemelli, L.go A. Gemelli 8, 00168 Rome (Italy); Distefano, Daniela, E-mail: daniela_distefano@hotmail.i [Department of Bio-Imaging and Radiological Sciences, Catholic University - Policlinic A. Gemelli, L.go A. Gemelli 8, 00168 Rome (Italy); Bufi, Enida, E-mail: reagandus@alice.i [Department of Bio-Imaging and Radiological Sciences, Catholic University - Policlinic A. Gemelli, L.go A. Gemelli 8, 00168 Rome (Italy); Mule, Antonino, E-mail: amule@rm.unicatt.i [Division of Pathology and Histology, Catholic University - Policlinic A. Gemelli, L.go A. Gemelli 8, 00168 Rome (Italy); Magno, Stefano, E-mail: smagno@rm.unicatt.i [Department of Surgery, Breast Unit, Catholic University Policlinic A. Gemelli, L.go A. Gemelli 8, 00168 Rome (Italy); Masetti, Riccardo, E-mail: riccardo.masetti@rm.unicatt.i [Department of Surgery, Breast Unit, Catholic University Policlinic A. Gemelli, L.go A. Gemelli 8, 00168 Rome (Italy); Bonomo, Lorenzo, E-mail: lbonomo@rm.unicatt.i [Dept. of Bio-Imaging and Radiological Sciences, Catholic Univ. - Policlinic A. Gemelli, L.go A. Gemelli 8, 00168 Rome (Italy)

    2010-08-15

    Introduction: Purpose of our study is to evaluate the role of the apparent diffusion coefficient (ADC) in the diagnosis of recurrent tumor on the scar in patients operated for breast cancer. Assess, therefore, the weight of diagnostic diffusion echo-planar sequence, in association with the morphological and dynamic sequences in the diagnosis of tumor recurrence versus surgical scar. Materials and methods: From September 2007 to March 2009, 72 patients operated for breast cancer with suspected recurrence on the scar were consecutively subjected to magnetic resonance imaging (MRI), including use of a diffusion sequence. All patients with pathological enhancement in the scar were then subjected to histological typing. MRI was considered negative in the absence of areas of suspicious enhancement. In all cases it was measured the ADC value in the scar area or in the area with pathological enhancement. The ADC values were compared with MRI findings and histological results obtained. Results: 26 cases were positive/doubtful at MRI and then subjected to histological typing: of these recurrences were 20 and benign were 6. 46 cases were judged negative at MRI and therefore not sent to cyto-histology. The average ADC value of recurrences was statistically lower of scarring (p < 0.001). Conclusions: ADC value can be a specific parameter in differential diagnosis between recurrence and scar. The diffusion sequence, in association with the morphological and dynamic sequences, can be considered a promising tool for the surgical indication in suspected recurrence of breast cancer.

  6. Avoiding preoperative breast MRI when conventional imaging is sufficient to stage patients eligible for breast conserving therapy

    Energy Technology Data Exchange (ETDEWEB)

    Pengel, Kenneth E., E-mail: k.pengel@nki.nl [Department of Radiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Loo, Claudette E. [Department of Radiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Wesseling, Jelle [Department of Pathology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Pijnappel, Ruud M. [Department of Radiology/Image Sciences Institute, University Medical Center Utrecht Heidelberglaan 100, 3584 CX Utrecht (Netherlands); Rutgers, Emiel J.Th. [Department of Surgical Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Gilhuijs, Kenneth G.A. [Department of Radiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Department of Radiology/Image Sciences Institute, University Medical Center Utrecht Heidelberglaan 100, 3584 CX Utrecht (Netherlands)

    2014-02-15

    Aim: To determine when preoperative breast MRI will not be more informative than available breast imaging and can be omitted in patients eligible for breast conserving therapy (BCT). Methods: We performed an MRI in 685 consecutive patients with 692 invasive breast tumors and eligible for BCT based on conventional imaging and clinical examination. We explored associations between patient, tumor, and conventional imaging characteristics and similarity with MRI findings. Receiver operating characteristic (ROC) analysis was employed to compute the area under the curve (AUC). Results: MRI and conventional breast imaging were similar in 585 of the 692 tumors (85%). At univariate analysis, age (p < 0.001), negative preoperative lymph node status (p = 0.011), comparable tumor diameter at mammography and at ultrasound (p = 0.001), negative HER2 status (p = 0.044), and absence of invasive lobular cancer (p = 0.005) were significantly associated with this similarity. At multivariate analysis, these factors, except HER2 status, retained significant associations. The AUC was 0.68. Conclusions: It is feasible to identify a subgroup of patients prior to preoperative breast MRI, who will most likely show similar results on conventional imaging as on MRI. These findings enable formulation of a practical consensus guideline to determine in which patients a preoperative breast MRI can be omitted.

  7. Radiomic analysis reveals DCE-MRI features for prediction of molecular subtypes of breast cancer

    Science.gov (United States)

    Fan, Ming; Li, Hui; Wang, Shijian; Zheng, Bin; Zhang, Juan; Li, Lihua

    2017-01-01

    The purpose of this study was to investigate the role of features derived from breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and to incorporated clinical information to predict the molecular subtypes of breast cancer. In particular, 60 breast cancers with the following four molecular subtypes were analyzed: luminal A, luminal B, human epidermal growth factor receptor-2 (HER2)-over-expressing and basal-like. The breast region was segmented and the suspicious tumor was depicted on sequentially scanned MR images from each case. In total, 90 features were obtained, including 88 imaging features related to morphology and texture as well as dynamic features from tumor and background parenchymal enhancement (BPE) and 2 clinical information-based parameters, namely, age and menopausal status. An evolutionary algorithm was used to select an optimal subset of features for classification. Using these features, we trained a multi-class logistic regression classifier that calculated the area under the receiver operating characteristic curve (AUC). The results of a prediction model using 24 selected features showed high overall classification performance, with an AUC value of 0.869. The predictive model discriminated among the luminal A, luminal B, HER2 and basal-like subtypes, with AUC values of 0.867, 0.786, 0.888 and 0.923, respectively. An additional independent dataset with 36 patients was utilized to validate the results. A similar classification analysis of the validation dataset showed an AUC of 0.872 using 15 image features, 10 of which were identical to those from the first cohort. We identified clinical information and 3D imaging features from DCE-MRI as candidate biomarkers for discriminating among four molecular subtypes of breast cancer. PMID:28166261

  8. Image to physical space registration of supine breast MRI for image guided breast surgery

    Science.gov (United States)

    Conley, Rebekah H.; Meszoely, Ingrid M.; Pheiffer, Thomas S.; Weis, Jared A.; Yankeelov, Thomas E.; Miga, Michael I.

    2014-03-01

    Breast conservation therapy (BCT) is a desirable option for many women diagnosed with early stage breast cancer and involves a lumpectomy followed by radiotherapy. However, approximately 50% of eligible women will elect for mastectomy over BCT despite equal survival benefit (provided margins of excised tissue are cancer free) due to uncertainty in outcome with regards to complete excision of cancerous cells, risk of local recurrence, and cosmesis. Determining surgical margins intraoperatively is difficult and achieving negative margins is not as robust as it needs to be, resulting in high re-operation rates and often mastectomy. Magnetic resonance images (MRI) can provide detailed information about tumor margin extents, however diagnostic images are acquired in a fundamentally different patient presentation than that used in surgery. Therefore, the high quality diagnostic MRIs taken in the prone position with pendant breast are not optimal for use in surgical planning/guidance due to the drastic shape change between preoperative images and the common supine surgical position. This work proposes to investigate the value of supine MRI in an effort to localize tumors intraoperatively using image-guidance. Mock intraoperative setups (realistic patient positioning in non-sterile environment) and preoperative imaging data were collected from a patient scheduled for a lumpectomy. The mock intraoperative data included a tracked laser range scan of the patient's breast surface, tracked center points of MR visible fiducials on the patient's breast, and tracked B-mode ultrasound and strain images. The preoperative data included a supine MRI with visible fiducial markers. Fiducial markers localized in the MRI were rigidly registered to their mock intraoperative counterparts using an optically tracked stylus. The root mean square (RMS) fiducial registration error using the tracked markers was 3.4mm. Following registration, the average closest point distance between the MR

  9. Comparison of static MRI and pseudo-dynamic MRI in temporomandibular joint disorder patients

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jin Ho; Yun, Kyoung In [Eulji Univ. School of Medicine, Seoul (Korea, Republic of); Park, In Woo; Choi, Hang Moon; Park, Moon Soo [Kangnung National Univ. College of Dentistry, Kangnung (Korea, Republic of)

    2006-12-15

    The purpose of this study was to elevate comparison of static MRI and pseudo-dynamic (cine) MRI in temporomandibular joint (TMJ) disorder patients. In this investigation, 33 patients with TMJ disorders were examined using both conventional static MRI and pseudo-dynamic MRI. Multiple spoiled gradient recalled acquisition in the steady state (SPGR) images were obtained when mouth opened and closed. Proton density weighted images were obtained at the closed and open mouth position in static MRI. Two oral and maxillofacial radiologists evaluated location of the articular disk, movement of condyle and bony change respectively and the posterior boundary of articular disk was obtained. No statistically significant difference was found in the observation of articular disk position, mandibular condylar movement and posterior boundary of articular disk using static MRI and pseudo-dynamic MRI (P>0.05). Statistically significant difference was noted in bony changes of condyle using static MRI and pseudo-dynamic MRI (P<0.05). This study showed that pseudo-dynamic MRI didn't make a difference in diagnosing internal derangement of TMJ in comparison with static MRI. But it was considered as an additional method to be supplemented in observing bony change.

  10. Internal mammary lymph nodes as incidental findings at screening breast MRI.

    Science.gov (United States)

    Ray, Kimberly M; Munir, Reema; Wisner, Dorota J; Azziz, Ania; Holland, Belinda Chang; Kornak, John; Joe, Bonnie N

    2015-01-01

    To evaluate the prevalence of internal mammary lymph nodes (IMLNs) on breast magnetic resonance imaging (MRI) in a screening population. We retrospectively reviewed 92 consecutive screening breast MRI exams. Logistic regression was performed to ascertain the risk of IMLNs in cancer-free subjects and to determine whether the risk varies with age. IMLNs were present in 48.9% of patients. Mean node size was 4 mm (range, 3-10 mm). The prevalence of IMLNs was not related to age. No patients developed breast cancer after a mean follow-up of 3 years. Subcentimeter IMLNs are common incidental findings at screening breast MRI. Published by Elsevier Inc.

  11. Breast MRI in nonpalpable breast lesions: a randomized trial with diagnostic and therapeutic outcome – MONET – study

    Science.gov (United States)

    Peters, Nicky HGM; Borel Rinkes, Inne HM; Mali, Willem PTM; van den Bosch, Maurice AAJ; Storm, Remmert K; Plaisier, Peter W; de Boer, Erwin; van Overbeeke, Adriaan J; Peeters, Petra HM

    2007-01-01

    Background In recent years there has been an increasing interest in MRI as a non-invasive diagnostic modality for the work-up of suspicious breast lesions. The additional value of Breast MRI lies mainly in its capacity to detect multicentric and multifocal disease, to detect invasive components in ductal carcinoma in situ lesions and to depict the tumor in a 3-dimensional image. Breast MRI therefore has the potential to improve the diagnosis and provide better preoperative staging and possibly surgical care in patients with breast cancer. The aim of our study is to assess whether performing contrast enhanced Breast MRI can reduce the number of surgical procedures due to better preoperative staging and whether a subgroup of women with suspicious nonpalpable breast lesions can be identified in which the combination of mammography, ultrasound and state-of-the-art contrast-enhanced Breast MRI can provide a definite diagnosis. Methods/Design The MONET – study (MR mammography Of Nonpalpable BrEast Tumors) is a randomized controlled trial with diagnostic and therapeutic endpoints. We aim to include 500 patients with nonpalpable suspicious breast lesions who are referred for biopsy. With this number of patients, the expected 12% reduction in surgical procedures due to more accurate preoperative staging with Breast MRI can be detected with a high power (90%). The secondary outcome is the positive and negative predictive value of contrast enhanced Breast MRI. If the predictive values are deemed sufficiently close to those for large core biopsy then the latter, invasive, procedure could possibly be avoided in some women. The rationale, study design and the baseline characteristics of the first 100 included patients are described. Trial registration Study protocol number NCT00302120 PMID:18045470

  12. Breast MRI in nonpalpable breast lesions: a randomized trial with diagnostic and therapeutic outcome – MONET – study

    Directory of Open Access Journals (Sweden)

    de Boer Erwin

    2007-11-01

    Full Text Available Abstract Background In recent years there has been an increasing interest in MRI as a non-invasive diagnostic modality for the work-up of suspicious breast lesions. The additional value of Breast MRI lies mainly in its capacity to detect multicentric and multifocal disease, to detect invasive components in ductal carcinoma in situ lesions and to depict the tumor in a 3-dimensional image. Breast MRI therefore has the potential to improve the diagnosis and provide better preoperative staging and possibly surgical care in patients with breast cancer. The aim of our study is to assess whether performing contrast enhanced Breast MRI can reduce the number of surgical procedures due to better preoperative staging and whether a subgroup of women with suspicious nonpalpable breast lesions can be identified in which the combination of mammography, ultrasound and state-of-the-art contrast-enhanced Breast MRI can provide a definite diagnosis. Methods/Design The MONET – study (MR mammography Of Nonpalpable BrEast Tumors is a randomized controlled trial with diagnostic and therapeutic endpoints. We aim to include 500 patients with nonpalpable suspicious breast lesions who are referred for biopsy. With this number of patients, the expected 12% reduction in surgical procedures due to more accurate preoperative staging with Breast MRI can be detected with a high power (90%. The secondary outcome is the positive and negative predictive value of contrast enhanced Breast MRI. If the predictive values are deemed sufficiently close to those for large core biopsy then the latter, invasive, procedure could possibly be avoided in some women. The rationale, study design and the baseline characteristics of the first 100 included patients are described. Trial registration Study protocol number NCT00302120

  13. Breast MRI in clinically and mammographically occult breast cancer presenting with an axillary metastasis: a systematic review

    OpenAIRE

    Bresser, J; De Vos, B.; van der Ent, F.; Hulsewé, K.

    2010-01-01

    Abstract Background Axillary metastatic lymphadenopathy with no primary tumour identified in the breast on physical examination, mammography or ultrasound is referred to as occult breast cancer. The goal of this systematic review is to give an overview of the value and additional considerations of using breast MRI in occult breast cancer. Methods The databases of Pubmed, Embase, CINAHL and the Cochrane library were searched for studies addressing th...

  14. Coccygeal movement: Assessment with dynamic MRI

    Energy Technology Data Exchange (ETDEWEB)

    Grassi, Roberto [Institute of Radiology, Second University of Naples, Piazza Miraglia, 80138 Naples (Italy)]. E-mail: Roberto.grassi@unina2.it; Lombardi, Giulio [Institute of Radiology, Second University of Naples, Piazza Miraglia, 80138 Naples (Italy); Reginelli, Alfonso [Institute of Radiology, Second University of Naples, Piazza Miraglia, 80138 Naples (Italy); Capasso, Francesco [Institute of Radiology, Second University of Naples, Piazza Miraglia, 80138 Naples (Italy); Romano, Francesco [Institute of Radiology, Second University of Naples, Piazza Miraglia, 80138 Naples (Italy); Floriani, Irene [Clinical Trial Unit, Oncology Department, Istituto di Ricerche Farmacologiche ' Mario Negri' , Milan (Italy); Colacurci, Nicola [Department of Gynecologic Obstetric and Reproduction Sciences, Second University of Naples, 80138 Naples (Italy)

    2007-03-15

    Purpose: Chronic coccygodynia is a difficult problem diagnostically and therapeutically. Moreover, there is no deep knowledge especially in the field of imaging of chronic coccygodynia. In this study several possible measurements are proposed, which all are able to demonstrate coccygeal movement during defecation, in order to assess coccygeal mobility using dynamic MRI during maximum contraction and during straining-evacuation. Materials and methods: A dynamic MRI study of the pelvic floor was performed in 112 patients. Five methods of measurement were assessed. Coccygeal movements were determined through the evaluation of three angles pair and two different distances measured during the phase of maximum contraction and during the phase of straining-evacuation. Results were compared according to age, sex, parity and experience of minor trauma. No patient included in the study had coccygodynia. Measurements taken by two radiologist were compared to determine interobserver agreement. Results: The maximum measurement values of the two distances are homogeneous, between 9 and 9.4 mm. The maximum measurement values of the three angles showed a difference that is between 21 deg. and 38 deg. Two of three angles showed a major measurement values in the funtional texts. In only one patient the coccyx was not mobile. Conclusion: Our dynamic MRI study indicates that the coccyx is mobile during defecation and that it is possible to demonstrate coccygeal excursions by assessing the difference between its positions at maximum contraction and during straining-evacuation. The measurement methods used in this study for evaluating coccygeal movements resulted in variably sized observed differences, but all yielded statistically significant results in demonstrating coccygeal excursion. Among the five measurement methods, two resulted in the largest differences. Our data indicate no correlation between coccygeal movements and age, sex, parity, minor trauma and coccygodynia.

  15. MRI of the breast: does the internet accurately report its beneficial uses and limitations?

    Science.gov (United States)

    Nekhlyudov, Larissa; Kiarsis, Keith; Elmore, Joann G

    2009-01-01

    As consumer use of the Internet for medical information grows, continuing evaluation of the medical content on the Internet is needed. We evaluated Internet sites describing breast magnetic resonance imaging (MRI), an emerging technology tool in breast cancer diagnosis and screening. We searched Google for sites describing breast MRI and abstracted the affiliation, content, media type, readability, and quality of 90 most popular unique sites. Over half (56%) of the sites were commercially sponsored. The content varied by site and included medical and procedural facts, information about clinical trials, grants and journal articles, as well as human interest stories. Most (82%) sites described potentially beneficial uses of breast MRI, such as further evaluation of newly diagnosed breast cancers (58%); screening women at high risk for breast cancer (54%); evaluation of abnormal breast findings (48%); screening women with dense breasts (48%) or implants (27%); and surveillance for breast cancer recurrences (24%). Approximately half (56%) of the sites described the limitations of breast MRI, most commonly false positive findings (44%) and costs (24%). Website quality, including the display of contact information, sponsorship, currency of information, authorship, and references varied. The reading level was close to high school graduate. Internet sites describing breast MRI were mostly commercially sponsored, more often described the potential beneficial uses of the procedure than its limitations, and were of variable quality and high reading level. With the lack of enforceable standards for display of medical information on the Internet, providers should encourage patients to direct their searches to the most credible sites.

  16. Hepatocellular carcinoma: perfusion quantification with dynamic contrast-enhanced MRI

    NARCIS (Netherlands)

    Taouli, B.; Johnson, R.S.; Hajdu, C.H.; Oei, M.T.H.; Merad, M.; Yee, H.; Rusinek, H.

    2013-01-01

    The objective of our study was to report our initial experience with dynamic contrast-enhanced MRI (DCE-MRI) for perfusion quantification of hepatocellular carcinoma (HCC) and surrounding liver.DCE-MRI of the liver was prospectively performed on 31 patients with HCC (male-female ratio, 26:5; mean ag

  17. Review of preoperative magnetic resonance imaging (MRI) in breast cancer: should MRI be performed on all women with newly diagnosed, early stage breast cancer?

    Science.gov (United States)

    Houssami, Nehmat; Hayes, Daniel F

    2009-01-01

    Randomized controlled trials have shown equivalent survival for women with early stage breast cancer who are treated with breast-conservation therapy (local excision and radiotherapy) or mastectomy. Decades of experience have demonstrated that breast-conservation therapy provides excellent local control based on defined standards of care. Magnetic resonance imaging (MRI) has been introduced in preoperative staging of the affected breast in women with newly diagnosed breast cancer because it detects additional foci of cancer that are occult on conventional imaging. The median incremental (additional) detection for MRI has been estimated as 16% in meta-analysis. In the absence of consensus on the role of preoperative MRI, we review data on its detection capability and its impact on treatment. We outline that the assumptions behind the adoption of MRI, namely that it will improve surgical planning and will lead to a reduction in re-excision surgery and in local recurrences, have not been substantiated by trials. Evidence consistently shows that MRI changes surgical management, usually from breast conservation to more radical surgery; however, there is no evidence that it improves surgical care or prognosis. Emerging data indicate that MRI does not reduce re-excision rates and that it causes false positives in terms of detection and unnecessary surgery; overall there is little high-quality evidence at present to support the routine use of preoperative MRI. Randomized controlled trials are needed to establish the clinical, psychosocial, and long-term effects of MRI and to show a related change in treatment from standard care in women newly affected by breast cancer.

  18. Ability of subtraction and dynamic MR imaging to detect breast tumors. Comparison with ultrasonography and mammography

    Energy Technology Data Exchange (ETDEWEB)

    Terao, Eri; Takeuchi, Hiroaki; Iwamura, Akira; Murakami, Yoshitaka; Harada, Junta; Tada, Shinpei (Jikei Univ., Tokyo (Japan). School of Medicine)

    1994-09-01

    We evaluated the ability of subtraction and dynamic MR imaging to accurately detect breast tumors. Sixty-five breast carcinomas and 24 fibroadenomas were examined by an SE pulse sequence using a 0.2 Tesla unit. Subtraction MR images were obtained every minute during dynamic study with Gd-DTPA. Almost all breast tumors were seen as very bright masses, and the margin of the mass was clearly demonstrated on subtraction MR images. Breast carcinomas and fibroadenomas showed characteristic time-intensity curves on dynamic study. Time-intensity curves of the early peak type and plateau type were seen in 97% of breast carcinomas, while the gradually increasing type was seen in 92% of fibroadenomas. The detectability of breast carcinoma was 98% by MRI, 98% by ultrasonography, and 87% by mammography. That of fibroadenoma was 95% by MRI, 91% by ultrasonography and 60% by mammography. Sensitivity and specificity for breast carcinoma were 98% and 92% for MRI and 97% and 71% for ultrasonography. For fibroadenoma, they were 96% and 98% for MRI and 89% and 92% for ultrasonography. (author).

  19. Influence of preoperative MRI on the surgical management of patients with operable breast cancer.

    NARCIS (Netherlands)

    Braun, M.; Polcher, M.; Schrading, S.; Zivanovic, O.; Kowalski, T.; Flucke, U.; Leutner, C.; Park-Simon, T.W.; Rudlowski, C.; Kuhn, W.; Kuhl, C.K.

    2008-01-01

    PURPOSE: Evaluation of the impact of preoperative magnetic resonance imaging (MRI) of the breast on the clinical management of patients with operable breast cancer (BC). METHODS: Retrospective analysis of 160 patients with operable breast cancer (stages Tis through T4), treated from 2002 through 200

  20. Dynamic contrast enhanced MRI in prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Alonzi, Roberto [Marie Curie Research Wing, Mount Vernon Cancer Centre, Rickmansworth Road, Northwood, Middlesex, HA6 2RN (United Kingdom)], E-mail: robertoalonzi@btinternet.com; Padhani, Anwar R. [Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Rickmansworth Road, Northwood, Middlesex, HA6 2RN (United Kingdom); Synarc Inc. 575 Market Street, San Francisco, CA 94105 (United States)], E-mail: anwar.padhani@paulstrickland-scannercentre.org.uk; Allen, Clare [Department of Imaging, University College Hospital, London, 235 Euston Road, NW1 2BU (United Kingdom)], E-mail: clare.allen@uclh.nhs.uk

    2007-09-15

    Angiogenesis is an integral part of benign prostatic hyperplasia (BPH), is associated with prostatic intraepithelial neoplasia (PIN) and is key to the growth and for metastasis of prostate cancer. Dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) using small molecular weight gadolinium chelates enables non-invasive imaging characterization of tissue vascularity. Depending on the technique used, data reflecting tissue perfusion, microvessel permeability surface area product, and extracellular leakage space can be obtained. Two dynamic MRI techniques (T{sub 2}*-weighted or susceptibility based and T{sub 1}-weighted or relaxivity enhanced methods) for prostate gland evaluations are discussed in this review with reference to biological basis of observations, data acquisition and analysis methods, technical limitations and validation. Established clinical roles of T{sub 1}-weighted imaging evaluations will be discussed including lesion detection and localisation, for tumour staging and for the detection of suspected tumour recurrence. Limitations include inadequate lesion characterisation particularly differentiating prostatitis from cancer, and in distinguishing between BPH and central gland tumours.

  1. Compressed Sensing for Breast MRI: Resolving the Trade-Off Between Spatial and Temporal Resolution.

    Science.gov (United States)

    Vreemann, Suzan; Rodriguez-Ruiz, Alejandro; Nickel, Dominik; Heacock, Laura; Appelman, Linda; van Zelst, Jan; Karssemeijer, Nico; Weiland, Elisabeth; Maas, Marnix; Moy, Linda; Kiefer, Berthold; Mann, Ritse M

    2017-10-01

    Ultrafast dynamic contrast-enhanced magnetic resonance imaging of the breast enables assessment of the contrast inflow dynamics while providing images with diagnostic spatial resolution. However, the slice thickness of common ultrafast techniques still prevents multiplanar reconstruction. In addition, some temporal blurring of the enhancement characteristics occurs in case view-sharing is used. We evaluate a prototype compressed-sensing volume-interpolated breath-hold examination (CS-VIBE) sequence for ultrafast breast MRI that improves through plane spatial resolution and avoids temporal blurring while maintaining an ultrafast temporal resolution (less than 5 seconds per volume). Image quality (IQ) of the new sequence is compared with an ultrafast view-sharing sequence (time-resolved angiography with interleaved stochastic trajectories [TWIST]), and assessment of lesion morphology is compared with a regular T1-weighted 3D Dixon sequence (VIBE-DIXON) with an acquisition time of 91 seconds. From April 2016 to October 2016, 30 women were scanned with the CS-VIBE sequence, replacing the routine ultrafast TWIST sequence in a hybrid breast MRI protocol. The need for informed consent was waived. All MRI scans were performed on a 3T MAGNETOM Skyra system (Siemens Healthcare, Erlangen, Germany) using a 16-channel bilateral breast coil. Two reader studies were conducted involving 5 readers. In the first study, overall IQ of CS-VIBE and TWIST in the axial plane was independently rated for 23 women for whom prior MRI examinations with TWIST were available. In addition, the presence of several types of artifacts was rated on a 5-point scale. The second study was conducted in women (n = 16) with lesions. In total, characteristics of 31 lesions (5 malignant and 26 benign) were described independently for CS-VIBE and VIBE-DIXON, according to the BI-RADS MRI-lexicon. In addition, a lesion conspicuity score was given. Using CS-VIBE, a much higher through-plane spatial resolution

  2. Impact of selective use of breast MRI on surgical decision-making in women with newly diagnosed operable breast cancer.

    Science.gov (United States)

    Brennan, Meagan E; McKessar, Merran; Snook, Kylie; Burgess, Ian; Spillane, Andrew J

    2017-04-01

    This study evaluated the impact of breast MRI on surgical planning in selected cases of breast malignancy (invasive cancer or DCIS). MRI was used when there was ambiguity on clinical and/or conventional imaging assessment. Consecutive women with breast malignancy undergoing breast MRI were included. Clinical, mammogram and ultrasound findings and surgical plan before and after MRI were recorded. MRI findings and histopathology results were documented and the impact of MRI on treatment planning was evaluated. MRI was performed in 181/1416 (12.8%) cases (invasive cancer 155/1219 (12.7%), DCIS 26/197 (13.2%)). Indications for MRI were: clinically dense breast tissue difficult to assess (n = 66; 36.5%), discordant clinical/conventional imaging assessment (n = 61; 33.7%), invasive lobular carcinoma in clinically dense breast tissue (n = 22; 12.2%), palpable/mass-forming DCIS (n = 11; 6.1%); other (n = 19; 10.5%). The recall rate for assessment of additional lesions was 35% (63/181). Additional biopsy-proven malignancy was found in 11/29 (37.9%) ipsilateral breast recalls and 8/34 (23.5%) contralateral breast recalls. MRI detected contralateral malignancy (unsuspected on conventional imaging) in 5/179 (2.8%). The additional information from MRI changed management in 69/181 (38.1%), with more unilateral surgery (wider excision or mastectomy) in 53/181 (29.3%), change to bilateral surgery in 12/181 (6.6%), less surgery in 4/181 (2.2%). Clinical examination estimated histological size within 20 mm in 57%, conventional imaging in 55% and MRI in 71%. MRI was most likely to show concordance with histopathology in the 'discordant assessment' and 'invasive lobular' groups and less likely for 'challenging clinically dense breast tissue.' MRI changed management in 69/181 (38.1%). Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. The value of magnetic resonance diffusion weighted imaging and dynamic contrast-enhanced MRI in the diagnosis of benign and malignant breast lesions%磁共振扩散加权成像及动态增强MRI在乳腺病变中的应用价值

    Institute of Scientific and Technical Information of China (English)

    杨晓棠; 杨继虎; 杜笑松; 张建新

    2011-01-01

    Objective To explore the relationship between the menstrual cycle and apparent diffusion coefficient(ADC) values of MR diffusion weighted imaging(DWI).To investigate the evaluation of DWI and dynamic contrast-enhanced MRI(DCE-MRI) in distinguishing benign from malignant breast lesions.Methods Thirty-four healthy, premenopausal female volunteers who had regular menstrual cycles and 96breast disease patients who proved by surgery or Needle aspiration pathology were included in the study.Of the 96 patients, there were 36 cases with 44 benign breast lesions and 60 cases with 70 malignant breast lesions.The healthy volunteers were scanned by conventional T1 weighted MRI, T2 weighted MRI and DWI once a week for 4 weeks with Siemens Sonata 1.5T MRI(b=1000s/mm2).The patients were examined by conventional MRI, DCE-MRI and DWI.DWI using Echo planar imaging technique and frequency selection suppression technology were used in DWI(b=1000 s/mm2)and fast low angle shot sequence was used in DCE-MRI.The data of DWI and DCE-MRI were sent to Leonardo workstation.Results ①ADC values of normal breast in the second week of the menstrual cycle reduced to minimum and then slowly increased, a comparison between the mean was not significant (F=1.029, P>0.05).② In DCE-MRI, type Ⅲ curve is the typical type of breast cancer, type Ⅰ and Ⅳ curve are the typical type of breast benign lesions.③When b=1000 s/mam2, the diagnostic threshold of ADC values between the benign breast lesions and malignant lesions was 1.25×10-3 mm2/s.Conclusions ADC values were less influenced by the menstrual cycle in normal breasts.The specificity and accuracy in the diagnosis of benign and maglinant breast lesions were improved with the combination of DCE-MRI and DWI.%目的 探讨月经周期对正常乳腺实质磁共振扩散加权成像(DWI)表观扩散系数(ADC)值的影响,并评价动态增强MRI(DCE-MRI)及DWI在乳腺病变鉴别诊断中的价值。方法 选取健康女性志愿者34

  4. MRI-guided breast vacuum biopsy: Localization of the lesion without contrast-agent application using diffusion-weighted imaging.

    Science.gov (United States)

    Berger, Nicole; Varga, Zsuzsanna; Frauenfelder, Thomas; Boss, Andreas

    2017-05-01

    In magnetic resonance-guided breast vacuum biopsies, the contrast agent for targeting suspicious lesions can typically be applied only once during an intervention, due to the slow elimination of the gadolinium chelate from the extracellular fluid space. This study evaluated the feasibility of diffusion-weighted imaging (DWI) for lesion targeting in vacuum assisted magnetic resonance imaging (MRI) biopsies. DWI may be used as an alternative to dynamic contrast-enhanced MRI with the advantage of reproducibility. However, the targeted lesion requires the characteristics of a mass-like lesion, substantial diffusion restriction, and a minimum size of approximately 1cm. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Effect of Imaging Parameter Thresholds on MRI Prediction of Neoadjuvant Chemotherapy Response in Breast Cancer Subtypes.

    Directory of Open Access Journals (Sweden)

    Wei-Ching Lo

    Full Text Available The purpose of this study is to evaluate the predictive performance of magnetic resonance imaging (MRI markers in breast cancer patients by subtype. Sixty-four patients with locally advanced breast cancer undergoing neoadjuvant chemotherapy were enrolled in this study. Each patient received a dynamic contrast-enhanced (DCE-MRI at baseline, after 1 cycle of chemotherapy and before surgery. Functional tumor volume (FTV, the imaging marker measured by DCE-MRI, was computed at various thresholds of percent enhancement (PEt and signal-enhancement ratio (SERt. Final FTV before surgery and percent changes of FTVs at the early and final treatment time points were used to predict patients' recurrence-free survival. The full cohort and each subtype defined by the status of hormone receptor and human epidermal growth factor receptor 2 (HR+/HER2-, HER2+, triple negative were analyzed. Predictions were evaluated using the Cox proportional hazard model when PEt changed from 30% to 200% in steps of 10% and SERt changed from 0 to 2 in steps of 0.2. Predictions with high hazard ratios and low p-values were considered as strong. Different profiles of FTV as predictors for recurrence-free survival were observed in each breast cancer subtype and strong associations with survival were observed at different PEt/SERt combinations that resulted in different FTVs. Findings from this retrospective study suggest that the predictive performance of imaging markers based on FTV may be improved with enhancement thresholds being optimized separately for clinically-relevant subtypes defined by HR and HER2 receptor expression.

  6. A superpixel-based framework for automatic tumor segmentation on breast DCE-MRI

    Science.gov (United States)

    Yu, Ning; Wu, Jia; Weinstein, Susan P.; Gaonkar, Bilwaj; Keller, Brad M.; Ashraf, Ahmed B.; Jiang, YunQing; Davatzikos, Christos; Conant, Emily F.; Kontos, Despina

    2015-03-01

    Accurate and efficient automated tumor segmentation in breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is highly desirable for computer-aided tumor diagnosis. We propose a novel automatic segmentation framework which incorporates mean-shift smoothing, superpixel-wise classification, pixel-wise graph-cuts partitioning, and morphological refinement. A set of 15 breast DCE-MR images, obtained from the American College of Radiology Imaging Network (ACRIN) 6657 I-SPY trial, were manually segmented to generate tumor masks (as ground truth) and breast masks (as regions of interest). Four state-of-the-art segmentation approaches based on diverse models were also utilized for comparison. Based on five standard evaluation metrics for segmentation, the proposed framework consistently outperformed all other approaches. The performance of the proposed framework was: 1) 0.83 for Dice similarity coefficient, 2) 0.96 for pixel-wise accuracy, 3) 0.72 for VOC score, 4) 0.79 mm for mean absolute difference, and 5) 11.71 mm for maximum Hausdorff distance, which surpassed the second best method (i.e., adaptive geodesic transformation), a semi-automatic algorithm depending on precise initialization. Our results suggest promising potential applications of our segmentation framework in assisting analysis of breast carcinomas.

  7. MRI surveillance for women with dense breasts and a previous breast cancer and/or high risk lesion.

    Science.gov (United States)

    Nadler, Michelle; Al-Attar, Hyder; Warner, Ellen; Martel, Anne L; Balasingham, Sharmila; Zhang, Liying; Lipton, Joseph H; Curpen, Belinda

    2017-08-01

    The role of surveillance breast MRI for women with mammographically dense breasts, a personal history of breast cancer (BC), atypical hyperplasia (AH), or lobular carcinoma in situ (LCIS) is unclear. We estimated the performance of annual surveillance MRI in women with a combination of these risk factors. We performed a retrospective review of the clinical, radiological, and pathological parameters of women who received annual concurrent surveillance breast MRI and mammography between 04/2013 and 12/2015 and fulfilled all of the following criteria: 1) age <70; 2) prior diagnosis of AH, LCIS or BC; 3) heterogeneously or extremely dense breast(s); and 4) did not qualify for our provincial breast MRI high risk screening program. This study included 198 patients (266 MRI exams). MRI detected 15 cancers: 11 invasive stage I and 4 in-situ. All but 1 were mammographically occult and there were no interval cancers. The cancer detection rate (CDR) and false positive (FP) rate were 6.1% and 21% for round one and 4.7% and 12.5% for round two, respectively. Not being on anti-estrogen therapy and having a 1st degree relative with BC significantly increased the likelihood of tumor detection. The CDR and FP rate of surveillance MRI in this study were comparable to those reported for women with BRCA mutations. The addition of annual MRI to mammography should be considered for surveillance of women with a combination of these risk factors, particularly if they have a family history of BC and are not on anti-estrogen therapy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Multiparametric and molecular imaging of breast tumors with MRI and PET/MRI; Multiparametrische und molekulare Bildgebung von Brusttumoren mit MRT und PET-MRT

    Energy Technology Data Exchange (ETDEWEB)

    Pinker, K. [Medizinische Universitaet Wien, Universitaetsklinik fuer Radiologie und Nuklearmedizin, Division fuer Molekulare und Gender Bildgebung, Wien (Austria); Memorial Sloan-Kettering Cancer Center, Department of Radiology, Molecular Imaging and Therapy Service, New York (United States); State University of Florida, Department of Scientific Computing in Medicine, Florida (United States); Marino, M.A. [Medizinische Universitaet Wien, Universitaetsklinik fuer Radiologie und Nuklearmedizin, Division fuer Molekulare und Gender Bildgebung, Wien (Austria); Policlinico Universitario G. Martino, University of Messina, Department of Biomedical Sciences and Morphologic and Functional Imaging, Messina (Italy); Meyer-Baese, A. [State University of Florida, Department of Scientific Computing in Medicine, Florida (United States); Helbich, T.H. [Medizinische Universitaet Wien, Universitaetsklinik fuer Radiologie und Nuklearmedizin, Division fuer Molekulare und Gender Bildgebung, Wien (Austria)

    2016-07-15

    Magnetic resonance imaging (MRI) of the breast is an indispensable tool in breast imaging for many indications. Several functional parameters with MRI and positron emission tomography (PET) have been assessed for imaging of breast tumors and their combined application is defined as multiparametric imaging. Available data suggest that multiparametric imaging using different functional MRI and PET parameters can provide detailed information about the hallmarks of cancer and may provide additional specificity. Multiparametric and molecular imaging of the breast comprises established MRI parameters, such as dynamic contrast-enhanced MRI, diffusion-weighted imaging (DWI), MR proton spectroscopy ({sup 1}H-MRSI) as well as combinations of radiological and MRI techniques (e.g. PET/CT and PET/MRI) using radiotracers, such as fluorodeoxyglucose (FDG). Multiparametric and molecular imaging of the breast can be performed at different field-strengths (range 1.5-7 T). Emerging parameters comprise novel promising techniques, such as sodium imaging ({sup 23}Na MRI), phosphorus spectroscopy ({sup 31}P-MRSI), chemical exchange saturation transfer (CEST) imaging, blood oxygen level-dependent (BOLD) and hyperpolarized MRI as well as various specific radiotracers. Multiparametric and molecular imaging has multiple applications in breast imaging. Multiparametric and molecular imaging of the breast is an evolving field that will enable improved detection, characterization, staging and monitoring for personalized medicine in breast cancer. (orig.) [German] Die Magnetresonanztomographie (MRT) der Brust ist ein etabliertes nichtinvasives bildgebendes Verfahren mit vielfaeltigen Indikationen. In den letzten Jahren wurden zahlreiche funktionelle MRT- und Positronenemissionstomographie(PET)-Parameter in der Brustbildgebung evaluiert, und ihre kombinierte Anwendung ist als multiparametrische Bildgebung definiert. Bisherige Daten legen nahe, dass die multiparametrische Bildgebung mit MRT und PET

  9. Outcome of MRI-guided vacuum-assisted breast biopsy – initial experience at Institute of Oncology Ljubljana, Slovenia

    OpenAIRE

    Zebic-Sinkovec, Marta; Hertl, Kristijana; Kadivec, Maksimiljan; Cavlek, Mihael; Podobnik, Gasper; Snoj, Marko

    2012-01-01

    Background. Like all breast imaging modalities MRI has limited specificity and the positive predictive value for lesions detected by MRI alone ranges between 15 and 50%. MRI guided procedures (needle biopsy, presurgical localisation) are mandatory for suspicious findings visible only at MRI, with potential influence on therapeutic decision. The aim of this retrospective study was to evaluate our initial clinical experience with MRI-guided vacuum-assisted breast biopsy as an alternative to sur...

  10. Dynamic MRI for the upper airway

    Energy Technology Data Exchange (ETDEWEB)

    Makabe, Takeshi; Muraya, Tamotsu; Hashimoto, Yasuhiro; Tainaka, Keiichi [Hakodate Municipal Hospital, Hokkaido (Japan)

    1995-01-01

    Although the conventional airway observations have been performed mainly using fluoroscopy and endoscopy, they both have defects and provide no satisfactory results in a single examination. Therefore, utilizing ultra-fast magnetic resonance imaging (MRI), a study was carried out for kinetic observations around an airway, directly via excellent tissue contrast images. Turbo-fast low-angle shot (FLASH) with T1-weighted 180deg preparation pulse was used during scanning. The study was also subjected to variable inversion time (TI) and flip angle (FA). Kinetic observation could be scanned in a second or so, and the dynamic study was carried out under a condition of supposed best tissue contrast. Turbo-FLASH, which is unique ultra-fast MRI in clinical use did not always have good tissue contrast. In the present study, the prolongation of TI and enlargement of FA were confirmed to give much better tissue contrast. Due to the simultaneous prolongation of the scanning time with that of TI, however, TI was set up at 300 msec to allow for a kinetic observation (TR=8.5 msec, TE=4 msec, FA=12deg, slice thickness, 8 mm). Clinically, good tissue contrast images around the airway was obtained and a direct observation could be made via the free sections. We are applying the present approach to observations of deglutition and the sleep-apnea syndrome. Regarding deglutition, the present approach is excellent in that easy observations can be made via swallowing saliva while confirming the position and for the sleep-apnea syndrome, it is very good for grasping the obstruction site. Thus, the dynamic study of the airway using turbo-FLASH was shown also to be clinically useful. (author).

  11. Breast cancer size estimation with MRI in BRCA mutation carriers and other high risk patients

    Energy Technology Data Exchange (ETDEWEB)

    Mann, R.M., E-mail: r.mann@rad.umcn.nl [Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen (Netherlands); Bult, P., E-mail: p.bult@path.umcn.nl [Radboud University Nijmegen Medical Centre, Department of Pathology, Nijmegen (Netherlands); Laarhoven, H.W.M. van, E-mail: h.vanlaarhoven@amc.uva.nl [Academic Medical Centre, University of Amsterdam, Department of Medical Oncology, Amsterdam (Netherlands); Radboud University Nijmegen Medical Centre, Department of Medical Oncology, Nijmegen (Netherlands); Span, P.N., E-mail: p.span@rther.umcn.nl [Radboud University Nijmegen Medical Centre, Department of Radiation Oncology, Nijmegen (Netherlands); Schlooz, M., E-mail: m.schlooz@chir.umcn.nl [Radboud University Nijmegen Medical Centre, Department of Surgery, Nijmegen (Netherlands); Veltman, J., E-mail: j.veltman@zgt.nl [Hospital group Twente (ZGT), Department of Radiology, Almelo (Netherlands); Hoogerbrugge, N., E-mail: n.hoogerbrugge@gen.umcn.nl [Radboud University Nijmegen Medical Centre, Department of Human Genetics, Nijmegen (Netherlands)

    2013-09-15

    Objective: To assess the value of breast MRI in size assessment of breast cancers in high risk patients, including those with a BRCA 1 or 2 mutation. Guidelines recommend invariably breast MRI screening for these patients and therapy is thus based on these findings. However, the accuracy of breast MRI for staging purposes is only tested in sporadic cancers. Methods: We assessed concordance of radiologic staging using MRI with histopathology in 49 tumors in 46 high risk patients (23 BRCA1, 12 BRCA2 and 11 Non-BRCA patients). The size of the total tumor area (TTA) was compared to pathology. In invasive carcinomas (n = 45) the size of the largest focus (LF) was also addressed. Results: Correlation of MRI measurements with pathology was 0.862 for TTA and 0.793 for LF. TTA was underestimated in 8(16%), overestimated in 5(10%), and correctly measured in 36(73%) cases. LF was underestimated in 4(9%), overestimated in 5(11%), and correctly measured in 36(80%) cases. Impact of BRCA 1 or 2 mutations on the quality of size estimation was not observed. Conclusions: Tumor size estimation using breast MRI in high risk patients is comparable to its performance in sporadic cancers. Therefore, breast MRI can safely be used for treatment planning.

  12. Adherence of Academic Radiologists in a Non-English Speaking Imaging Center to the BI-RADS Standards of Reporting Breast MRI

    Directory of Open Access Journals (Sweden)

    Sepideh Sefidbakht

    2015-01-01

    Full Text Available Objectives: To assess the adherence of academic radiologists in a university center to BI-RADS lexicon (BLA and to evaluate the structural completeness of breast MRI reports. Materials and Methods: Breast MRI reports made during 2012 in a single academic center by six readers were scored for formal completeness (FS including recording the MRI protocol, making relevant clinical correlation, and describing background enhancement; BLA including mass rather than lesion, describing lesion outline, enhancement characteristics, and dynamic curve; and also expressing the final conclusion using BLA, resulting in a maximal total score of 8. FS and BLA were correlated with reader characteristics including breast imaging background, years of academic experience, and number of breast MRIs reported yearly. Tests used for statistical analysis were the Mann-Whitney U test and analysis of variance (ANOVA. Results: Overall BLA was 38.9%. This percentage was 60.1% and 3.7% in radiologists with and without breast imaging background, respectively (P = 0.000. Mean FS among all readers was 3.81 ± 1.75. This score was 2.54 ± 1.1 for readers without breast imaging background and 4.6 ± 1.6 for the readers regularly involved in breast imaging (P = 0.000. Conclusions: Higher degree of BLA and higher mean FS were associated with radiologists regularly involved in breast imaging. No association was found with years of academic experience or number of breast MRIs interpreted yearly.

  13. The combination of FDG PET and dynamic contrast-enhanced MRI improves the prediction of disease-free survival in patients with advanced breast cancer after the first cycle of neoadjuvant chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Ilhan; Kim, Byung II; Choi, Chang Woon; Lim, Sang Moo [Korea Institute of Radiological and Medical Sciences (KIRAMS), Department of Nuclear Medicine, Korea Cancer Center Hospital, 75 Nowongil, Nowon Gu, Seoul (Korea, Republic of); Korea Institute of Radiological and Medical Sciences (KIRAMS), Molecular Imaging Research Center, Seoul (Korea, Republic of); Noh, Woo Chul; Kim, Hyun-Ah; Kim, Eun-Kyu [Korea Institute of Radiological and Medical Sciences (KIRAMS), Department of Surgery, Korea Cancer Center Hospital, Seoul (Korea, Republic of); Park, Jihyun; Byun, Byung Hyun [Korea Institute of Radiological and Medical Sciences (KIRAMS), Department of Nuclear Medicine, Korea Cancer Center Hospital, 75 Nowongil, Nowon Gu, Seoul (Korea, Republic of); Park, Ji Ae; Kim, Kyeong Min [Korea Institute of Radiological and Medical Sciences (KIRAMS), Molecular Imaging Research Center, Seoul (Korea, Republic of); Park, Ko Woon [Korea Institute of Radiological and Medical Sciences (KIRAMS), Department of Radiology, Korea Cancer Center Hospital, Seoul (Korea, Republic of); Lee, Seung Sook [Korea Institute of Radiological and Medical Sciences (KIRAMS), Department of Pathology, Korea Cancer Center Hospital, Seoul (Korea, Republic of); You, Eun Young [Gachon University School of Medicine and Science, Department of Radiology, Gil Hospital, Incheon (Korea, Republic of)

    2014-10-15

    The aim of this study was to investigate the potential of FDG PET/CT and MRI in predicting disease-free survival (DFS) after neoadjuvant chemotherapy (NAC) and surgery in patients with advanced breast cancer. The analysis included 54 women with advanced breast cancer. All patients received three cycles of NAC, underwent curative surgery, and then received three cycles of additional chemotherapy. Before and after the first cycle of NAC, all patients underwent sequential PET/CT and MRI. All patients were analysed using a diverse range of parameters. including maximal standardized uptake value (SUV), percent change in SUV (ΔSUV), initial slope of the enhancement curve (MRslope), apparent diffusion coefficient (ADC), tumour size, change in MRslope (ΔMRslope), change in ADC (ΔADC), change in tumour size (Δsize) and other clinicopathological parameters. The relationships between covariates and DFS after surgery were analysed using the Kaplan-Meier method and the multivariate Cox proportional hazards model. Time-dependent receiver operating characteristic curves were used to determine the optimal cut-off values of imaging parameters for DFS. Of the 54 patients, 13 (24 %) experienced recurrence at a median follow-up of 38 months (range 25 - 45 months). Univariate and multivariate analyses showed that a lesser decline in SUV, a lesser decline in MRslope, a lesser increase in ADC, and ER negativity were significantly associated with a poorer DFS (P = 0.0006, ΔSUV threshold -41 %; P = 0.0016, ΔMRslope threshold -6 %; P = 0.011, ΔADC threshold 11 %; and P = 0.0086, ER status, respectively). Patients with a combination of ΔSUV >-41 % and ΔMRslope >-6 % showed a significantly higher recurrence rate (77.8 %) than the remaining of patients (13.3 %, P < 0.0001). Functional parameters of both FDG PET and MRI after the first cycle of NAC are useful for predicting DFS in patients with advanced breast cancer. This approach could lead to an improvement in patient care because

  14. Combined use of {sup 18}F-FDG PET/CT and MRI for response monitoring of breast cancer during neoadjuvant chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Pengel, Kenneth E.; Loo, Claudette E. [The Netherlands Cancer Institute, Department of Radiology, PO Box 90203, Amsterdam (Netherlands); Koolen, Bas B.; Vogel, Wouter V.; Valdes Olmos, Renato A. [The Netherlands Cancer Institute, Department of Nuclear Medicine, Amsterdam (Netherlands); Wesseling, Jelle; Lips, Esther H. [The Netherlands Cancer Institute, Department of Pathology, Amsterdam (Netherlands); Rutgers, Emiel J.T.; Vrancken Peeters, Marie Jeanne T.F.D. [The Netherlands Cancer Institute, Department of Surgical Oncology, Amsterdam (Netherlands); Rodenhuis, Sjoerd [The Netherlands Cancer Institute, Department of Medical Oncology, Amsterdam (Netherlands); Gilhuijs, Kenneth G.A. [The Netherlands Cancer Institute, Department of Radiology, PO Box 90203, Amsterdam (Netherlands); University Medical Center Utrecht, Department of Radiology/Image Sciences Institute, Utrecht (Netherlands)

    2014-08-15

    To explore the potential complementary value of PET/CT and dynamic contrast-enhanced MRI in predicting pathological response to neoadjuvant chemotherapy (NAC) of breast cancer and the dependency on breast cancer subtype. We performed {sup 18}F-FDG PET/CT and MRI examinations before and during NAC. The imaging features evaluated on both examinations included baseline and changes in {sup 18}F-FDG maximum standardized uptake value (SUVmax) on PET/CT, and tumour morphology and contrast uptake kinetics on MRI. The outcome measure was a (near) pathological complete response ((near-)pCR) after surgery. Receiver operating characteristic curves with area under the curve (AUC) were used to evaluate the relationships between patient, tumour and imaging characteristics and tumour responses. Of 93 patients, 43 achieved a (near-)pCR. The responses varied among the different breast cancer subtypes. On univariate analysis the following variables were significantly associated with (near-)pCR: age (p = 0.033), breast cancer subtype (p < 0.001), relative change in SUVmax on PET/CT (p < 0.001) and relative change in largest tumour diameter on MRI (p < 0.001). The AUC for the relative reduction in SUVmax on PET/CT was 0.78 (95 % CI 0.68-0.88), and for the relative reduction in tumour diameter at late enhancement on MRI was 0.79 (95 % CI 0.70-0.89). The AUC increased to 0.90 (95 % CI 0.83-0.96) in the final multivariate model with PET/CT, MRI and breast cancer subtype combined (p = 0.012). PET/CT and MRI showed comparable value for monitoring response during NAC. Combined use of PET/CT and MRI had complementary potential. Research with more patients is required to further elucidate the dependency on breast cancer subtype. (orig.)

  15. MRI-Guided Intervention for Breast Lesions Using the Freehand Technique in a 3.0-T Closed-Bore MRI Scanner: Feasibility and Initial Results

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hye Young [Department of Radiology, Gyeongsang National University Hospital, Jinju 660-702 (Korea, Republic of); Kim, Sun Mi; Jang, Mijung; Yun, Bo La [Department of Radiology, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Kim, Sung-Won; Kang, Eunyoung [Department of Surgery, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Park, So Yeon [Department of Pathology, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Moon, Woo Kyung [Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 110-744 (Korea, Republic of); Ko, Eun Sook [Department of Radiology, Samsung Medical Center, Seoul 135-710 (Korea, Republic of)

    2013-07-01

    To report the feasibility of magnetic resonance imaging (MRI)-guided intervention for diagnosing suspicious breast lesions detectable by MRI only, using the freehand technique with a 3.0-T closed-bore MRI scanner. Five women with 5 consecutive MRI-only breast lesions underwent MRI-guided intervention: 3 underwent MRI-guided needle localization and 2, MRI-guided vacuum-assisted biopsy. The interventions were performed in a 3.0-T closed-bore MRI system using a dedicated phased-array breast coil with the patients in the prone position; the freehand technique was used. Technical success and histopathologic outcome were analyzed. MRI showed that four lesions were masses (mean size, 11.5 mm; range, 7-18 mm); and 1, a nonmass-like enhancement (maximum diameter, 21 mm). The locations of the lesions with respect to the breast with index cancer were as follows: different quadrant, same breast - 3 cases; same quadrant, same breast - 1 case; and contralateral breast - 1 case. Histopathologic evaluation of the lesions treated with needle localization disclosed perilobular hemangioma, fibrocystic change, and fibroadenomatous change. The lesions treated with vacuum-assisted biopsy demonstrated a radial scar and atypical apocrine hyperplasia. Follow-up MRI after 2-7 months (mean, 4.6 months) confirmed complete lesion removal in all cases. MRI-guided intervention for breast lesions using the freehand technique with a 3.0-T closed-bore MRI scanner is feasible and accurate for diagnosing MRI-only lesions.

  16. Evaluation of a Nonrigid Motion Compensation Technique Based on Spatiotemporal Features for Small Lesion Detection in Breast MRI

    Directory of Open Access Journals (Sweden)

    F. Steinbruecker

    2012-01-01

    the performance of a new nonrigid motion correction algorithm based on the optical flow method. For each of the small lesions, we extracted morphological and dynamical features describing both global and local shape, and kinetics behavior. In this paper, we compare the performance of each extracted feature set under consideration of several 2D or 3D motion compensation parameters for the differential diagnosis of enhancing lesions in breast MRI. Based on several simulation results, we determined the optimal motion compensation parameters. Our results have shown that motion compensation can improve the classification results. The results suggest that the computerized analysis system based on the non-rigid motion compensation technique and spatiotemporal features has the potential to increase the diagnostic accuracy of MRI mammography for small lesions and can be used as a basis for computer-aided diagnosis of breast cancer with MR mammography.

  17. Full automatic fiducial marker detection on coil arrays for accurate instrumentation placement during MRI guided breast interventions

    Science.gov (United States)

    Filippatos, Konstantinos; Boehler, Tobias; Geisler, Benjamin; Zachmann, Harald; Twellmann, Thorsten

    2010-02-01

    With its high sensitivity, dynamic contrast-enhanced MR imaging (DCE-MRI) of the breast is today one of the first-line tools for early detection and diagnosis of breast cancer, particularly in the dense breast of young women. However, many relevant findings are very small or occult on targeted ultrasound images or mammography, so that MRI guided biopsy is the only option for a precise histological work-up [1]. State-of-the-art software tools for computer-aided diagnosis of breast cancer in DCE-MRI data offer also means for image-based planning of biopsy interventions. One step in the MRI guided biopsy workflow is the alignment of the patient position with the preoperative MR images. In these images, the location and orientation of the coil localization unit can be inferred from a number of fiducial markers, which for this purpose have to be manually or semi-automatically detected by the user. In this study, we propose a method for precise, full-automatic localization of fiducial markers, on which basis a virtual localization unit can be subsequently placed in the image volume for the purpose of determining the parameters for needle navigation. The method is based on adaptive thresholding for separating breast tissue from background followed by rigid registration of marker templates. In an evaluation of 25 clinical cases comprising 4 different commercial coil array models and 3 different MR imaging protocols, the method yielded a sensitivity of 0.96 at a false positive rate of 0.44 markers per case. The mean distance deviation between detected fiducial centers and ground truth information that was appointed from a radiologist was 0.94mm.

  18. Using deep learning to segment breast and fibroglandular tissue in MRI volumes

    NARCIS (Netherlands)

    Dalmis, M.U.; Litjens, G.J.; Holland, K.; Setio, A.A.A.; Mann, R.M.; Karssemeijer, N.; Gubern Merida, A.

    2017-01-01

    PURPOSE: Automated segmentation of breast and fibroglandular tissue (FGT) is required for various computer-aided applications of breast MRI. Traditional image analysis and computer vision techniques, such atlas, template matching, or, edge and surface detection, have been applied to solve this task.

  19. MRI-guided High-Intensity Focused Ultrasound of Breast Cancer

    NARCIS (Netherlands)

    Merckel, L.G.

    2014-01-01

    Magnetic resonance imaging-guided high-intensity focused ultrasound (MR-HIFU) is a promising technique for completely noninvasive tumor ablation. This thesis focuses on its application for the treatment of patients with breast cancer. The first part of the thesis describes the role of breast MRI for

  20. Computer-aided detection in breast MRI : a systematic review and meta-analysis

    NARCIS (Netherlands)

    Dorrius, Monique D.; Jansen-van der Weide, Marijke C.; van Ooijen, Peter M. A.; Pijnappel, Ruud M.; Oudkerk, Matthijs

    To evaluate the additional value of computer-aided detection (CAD) in breast MRI by assessing radiologists' accuracy in discriminating benign from malignant breast lesions. A literature search was performed with inclusion of relevant studies using a commercially available CAD system with automatic

  1. American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography.

    NARCIS (Netherlands)

    Saslow, D.; Boetes, C.; Burke, W.; Harms, S.; Leach, M.O.; Lehman, C.D.; Morris, E.; Pisano, E.; Schnall, M.; Sener, S.; Smith, R.A.; Warner, E.; Yaffe, M.; Andrews, K.S.; Russell, C.A.

    2007-01-01

    New evidence on breast Magnetic Resonance Imaging (MRI) screening has become available since the American Cancer Society (ACS) last issued guidelines for the early detection of breast cancer in 2003. A guideline panel has reviewed this evidence and developed new recommendations for women at differen

  2. MRI-guided High-Intensity Focused Ultrasound of Breast Cancer

    NARCIS (Netherlands)

    Merckel, L.G.

    2014-01-01

    Magnetic resonance imaging-guided high-intensity focused ultrasound (MR-HIFU) is a promising technique for completely noninvasive tumor ablation. This thesis focuses on its application for the treatment of patients with breast cancer. The first part of the thesis describes the role of breast MRI for

  3. [MRI-guided biopsy of the breast: new possibilities but also new problems

    NARCIS (Netherlands)

    Wobbes, Th.

    2006-01-01

    The use of MRI in the detection and management of breast cancer is increasing. Because of its relatively low specificity, many patients turn out in retrospect to have a false-positive biopsy. Conversely, due to the shortcomings of available biopsy techniques, breast cancer can also be missed and lef

  4. The role of MRI in the diagnosis of acute radiation reaction in breast cancer patient

    Science.gov (United States)

    Startseva, Zh A.; Musabaeva, L. I.; Usova, AV; Frolova, I. G.; Simonov, K. A.; Velikaya, V. V.

    2016-02-01

    A clinical case with acute radiation reaction of the left breast after organ-preserving surgery with 10 Gy IORT (24.8 Gy) conventional radiation therapy has been presented. Comprehensive MRI examination showed signs of radiation- induced damage to skin, soft tissues and vessels of the residual breast.

  5. Breast DCE-MRI Kinetic Heterogeneity Tumor Markers: Preliminary Associations With Neoadjuvant Chemotherapy Response1

    Science.gov (United States)

    Ashraf, Ahmed; Gaonkar, Bilwaj; Mies, Carolyn; DeMichele, Angela; Rosen, Mark; Davatzikos, Christos; Kontos, Despina

    2015-01-01

    The ability to predict response to neoadjuvant chemotherapy for women diagnosed with breast cancer, either before or early on in treatment, is critical to judicious patient selection and tailoring the treatment regimen. In this paper, we investigate the role of contrast agent kinetic heterogeneity features derived from breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for predicting treatment response. We propose a set of kinetic statistic descriptors and present preliminary results showing the discriminatory capacity of the proposed descriptors for predicting complete and non-complete responders as assessed from pre-treatment imaging exams. The study population consisted of 15 participants: 8 complete responders and 7 non-complete responders. Using the proposed kinetic features, we trained a leave-one-out logistic regression classifier that performs with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.84 under the ROC. We compare the predictive value of our features against commonly used MRI features including kinetics of the characteristic kinetic curve (CKC), maximum peak enhancement (MPE), hotspot signal enhancement ratio (SER), and longest tumor diameter that give lower AUCs of 0.71, 0.66, 0.64, and 0.54, respectively. Our proposed kinetic statistics thus outperform the conventional kinetic descriptors as well as the classifier using a combination of all the conventional descriptors (i.e., CKC, MPE, SER, and longest diameter), which gives an AUC of 0.74. These findings suggest that heterogeneity-based DCE-MRI kinetic statistics could serve as potential imaging biomarkers for tumor characterization and could be used to improve candidate patient selection even before the start of the neoadjuvant treatment. PMID:26055172

  6. Breast DCE-MRI Kinetic Heterogeneity Tumor Markers: Preliminary Associations With Neoadjuvant Chemotherapy Response

    Directory of Open Access Journals (Sweden)

    Ahmed Ashraf

    2015-06-01

    Full Text Available The ability to predict response to neoadjuvant chemotherapy for women diagnosed with breast cancer, either before or early on in treatment, is critical to judicious patient selection and tailoring the treatment regimen. In this paper, we investigate the role of contrast agent kinetic heterogeneity features derived from breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI for predicting treatment response. We propose a set of kinetic statistic descriptors and present preliminary results showing the discriminatory capacity of the proposed descriptors for predicting complete and non-complete responders as assessed from pre-treatment imaging exams. The study population consisted of 15 participants: 8 complete responders and 7 non-complete responders. Using the proposed kinetic features, we trained a leave-one-out logistic regression classifier that performs with an area under the receiver operating characteristic (ROC curve (AUC of 0.84 under the ROC. We compare the predictive value of our features against commonly used MRI features including kinetics of the characteristic kinetic curve (CKC, maximum peak enhancement (MPE, hotspot signal enhancement ratio (SER, and longest tumor diameter that give lower AUCs of 0.71, 0.66, 0.64, and 0.54, respectively. Our proposed kinetic statistics thus outperform the conventional kinetic descriptors as well as the classifier using a combination of all the conventional descriptors (i.e., CKC, MPE, SER, and longest diameter, which gives an AUC of 0.74. These findings suggest that heterogeneity-based DCE-MRI kinetic statistics could serve as potential imaging biomarkers for tumor characterization and could be used to improve candidate patient selection even before the start of the neoadjuvant treatment.

  7. Breast DCE-MRI Kinetic Heterogeneity Tumor Markers: Preliminary Associations With Neoadjuvant Chemotherapy Response.

    Science.gov (United States)

    Ashraf, Ahmed; Gaonkar, Bilwaj; Mies, Carolyn; DeMichele, Angela; Rosen, Mark; Davatzikos, Christos; Kontos, Despina

    2015-06-01

    The ability to predict response to neoadjuvant chemotherapy for women diagnosed with breast cancer, either before or early on in treatment, is critical to judicious patient selection and tailoring the treatment regimen. In this paper, we investigate the role of contrast agent kinetic heterogeneity features derived from breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for predicting treatment response. We propose a set of kinetic statistic descriptors and present preliminary results showing the discriminatory capacity of the proposed descriptors for predicting complete and non-complete responders as assessed from pre-treatment imaging exams. The study population consisted of 15 participants: 8 complete responders and 7 non-complete responders. Using the proposed kinetic features, we trained a leave-one-out logistic regression classifier that performs with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.84 under the ROC. We compare the predictive value of our features against commonly used MRI features including kinetics of the characteristic kinetic curve (CKC), maximum peak enhancement (MPE), hotspot signal enhancement ratio (SER), and longest tumor diameter that give lower AUCs of 0.71, 0.66, 0.64, and 0.54, respectively. Our proposed kinetic statistics thus outperform the conventional kinetic descriptors as well as the classifier using a combination of all the conventional descriptors (i.e., CKC, MPE, SER, and longest diameter), which gives an AUC of 0.74. These findings suggest that heterogeneity-based DCE-MRI kinetic statistics could serve as potential imaging biomarkers for tumor characterization and could be used to improve candidate patient selection even before the start of the neoadjuvant treatment.

  8. MRI动态增强扫描与扩散加权成像对乳腺癌诊断价值的对比分析%Comparative Study the Diagnostic Value of Breast Cancer in Dynamic Contrast-enhanced MRI and Diffusion-weighted Imaging

    Institute of Scientific and Technical Information of China (English)

    兰庆茂; 吕亚萍; 马雪梅; 孙嗣麒; 毛勤香; 黄可祥

    2011-01-01

    Objective To study the diagnostic value and insufficient of brest cacere in dynamic contrast-enhanced magnetic resonance imaging( MRI )scan and diffusion weighted imaging( DWI )by the SPINE matrix coil with simple bracker. Methods 37 pathological proven cases of breast cancer were examined by MRI in dynamic contrast-enhanced scanning and DWI,and the diagnostic value and deficiency were analyzed. Results In dynamic contrast-enhanced magnetic resonance imaging ,irregular shape ,spiculated margin , rim enhancement , signal intensity time curve( type Ⅱor Ⅲ )were taken as diagnostic criteria for breast cancer, the diagnostic sensitivities were 78. 4%,70. 3% ,94. 6% and 89. 2% , respectively.The lesions appeared as marked hypher-intensity on DWI( b value =0 ). The higher the b value,the lower the signal intensity on DWI. Conclusion The dynamic contrast-enhanced MRI has important value in the diagnosis of breast cancer diagnosis,and DWI has important auxiliary diagnostic value.%目的 探讨简易乳腺支架配合SPINE matrix线圈MRI动态增强减影扫描及扩散加权成像(DWI)对乳腺癌的诊断价值.方法 37例经手术病理证实的乳腺癌分别采用MRI动态增强扫描、DWI,对比分析其诊断乳腺癌的价值及存在的不足.结果 MRI动态增强减影扫描以形状不规则、毛刺征、环形强化和Ⅱ型或Ⅲ型曲线作为诊断乳腺癌标准,其敏感度分别为78.4%、70.3%、94.6%和89.2%.DWI中b=0时病灶呈明显高信号,随b值增加病灶信号强度依次降低.结论 MRI动态增强扫描对乳腺癌具有特征性的诊断价值;DWI具有重要辅助性的诊断价值.

  9. Invasive lobular carcinoma of the breast: MRI pathological correlation following bilateral total mastectomy.

    Science.gov (United States)

    Stivalet, Aude; Luciani, Alain; Pigneur, Frederic; Dao, Thu Ha; Beaussart, Pauline; Merabet, Zahira; Perlbarg, Julie; Meyblum, Evelyne; Baranes, Laurence; Calitchi, Elie; Lepage, Christophe; Belkacemi, Yazid; Lagrange, Jean-Leon; Lantieri, Laurent; Rahmouni, Alain

    2012-05-01

    Invasive lobular carcinoma (ILC) is more often multifocal and bilateral than invasive ductal carcinoma. MRI is usually recommended for detection of all ILC sites. The performance of known diagnostic breast MRI criteria for ILC characterization has not been evaluated to date using bilateral mastectomy specimens as gold standard. To determine the value of BI-RADS 2006 MRI criteria for ILC detection and characterization, using pathological examination of bilateral mastectomy specimens as the reference standard. Between 2004 and 2007, we retrospectively included all patients with pathologically documented ILC referred to our institution for bilateral mastectomy and preoperative bilateral breast MRI. The location, diameter, and characteristics (BI-RADS) of all lesions were compared with pathological findings. The sensitivity and positive predictive value of bilateral breast MRI for the diagnosis of ILC were calculated. Association of MRI BI-RADS categorical variables and characterization of ILC were assessed (Fisher exact test). Among 360 patients treated for ILC in 2004-2007, 15 patients qualified for this study. Thirty-one ILC foci were found on pathological examination (30 ipsilateral and 1 contralateral tumor; mean diameter 23 mm; range 2-60 mm) and all were identified on MRI, with 90% of masses and 10% non-mass-like enhancements; MRI features significantly associated with ILC included absence of smooth margins (P = 0.02) and rim-shaped enhancement (P = 0.039). Enhancement kinetics of the 31 foci were evenly distributed among wash-out, plateau, and persistent profiles. Eleven additional lesions were seen on MRI, mainly corresponding to fibrocystic disease; 91% presented as masses and 9% had a wash-out profile. Based on the 2006 BI-RADS criteria, breast MRI shows a high sensitivity for ILC detection, at the expense of a 26% false-positive rate, suggesting that a pathological proof by US- or MR-guided biopsy is required in case of suspicious MRI images in this context.

  10. Invasive lobular carcinoma of the breast: MRI pathological correlation following bilateral total mastectomy

    Energy Technology Data Exchange (ETDEWEB)

    Stivalet, Aude; Pigneur, Frederic (AP-HP, Groupe Henri Mondor Albert Chenevier, Imagerie Medicale, Creteil (France)); Luciani, Alain (AP-HP, Groupe Henri Mondor Albert Chenevier, Imagerie Medicale, Creteil (France); INSERM Unite U 955, Equipe 17, Univ. Paris Est Creteil, Creteil (France)), email: alain.luciani@hmn.aphp.fr (and others)

    2012-05-15

    Background: Invasive lobular carcinoma (ILC) is more often multifocal and bilateral than invasive ductal carcinoma. MRI is usually recommended for detection of all ILC sites. The performance of known diagnostic breast MRI criteria for ILC characterization has not been evaluated to date using bilateral mastectomy specimens as gold standard. Purpose: To determine the value of BI-RADS 2006 MRI criteria for ILC detection and characterization, using pathological examination of bilateral mastectomy specimens as the reference standard. Material and Methods: Between 2004 and 2007, we retrospectively included all patients with pathologically documented ILC referred to our institution for bilateral mastectomy and preoperative bilateral breast MRI. The location, diameter, and characteristics (BI-RADS) of all lesions were compared with pathological findings. The sensitivity and positive predictive value of bilateral breast MRI for the diagnosis of ILC were calculated. Association of MRI BI-RADS categorical variables and characterization of ILC were assessed (Fisher exact test). Results: Among 360 patients treated for ILC in 2004-2007, 15 patients qualified for this study. Thirty-one ILC foci were found on pathological examination (30 ipsilateral and 1 contralateral tumor; mean diameter 23 mm; range 2-60 mm) and all were identified on MRI, with 90% of masses and 10% non-mass-like enhancements; MRI features significantly associated with ILC included absence of smooth margins (P = 0.02) and rim-shaped enhancement (P = 0.039). Enhancement kinetics of the 31 foci were evenly distributed among wash-out, plateau, and persistent profiles. Eleven additional lesions were seen on MRI, mainly corresponding to fibrocystic disease; 91% presented as masses and 9% had a wash-out profile. Conclusion: Based on the 2006 BI-RADS criteria, breast MRI shows a high sensitivity for ILC detection, at the expense of a 26% false-positive rate, suggesting that a pathological proof by US- or MR

  11. MRI screening for breast cancer in women at high risk; is the Australian breast MRI screening access program addressing the needs of women at high risk of breast cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Schenberg, Tess [Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Mitchell, Gillian [Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria (Australia); Taylor, Donna [School of Surgery, University of Western Australia, Perth, Western Australia (Australia); Department of Radiology, Royal Perth Hospital, Perth, Western Australia (Australia); BreastScreen Western Australia, Adelaide Terrace, Perth, Western Australia (Australia); Saunders, Christobel [School of Surgery, University of Western Australia, Perth, Western Australia (Australia); Department of General Surgery, St John of God Hospital, Perth, Western Australia (Australia); Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia)

    2015-09-15

    Breast magnetic resonance imaging (MRI) screening of women under 50 years old at high familial risk of breast cancer was given interim funding by Medicare in 2009 on the basis that a review would be undertaken. An updated literature review has been undertaken by the Medical Services Advisory Committee but there has been no assessment of the quality of the screening or other screening outcomes. This review examines the evidence basis of breast MRI screening and how this fits within an Australian context with the purpose of informing future modifications to the provision of Medicare-funded breast MRI screening in Australia. Issues discussed will include selection of high-risk women, the options for MRI screening frequency and measuring the outcomes of screening.

  12. Additional findings at preoperative breast MRI: the value of second-look digital breast tomosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Clauser, Paola; Pancot, Martina; Girometti, Rossano; Bazzocchi, Massimo; Zuiani, Chiara [University of Udine, Azienda Ospedaliero-Universitaria, ' ' S.Maria della Misericordia' ' , Institute of Diagnostic Radiology, Department of Medical and Biological Sciences, Udine (Italy); Carbonaro, Luca A. [IRCCS Policlinico San Donato, Unit of Radiology, Milan (Italy); Sardanelli, Francesco [IRCCS Policlinico San Donato, Unit of Radiology, Milan (Italy); Universita degli Studi di Milano, Department of Biomedical Sciences of Health, Milan (Italy)

    2015-10-15

    To evaluate second-look digital breast tomosynthesis (SL-DBT) for additional findings (AFs) at preoperative MRI compared with second-look ultrasound (SL-US). We included 135 patients with breast cancer who underwent digital mammography (DM), DBT, US, and MRI at two centres. MR images were retrospectively evaluated to find AFs, described as focus, mass, or non-mass; ≤10 mm or >10 mm in size; BI-RADS 3, 4, or 5. DM and DBT exams were reviewed looking for MRI AFs; data on SL-US were collected. Reference standard was histopathology or ≥12-month negative follow-up. Fisher exact test and McNemar test were used. Eighty-four AFs were detected in 53/135 patients (39 %, 95 %CI 31-48 %). A correlate was found for 44/84 (52 %, 95 %CI 41-63 %) at SL-US, for 20/84 (24 %, 95 %CI 11-28 %) at SL-DM, for 42/84 (50 %, 95 %CI 39-61 %) at SL-DBT, for 63/84 (75 %, 95 %CI 64-84 %) at SL-DBT, and/or SL-US, the last rate being higher than for SL-US only, overall (p < 0.001), for mass or non-mass, ≤ or >10 mm, BI-RADS 4 or 5, or malignant lesions (p < 0.031). Of 21 AFs occult at both SLs, 17 were malignant (81 %, 95 %CI 58-94 %). When adding SL-DBT to SL-US, AFs detection increased from 52 % to 75 %. MR-guided biopsy is needed for the remaining 25 %. (orig.)

  13. Breast MRI: Are T2 IR sequences useful in the evaluation of breast lesions?

    Energy Technology Data Exchange (ETDEWEB)

    Ballesio, Laura [Department of Radiological Sciences, Umberto I Hospital, ' Sapienza' University of Rome, Viale Del Policlinico 155, 00161 Rome (Italy); Savelli, Sara [Department of Radiological Sciences, Umberto I Hospital, ' Sapienza' University of Rome, Viale Del Policlinico 155, 00161 Rome (Italy)], E-mail: sarasavelli@hotmail.it; Angeletti, Marco; Porfiri, Lucio Maria; D' Ambrosio, Ilaria; Maggi, Claudia; Castro, Elisabetta Di; Bennati, Paolo; Fanelli, Gloria Pasqua [Department of Radiological Sciences, Umberto I Hospital, ' Sapienza' University of Rome, Viale Del Policlinico 155, 00161 Rome (Italy); Vestri, Anna Rita [Department of Experimental Medicine, Umberto I Hospital, ' Sapienza' University of Rome, Viale Del Policlinico 155, 00161 Rome (Italy); Manganaro, Lucia [Department of Radiological Sciences, Umberto I Hospital, ' Sapienza' University of Rome, Viale Del Policlinico 155, 00161 Rome (Italy)

    2009-07-15

    Aim: To evaluate the potential role of signal intensities calculated in T2 images as an adjunctive parameter in the analysis of mass-like enhancements classified as BIRADS (Breast Imaging Reporting and Data System) assessment categories 2, 3, 4 or 5 with the standard T1 criteria. Materials and methods: After a retrospective review of 338-breast Magnetic Resonance Imaging (MRI) performed for the evaluation of a suspicious lesion we selected a group of 65 mass-like enhancements ranging from 5 to 20 mm, classified as BIRADS assessment categories 2, 3, 4 or 5, histologically proved. In all cases we calculated the ratio between the signal intensity (SI) of the nodule and the pectoralis major muscle (LMSIR, lesion to muscle signal intensity ratio) with a multiROIs (region of interest) analysis on T2 images. A ROC analysis was performed to test the ability of the two diagnostic parameters separately considered (BIRADS and LMSIR) and combined in a new mono-dimensional variable obtained by a computerized discriminant function. Results: Histological examination assessed 34 malignant lesions (52.3%) and 31 benign lesions (47.7%). The evaluation of ROC curves gave the following results: BIRADS area under the curve (AUC) 0.913, S.E. 0.0368, LMSIR AUC 0.854, S.E. 0.0487, combined BIRADS-LMSIR AUC 0.965, S.E. 0.0191 with a definitive increase in the AUC between the overall ROC area and those of the two diagnostic modalities separately considered. Discussion: T2-weighted SI assessment with LMSIR measurement improves the diagnostic information content of standard breast MRI and can be considered a promising potential tool in the differential diagnosis of mass-like enhancements judged as borderline lesions (BIRADS 3 and 4)

  14. Breast MRI: Are T2 IR sequences useful in the evaluation of breast lesions?

    Science.gov (United States)

    Ballesio, Laura; Savelli, Sara; Angeletti, Marco; Porfiri, Lucio Maria; D'Ambrosio, Ilaria; Maggi, Claudia; Castro, Elisabetta Di; Bennati, Paolo; Fanelli, Gloria Pasqua; Vestri, Anna Rita; Manganaro, Lucia

    2009-07-01

    To evaluate the potential role of signal intensities calculated in T2 images as an adjunctive parameter in the analysis of mass-like enhancements classified as BIRADS (Breast Imaging Reporting and Data System) assessment categories 2, 3, 4 or 5 with the standard T1 criteria. After a retrospective review of 338-breast Magnetic Resonance Imaging (MRI) performed for the evaluation of a suspicious lesion we selected a group of 65 mass-like enhancements ranging from 5 to 20mm, classified as BIRADS assessment categories 2, 3, 4 or 5, histologically proved. In all cases we calculated the ratio between the signal intensity (SI) of the nodule and the pectoralis major muscle (LMSIR, lesion to muscle signal intensity ratio) with a multiROIs (region of interest) analysis on T2 images. A ROC analysis was performed to test the ability of the two diagnostic parameters separately considered (BIRADS and LMSIR) and combined in a new mono-dimensional variable obtained by a computerized discriminant function. Histological examination assessed 34 malignant lesions (52.3%) and 31 benign lesions (47.7%). The evaluation of ROC curves gave the following results: BIRADS area under the curve (AUC) 0.913, S.E. 0.0368, LMSIR AUC 0.854, S.E. 0.0487, combined BIRADS-LMSIR AUC 0.965, S.E. 0.0191 with a definitive increase in the AUC between the overall ROC area and those of the two diagnostic modalities separately considered. T2-weighted SI assessment with LMSIR measurement improves the diagnostic information content of standard breast MRI and can be considered a promising potential tool in the differential diagnosis of mass-like enhancements judged as borderline lesions (BIRADS 3 and 4).

  15. Abbreviated protocol for breast MRI: Are multiple sequences needed for cancer detection?

    Energy Technology Data Exchange (ETDEWEB)

    Mango, Victoria L., E-mail: vlm2125@columbia.edu [Columbia University Medical Center, Herbert Irving Pavilion, 161 Fort Washington Avenue, 10th Floor, New York, NY 10032 (United States); Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); Morris, Elizabeth A., E-mail: morrise@mskcc.org [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); David Dershaw, D., E-mail: dershawd@mskcc.org [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); Abramson, Andrea, E-mail: abramsoa@mskcc.org [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); Fry, Charles, E-mail: charles_fry@nymc.edu [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); New York Medical College, 40 Sunshine Cottage Rd, Valhalla, NY 10595 (United States); Moskowitz, Chaya S. [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); Hughes, Mary, E-mail: hughesm@mskcc.org [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); Kaplan, Jennifer, E-mail: kaplanj@mskcc.org [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States); Jochelson, Maxine S., E-mail: jochelsm@mskcc.org [Memorial Sloan-Kettering Cancer Center, Breast and Imaging Center, 300 East 66th Street, New York, NY 10065 (United States)

    2015-01-15

    Highlights: • Abbreviated breast MR demonstrates high sensitivity for breast carcinoma detection. • Time to perform/interpret the abbreviated exam is shorter than a standard MRI exam. • An abbreviated breast MRI could reduce costs and make MRI screening more available. - Abstract: Objective: To evaluate the ability of an abbreviated breast magnetic resonance imaging (MRI) protocol, consisting of a precontrast T1 weighted (T1W) image and single early post-contrast T1W image, to detect breast carcinoma. Materials and methods: A HIPAA compliant Institutional Review Board approved review of 100 consecutive breast MRI examinations in patients with biopsy proven unicentric breast carcinoma. 79% were invasive carcinomas and 21% were ductal carcinoma in situ. Four experienced breast radiologists, blinded to carcinoma location, history and prior examinations, assessed the abbreviated protocol evaluating only the first post-contrast T1W image, post-processed subtracted first post-contrast and subtraction maximum intensity projection images. Detection and localization of tumor were compared to the standard full diagnostic examination consisting of 13 pre-contrast, post-contrast and post-processed sequences. Results: All 100 cancers were visualized on initial reading of the abbreviated protocol by at least one reader. The mean sensitivity for each sequence was 96% for the first post-contrast sequence, 96% for the first post-contrast subtraction sequence and 93% for the subtraction MIP sequence. Within each sequence, there was no significant difference between the sensitivities among the 4 readers (p = 0.471, p = 0.656, p = 0.139). Mean interpretation time was 44 s (range 11–167 s). The abbreviated imaging protocol could be performed in approximately 10–15 min, compared to 30–40 min for the standard protocol. Conclusion: An abbreviated breast MRI protocol allows detection of breast carcinoma. One pre and post-contrast T1W sequence may be adequate for detecting

  16. Dynamic Breast Magnetic Resonance Imaging without Complications in a Patient with Dual-Chamber Demand Pacemaker

    Energy Technology Data Exchange (ETDEWEB)

    Sardanelli, F.; Lupo, P.; Esseridou, A.; Fausto, A.; Quarenghi, M. [Policlinico San Donato, San Donato Milanese, Milan (Italy). Depts. of Radiology, Arrhythmia and Electrophysiology Center

    2006-02-15

    Mammography and ultrasound indicated a cancer of the right breast in a 77-year-old woman with a dual-chamber demand pacemaker. The patient was not pacemaker-dependent. She underwent breast 1.5T magnetic resonance imaging (MRI) (dynamic gradient echo sequence with Gd-DOTA 0.1 mmol/kg). Before the patient entered the MR room, the configuration of the device was changed (the response to magnet was switched from asynchronous to off and the rate-responsive algorithm was disabled). No relevant modifications of heart rhythm or rate were observed during the MR examination. No symptom was reported. Immediately after the examination, the pacemaker interrogation showed neither program changes nor alert warnings. MRI detected a bifocal cancer in the right breast which allowed tailored breast-conserving treatment to be initiated. Histopathology confirmed a bifocal invasive ductal carcinoma.

  17. Preoperative Breast MRI: Surgeons' Patient Selection Patterns and Potential Bias in Outcomes Analyses.

    Science.gov (United States)

    Lee, Jiyon; Tanaka, Elaine; Eby, Peter R; Zhou, Shouhao; Wei, Wei; Eppelheimer, Christine; Loving, Vilert A

    2017-04-01

    The purpose of this study is to determine which patient- and tumor-related and clinical variables influence dedicated breast surgeons' and general surgeons' referrals for preoperative breast MRI for patients with newly diagnosed breast cancer. Surgeons who perform breast surgery responded to a survey from June 16, 2014, through August 11, 2014. Participants self-identified as breast or general surgeons and provided professional practice details. They used Likert scores (range, 1-7 with increasing likelihood to order MRI) to weigh numerous patient- and tumor-related and clinical variables. Mean likelihood scores were calculated and compared using a linear mixed model. A p ≤ 0.05 was considered statistically significant. Two hundred eighty-nine surveys from 154 (53%) breast surgeons and 135 (47%) general surgeons showed an overall likelihood to refer for patients with a BRCA mutation (mean Likert score, 6.17), familial (mean Likert score, 5.33) or personal (mean Likert score, 5.10) breast cancer history, extremely dense breasts (mean Likert score, 5.30), age younger than 40 years (mean Likert score, 5.24), axillary nodal involvement (mean Likert score, 6.22), tumor that is mammographically occult (mean Likert score, 5.62) or fixed to the pectoralis (mean Likert score, 5.49), tumor that is a candidate for neoadjuvant treatment (mean Likert score, 5.38), multifocal or multicentric disease (mean Likert score, 5.22), invasive lobular carcinoma (mean Likert score, 5.20), T3 (mean Likert score, 4.48) or T2 (mean Likert score, 4.41) tumor, triple-negative breast cancer (mean Likert score, 4.66), a patient who is a candidate for mastectomy requesting breast conservation therapy (mean Likert score, 5.27), and radiologists' recommendations (mean Likert score, 5.19). Across all patient ages, breast surgeons referred more often than did general surgeons (mean Likert score, 4.32 vs 3.92; p = 0.03), especially for patients with BRCA mutation (mean Likert score, 6.39 vs 5.93; p

  18. Can T2-weighted 3-T breast MRI predict clinically occult inflammatory breast cancer before pathological examination? A single-center experience.

    Science.gov (United States)

    Uematsu, Takayoshi; Kasami, Masako; Watanabe, Junichiro

    2014-01-01

    Occult inflammatory breast cancer (IBC) is defined as an invasive cancer without any clinical inflammatory signs but with pathologically proven dermal lymphovascular invasion. The purpose of this study is to evaluate the ability of 3-T breast MRI to predict occult IBC before pathological examination and compare its effectiveness with that of mammography (MMG) and ultrasound (US). A retrospective review of clinical, radiological, and pathological records of 460 consecutive breast cancers revealed five proved occult IBCs. We analyzed the findings of 3-T MRI, MMG, and US for these five occult IBCs. Primary breast lesions were detected by 3-T MRI, MMG, and US in all five breasts with occult IBCs. 3-T MRI revealed 40% mass type lesions and 60% non-mass-like type lesions. Kinetic curve analysis of the primary breast lesions showed a rapid initial kinetic phase in 80% of lesions and a delayed washout pattern in 60% of lesions. 3-T MRI showed slight skin thickness in 60% of breasts, whereas MMG and US showed slight skin thickness in 40 and 20% of breasts, respectively. Subcutaneous and prepectoral edema, as evaluated on T2-weighted images, was present in all five breasts with occult IBCs. The presence of subcutaneous and prepectoral edema on T2-weighted 3-T breast MRI is an important finding that should suggest the diagnosis of occult IBC before pathological examination.

  19. Dynamic contrast-enhanced magnetic resonance imaging for prediction of response to neoadjuvant chemotherapy in breast cancer

    Science.gov (United States)

    Fu, Juzhong; Fan, Ming; Zheng, Bin; Shao, Guoliang; Zhang, Juan; Li, Lihua

    2016-03-01

    Breast cancer is the second leading cause of women death in the United States. Currently, Neoadjuvant Chemotherapy (NAC) has become standard treatment paradigms for breast cancer patients. Therefore, it is important to find a reliable non-invasive assessment and prediction method which can evaluate and predict the response of NAC on breast cancer. The Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) approach can reflect dynamic distribution of contrast agent in tumor vessels, providing important basis for clinical diagnosis. In this study, the efficacy of DCE-MRI on evaluation and prediction of response to NAC in breast cancer was investigated. To this end, fifty-seven cases of malignant breast cancers with MRI examination both before and after two cycle of NAC were analyzed. After pre-processing approach for segmenting breast lesions and background regions, 126-dimensional imaging features were extracted from DCE-MRI. Statistical analyses were then performed to evaluate the associations between the extracted DCE-MRI features and the response to NAC. Specifically, pairwise t test was used to calculate differences of imaging features between MRI examinations before-and-after NAC. Moreover, the associations of these image features with response to NAC were assessed using logistic regression. Significant association are found between response to NAC and the features of lesion morphology and background parenchymal enhancement, especially the feature of background enhancement in normal side of breast (P=0.011). Our study indicate that DCE-MRI features can provide candidate imaging markers to predict response of NAC in breast cancer.

  20. Factors affecting sensitivity and specificity of screening mammography and MRI in women with an inherited risk for breast cancer.

    NARCIS (Netherlands)

    Kriege, M.; Brekelmans, C.T.; Obdeijn, I.M.; Boetes, C.; Zonderland, H.M.; Muller, S.H.; Kok, T.; Manoliu, R.A.; Besnard, A.P.; Tilanus-Linthorst, M.M.; Seynaeve, C.; Bartels, C.C.; Kaas, R.; Meijer, S.; Oosterwijk-Wakka, J.C.; Hoogerbrugge-van der Linden, N.; Tollenaar, R.A.E.M.; Rutgers, E.J.; Koning, H.J. de; Klijn, J.G.M.

    2006-01-01

    BACKGROUND: The MRISC study is a screening study, in which women with an increased risk of hereditary breast cancer are screened by a yearly mammography and MRI, and half-yearly clinical breast examination. The sensitivity found in this study was 40% for mammography and 71% for MRI and the specifici

  1. Factors affecting sensitivity and specificity of screening mammography and MRI in women with an inherited risk for breast cancer

    NARCIS (Netherlands)

    Kriege, Mieke; Brekelmans, Cecile T. M.; Obdeijn, Inge Marie; Boetes, Carla; Zonderland, Harmine M.; Muller, Sara H.; Kok, Theo; Manoliu, Radu A.; Besnard, A. Peter E.; Tilanus-Linthorst, Madeleine M. A.; Seynaeve, Caroline; Bartels, Carina C. M.; Kaas, Reini; Meijer, Siebren; Oosterwijk, Jan C.; Hoogerbrugge, Nicoline; Tollenaar, Rob A. E. M.; Rutgers, Emiel J. T.; de Koning, Harry J.; Klijn, Jan G. M.

    2006-01-01

    Background The MRISC study is a screening study, in which women with an increased risk of hereditary breast cancer are screened by a yearly mammography and MRI, and half-yearly clinical breast examination. The sensitivity found in this study was 40% for mammography and 71% for MRI and the specificit

  2. Does the degree of background enhancement in breast MRI affect the detection and staging of breast cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Uematsu, Takayoshi [Shizuoka Cancer Center Hospital, Breast Imaging and Breast Intervention Section, Shizuoka (Japan); Kasami, Masako [Shizuoka Cancer Center Hospital, Department of Pathology, Naga-izumi, Shizuoka (Japan); Watanabe, Junichiro [Shizuoka Cancer Center Hospital, Division of Medical Oncology, Naga-izumi, Shizuoka (Japan)

    2011-11-15

    The purpose of this study was to assess the influence of background enhancement on the detection and staging of breast cancer using MRI as an adjunct to mammography or ultrasound. One hundred forty-six bilateral breast MRI examinations were evaluated to assess the extent of a known primary tumour and to problem solve after mammography or ultrasound without adjusting for the phase in the patients' menstrual cycle. The background enhancement was classified into four categories by visual evaluation: minimal, mild, moderate and marked. In total, 131 histologically confirmed abnormal cases (104 malignant and 27 benign) and 15 normal cases were included in the analysis. There was no tumour size-related bias between the groups (p = 0.522). For the primary index tumour, the sensitivities of MRI with minimal/mild and moderate/marked background enhancement were 100% and 76% (p = 0.001), respectively. Thus, the degree of background enhancement did not affect the specificity. For evaluating tumour extent (n = 104), the accuracy of MRI with moderate/marked background enhancement (52%) was significantly lower than that with minimal/mild background enhancement (84%; p = 0.002). The degree of background enhancement affected the detection and staging of breast cancer using MRI. (orig.)

  3. Quantitative MRI analysis of dynamic enhancement of focal liver lesions

    Directory of Open Access Journals (Sweden)

    S. S. Bagnenko

    2012-01-01

    Full Text Available In our study 45 patients with different focal liver lesions (110 nodules were examined using high field MR-system (1,5 T. During this investigation quantitative MRI analysis of dynamic enhancement of various hepatic lesions and parenchymatous organs of abdomen were performed. It was shown that quantitative evaluation of enhanced MRI improves understanding of vascular transformation processes in pathologic hepatic focuses and in liver itself that is important for differential diagnoses of these diseases.

  4. Enhanced MRI of breast cancer smaller than 3 cm

    Energy Technology Data Exchange (ETDEWEB)

    Ikeda, Yukio; Yoshida, Shouji (Hyogo Medical Center for Adults (Japan)); Narabayashi, Isamu (and others)

    1991-11-01

    Twenty-two patients with breast cancers were studied using magnetic resonance (MR) imaging with a cylindrical surface coil at 1.5 Tesla. All were examined with the FE sequence and Gd-DTPA as a contrast medium. These images were compared with micrographs of the specimens. All cancers were enhanced clearly, and demarcated margins or spiculations of the tumors were seen as clearly on MR images as on micrographs of the specimens. In 12 patients (9 carcinomas, 2 fibroadenomas and 1 benign phyllodes tumor), dynamic studies were performed after the intravenous injection of Gd-DTPA. All nine carcinomas showed enhancement characterized by a sudden increase in signal intensity on the order of 100% or more with the first 2 minutes after injection. Two fibroadenomas were enhanced slowly. Thirteen patients with breast cancers were examined with several sequences (FE, T{sub 1}-weighted SE, T{sub 2}-weighted SE and STIR) with or without Gd-DTPA. The most clearly delineated images of the tumors were those of FE images with Gd-DTPA enhancement. A phantom constituted of various concentrations of Gd-DTPA in 20% albumin solution was measured by signal intensities with T{sub 1}-weighted SE sequence and FE sequence. The ratio of enhancement of the 20% albumin solution relative to the Gd-DTPA concentration was higher with the FE sequence than with the SE sequence. The sensitivity of the FE sequence to Gd-DTPA enhancement was 1.5 times that of the SE sequence under the usual concentration of Gd-DTPA. (author).

  5. Impact of menopausal status on background parenchymal enhancement and fibroglandular tissue on breast MRI

    Energy Technology Data Exchange (ETDEWEB)

    King, Valencia [Memorial Sloan-Kettering Cancer Center, Department of Radiology, Breast Imaging Section, New York, NY (United States); Memorial Sloan-Kettering Cancer Center, Department of Radiology, New York, NY (United States); Gu, Yajia [Fudan University Shanghai Cancer Center, Department of Radiology, Shanghai (China); Fudan University, Department of Oncology, Shanghai Medical College, Shanghai (China); Kaplan, Jennifer B.; Morris, Elizabeth A. [Memorial Sloan-Kettering Cancer Center, Department of Radiology, Breast Imaging Section, New York, NY (United States); Brooks, Jennifer D.; Pike, Malcolm C. [Memorial Sloan-Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY (United States)

    2012-12-15

    To evaluate the effect of menopausal status on the background parenchymal enhancement (BPE) and amount of fibroglandular tissue (FGT) on breast MRI. Retrospective review identified 1,130 women who underwent screening breast MRI between July and November 2010. In 28 of these women, breast MRI was performed both at one time point while pre- and one time point while post-menopausal (median interval 49 months). Two independent readers blinded to menopausal status used categorical scales to rate BPE (minimal/mild/moderate/marked) and FGT (fatty/scattered/heterogeneously dense/dense). Consensus was reached when there was disagreement. The sign test was used to assess changes in rating categories, and the Spearman rank and Fisher's exact tests were used to measure correlations and associations between variables. Significant proportions of women demonstrated decreases in BPE and FGT on post-menopausal breast MRI (P = 0.0001 and P = 0.0009). BPE category was unchanged in 39 % (11/28) and decreased in 61 % (17/28) of women. FGT category was unchanged in 61 % (17/28) and decreased in 39 % (11/28) of women. Age, reason for menopause, or interval between MRIs had no significant impact on changes in BPE and FGT. On MRI, BPE, and FGT decrease after menopause in significant proportions of women; BPE decreases more than FGT. (orig.)

  6. Automated detection of breast tumor in MRI and comparison of kinetic features for assessing tumor response to chemotherapy

    Science.gov (United States)

    Aghaei, Faranak; Tan, Maxine; Zheng, Bin

    2015-03-01

    Dynamic contrast-enhanced breast magnetic resonance imaging (DCE-MRI) is used increasingly in diagnosis of breast cancer and assessment of treatment efficacy in current clinical practice. The purpose of this preliminary study is to develop and test a new quantitative kinetic image feature analysis method and biomarker to predict response of breast cancer patients to neoadjuvant chemotherapy using breast MR images acquired before the chemotherapy. For this purpose, we developed a computer-aided detection scheme to automatically segment breast areas and tumors depicting on the sequentially scanned breast MR images. From a contrast-enhancement map generated by subtraction of two image sets scanned pre- and post-injection of contrast agent, our scheme computed 38 morphological and kinetic image features from both tumor and background parenchymal regions. We applied a number of statistical data analysis methods to identify effective image features in predicting response of the patients to the chemotherapy. Based on the performance assessment of individual features and their correlations, we applied a fusion method to generate a final image biomarker. A breast MR image dataset involving 68 patients was used in this study. Among them, 25 had complete response and 43 had partially response to the chemotherapy based on the RECIST guideline. Using this image feature fusion based biomarker, the area under a receiver operating characteristic curve is AUC = 0.850±0.047. This study demonstrated that a biomarker developed from the fusion of kinetic image features computed from breast MR images acquired pre-chemotherapy has potentially higher discriminatory power in predicting response of the patients to the chemotherapy.

  7. Preoperative breast MRI can reduce the rate of tumor-positive resection margins and reoperations in patients undergoing breast-conserving surgery

    NARCIS (Netherlands)

    A.I.M. Obdeijn (Inge-Marie); M.M.A. Tilanus-Linthorst (Madeleine); S. Spronk (Sandra); C.H.M. van Deurzen (Carolien); C. de Monyé (Cécile); M.G.M. Hunink (Myriam); M.B. Menke (Marian )

    2013-01-01

    textabstractOBJECTIVE. In breast cancer patients eligible for breast-conserving surgery, we evaluated whether the information provided by preoperative MRI of the breast would result in fewer tumor-positive resection margins and fewer reoperations. SUBJECTS AND METHODS. The study group consisted of 1

  8. Malignancy Rate, Number Needed to Treat, and Positive Predictive Value for Breast MRI.

    Science.gov (United States)

    Kennedy, John S; Robbins, Patrick A

    2016-09-01

    Breast MRI is being used more frequently for advanced screening for breast cancer. Patients may be at increased risk, or are symptomatic, with nonsuspicious mammograms. There is little data regarding the likelihood of a recommendation for biopsy, or for detecting a malignancy, in this population. We intended to determine the malignancy rate, number needed to treat, and positive predictive value for patients receiving adjunctive MRI at our institution. A retrospective review of all breast MRIs from 2008 to 2010 was done. Patients with any prior diagnosis of breast cancer, or BRCA+ were excluded. There were 324 patients. Most common reasons for ordering the breast MRI included: abnormal test result 130 (44%), palpable mass 74 (23%), family history 58 (18%), breast pain 47 (15%), and nipple discharge 45 (14%). Breast Imaging-Reporting and Data System score (BIRADS) was 1 or 2 in 36 per cent, 4 or 5 in 18 per cent, 3 in 26 per cent, 0 in 10 per cent, and not given in 9 per cent. Biopsy was recommended in 77 (24%), with biopsy actually performed in 57 (18%). Of the eight cancers identified, four (1.2%) were ductal carcinoma in situ (DCIS) and four (1.2%) were invasive cancer, yielding a true-positive rate of 2.5 per cent. Number needed to treat was 40. Positive predictive value was 14 per cent with a false-positive rate of 86 per cent. In this group of generally higher risk women, typically prescreened with mammography, 1.2 per cent had an invasive cancer, and another 1.2 per cent had DCIS. Those who undergo biopsy are 6.1 times more likely to have benign pathology. The efficacy of adjunctive breast MRI could be improved through refinements in indication, test interpretation, or alternative screening strategies.

  9. In newly diagnosed breast cancer, screening MRI of the contralateral breast detects mammographically occult cancer, even in elderly women: the mayo clinic in Florida experience.

    Science.gov (United States)

    Bernard, Johnny Ray; Vallow, Laura A; DePeri, Elizabeth R; McNeil, Rebecca B; Feigel, Deborah G; Amar, Surabhi; Buskirk, Steven J; Perez, Edith A

    2010-01-01

    The role of magnetic resonance imaging (MRI) in patients with newly diagnosed breast cancer is somewhat controversial. The purpose of this study was to evaluate the prevalence of synchronous, occult contralateral breast cancer detected by MRI but not by mammography or clinical breast examination in women with newly diagnosed breast cancer, including those aged 70 years or older at our institution. MRI results for women with newly diagnosed breast cancer who underwent bilateral breast MRI after negative mammography and clinical examination between February 2003 and November 2007 at Mayo Clinic in Florida were reviewed. The prevalence of pathologically confirmed contralateral carcinoma diagnosed solely by MRI was determined and analyzed in the context of age, family history, menopausal status, breast density, and primary-tumor characteristics. Logistic regression was used to explore the association between contralateral carcinoma and potential patient risk factors. A total of 425 women were evaluated, of whom 129 (30%) were aged 70 years or older. A contralateral biopsy was recommended and performed solely on the basis of MRI in 72 of the 425 women (17%). Sixteen of these 72 women (22%) had pathologically confirmed carcinoma, including seven in the older subgroup. The prevalence of clinically and mammographically occult contralateral carcinoma detected by MRI was 3.8% (16/425) overall and 5.4% (7/129) in the group of older women. When potential risk factors for contralateral breast cancer were evaluated, postmenopausal status was the only significant predictor of contralateral cancer detected by MRI (p = 0.016). We concluded that contralateral breast screening with MRI should be considered in postmenopausal women with newly diagnosed breast cancer, even those aged 70 years or older at diagnosis.

  10. The application of breast DCE-MRI combined with time signal curve in diagnosing early breast cancer%磁共振动态增强乳腺扫描及时间信号曲线结合在早期乳腺癌诊断中的应用价值

    Institute of Scientific and Technical Information of China (English)

    Yakun He; Guohui Xu; Jing Ren; Min Wang; Jin Liu

    2013-01-01

    Objective:The aim of this study was to investigate the application value of breast dynamic contrast-enhanced magnetic resonance imaging combined with time signal curve in diagnosis of early breast cancer. Methods:Conducted dynamic contrast-enhanced MRI and drew the time signal curves of breast lesions in 60 patients with breast disease (malignant 46, benign 14). Results:Morphological features of malignant tumors mostly showed blurred or thin spiculate outlines, irregular shape or lobular signs, signal heterogeneity or peripheral enhancement in dynamic contrast-enhanced MRI. Time signal curve showed type III or II. Morphologic features of benign tumors mostly showed clear edge, regular shape and homogeneous signal, or diffuse spot enhancement. Time signal curve showed type I or II. Conclusion:breast dynamic contrast enhanced scan in MRI can provide morphology and functional diagnosis information of the breast tissues. Dynamic contrast-enhanced MRI combined with time signal curve can further improve the accuracy of diagnosis of early breast cancer.

  11. B1 homogeneity of breast MRI using RF shimming with individual specific values in volunteers simulating patients after mastectomy.

    Science.gov (United States)

    Abe, Takayuki

    2016-11-01

    Background Magnetic resonance imaging (MRI) using a 3-T MRI scanner is now widely used for clinical examinations. However, B1 inhomogeneity becomes larger with MRI scanners using 3-T and higher. It especially becomes a problem in the breast. To improve B1 homogeneity, a RF shimming technique has been developed. Purpose To evaluate the B1 homogeneity of breast MRI using RF shimming with individual specific values for subjects after mastectomy. Material and Methods The subjects are healthy female volunteers who underwent normal breast imaging, followed by imaging of one breast while the other breast was bound tightly to the chest by bleached cotton cloths (simulating volunteers after mastectomy). B1 mappings were performed with RF shimming using two techniques: (i) optimized fixed value; and (ii) individual specific values using a 3-T MRI scanner. The means and standard deviations of the B1 maps for all slices in the breast were measured and compared between the fixed value and the individual specific value cases. Results For normal volunteers, the breast B1 variation was not statistically significantly different between the RF shimming techniques. For volunteers after simulated surgery, the breast B1 variation was (1.02 ± 0.29) with the fixed value and (0.98 ± 0.22) with the individual specific value ( P volunteers after simulated surgery. Conclusion RF shimming with individual specific values has the potential to improve the B1 homogeneity of breast MRI in patients after mastectomy.

  12. Cine MRI of Tracheal Dynamics in Healthy Volunteers and Patients With Tracheobronchomalacia.

    Science.gov (United States)

    Ciet, Pierluigi; Boiselle, Phillip M; Heidinger, Benedikt; Andrinopoulou, Eleni-Rosalina; O'Donnel, Carl; Alsop, David C; Litmanovich, Diana E

    2017-10-01

    Bronchoscopy and MDCT are routinely used to assess tracheobronchomalacia (TBM). Recently, dynamic MRI (cine MRI) has been proposed as a radiation-free alternative to MDCT. In this study, we tested cine MRI assessment of airway dynamics during various breathing conditions and compared cine MRI and MDCT measurements in healthy volunteers and patients with suspected TBM. Cine MRI was found to be a technically feasible alternative to MDCT for assessing central airway dynamics.

  13. Physiologically informed dynamic causal modeling of fMRI data.

    Science.gov (United States)

    Havlicek, Martin; Roebroeck, Alard; Friston, Karl; Gardumi, Anna; Ivanov, Dimo; Uludag, Kamil

    2015-11-15

    The functional MRI (fMRI) signal is an indirect measure of neuronal activity. In order to deconvolve the neuronal activity from the experimental fMRI data, biophysical generative models have been proposed describing the link between neuronal activity and the cerebral blood flow (the neurovascular coupling), and further the hemodynamic response and the BOLD signal equation. These generative models have been employed both for single brain area deconvolution and to infer effective connectivity in networks of multiple brain areas. In the current paper, we introduce a new fMRI model inspired by experimental observations about the physiological underpinnings of the BOLD signal and compare it with the generative models currently used in dynamic causal modeling (DCM), a widely used framework to study effective connectivity in the brain. We consider three fundamental aspects of such generative models for fMRI: (i) an adaptive two-state neuronal model that accounts for a wide repertoire of neuronal responses during and after stimulation; (ii) feedforward neurovascular coupling that links neuronal activity to blood flow; and (iii) a balloon model that can account for vascular uncoupling between the blood flow and the blood volume. Finally, we adjust the parameterization of the BOLD signal equation for different magnetic field strengths. This paper focuses on the form, motivation and phenomenology of DCMs for fMRI and the characteristics of the various models are demonstrated using simulations. These simulations emphasize a more accurate modeling of the transient BOLD responses - such as adaptive decreases to sustained inputs during stimulation and the post-stimulus undershoot. In addition, we demonstrate using experimental data that it is necessary to take into account both neuronal and vascular transients to accurately model the signal dynamics of fMRI data. By refining the models of the transient responses, we provide a more informed perspective on the underlying neuronal

  14. Quantitative Clinical Evaluation of a Simultaneous PETI MRI Breast Imaging System

    Energy Technology Data Exchange (ETDEWEB)

    Schlyer D. J.; Schlyer, D.J.

    2013-04-03

    A prototype simultaneous PET-MRI breast scanner has been developed for conducting clinical studies with the goal of obtaining high resolution anatomical and functional information in the same scan which can lead to faster and better diagnosis, reduction of unwanted biopsies, and better patient care.

  15. Comparative effectiveness of breast MRI and mammography in screening young women with elevated risk of developing breast cancer: a retrospective cohort study.

    Science.gov (United States)

    Narayan, Anand K; Visvanathan, Kala; Harvey, Susan C

    2016-08-01

    Screening guidelines recommend that women with 20 % or greater lifetime risk of breast cancer undergo annual breast MRI screening to supplement mammography, irrespective of age. In patients less than 40 years, mammography is often avoided due to concerns about radiation and decreased performance. However, prior studies have been limited by large percentages of women above 40 with decreased breast density. Our purpose was to test whether adding mammography to breast MRI screening compared to breast MRI screening alone in women below 40 increases cancer detection rates. After obtaining IRB approval, chart review identified patients aged 25-40 years undergoing breast MR screening (2005-2014). Demographics, risk factors, BI-RADS assessments, background parenchymal enhancement, and mammographic breast tissue density were recorded. Cancer detection rates, short-term follow-up (BIRADS 3), image-guided biopsy (BIRADS 4,5), and PPV1-3 were calculated. 342 breast MRI exams were identified (average age was 33, 37 % were nulliparous, and 64 % had prior benign biopsy), 226 (66 %) of which underwent concurrent mammography. Risk factors included 64 % with breast cancer in first-degree relative(s), 90 % had heterogeneous or extremely dense breast tissue on mammography, and 16 % were BRCA carriers. Four invasive cancers were detected by MRI (11.7 cancers/1000 examinations, 95 % CI 8.3, 15.1). None of these was detected by mammography, and no cancers were independently identified by mammography. Breast MRI screening in high-risk women under 40 yielded elevated cancer detection rates (11.7/1000). The cancer detection rate for mammography was 0 %, suggesting that MRI alone may be useful in screening high-risk women under 40.

  16. Intravoxel incoherent motion MR imaging for breast lesions: comparison and correlation with pharmacokinetic evaluation from dynamic contrast-enhanced MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Chunling; Liu, Zaiyi; Zhang, Jine; He, Hui; Zhang, Shuixing; Liang, Changhong [Guangdong General Hospital/Guangdong Academy of Medical Sciences, Department of Radiology, GuangZhou (China); Wang, Kun [Guangdong General Hospital/Guangdong Academy of Medical Sciences, Department of Breast Cancer, Cancer Center, GuangZhou (China); Chan, Queenie [Philips Healthcare, 6/F, Core Building 1, 1 Science Park East Avenue, Hong Kong Science Park, Shatin, New Territories, Hong Kong (China)

    2016-11-15

    To compare diagnostic performance for breast lesions by quantitative parameters derived from intravoxel incoherent motion (IVIM) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) and to explore whether correlations exist between these parameters. IVIM and DCE MRI were performed on a 1.5-T MRI scanner in patients with suspicious breast lesions. Thirty-six breast cancers and 23 benign lesions were included in the study. Quantitative parameters from IVIM (D, f and D*) and DCE MRI (K{sup trans}, K{sub ep}, V{sub e} and V{sub p}) were calculated and compared between malignant and benign lesions. Spearman correlation test was used to evaluate correlations between them. D, f, D* from IVIM and K{sup trans}, K{sub ep}, V{sub p} from DCE MRI were statistically different between breast cancers and benign lesions (p < 0.05, respectively) and D demonstrated the largest area under the receiver-operating characteristic curve (AUC = 0.917) and had the highest specificity (83 %). The f value was moderately statistically correlated with V{sub p} (r = 0.692) and had a poor correlation with K{sup trans} (r = 0.456). IVIM MRI is useful in the differentiation of breast lesions. Significant correlations were found between perfusion-related parameters from IVIM and DCE MRI. IVIM may be a useful adjunctive tool to standard MRI in diagnosing breast cancer. (orig.)

  17. A novel approach to contrast-enhanced breast magnetic resonance imaging for screening: high-resolution ultrafast dynamic imaging.

    Science.gov (United States)

    Mann, Ritse M; Mus, Roel D; van Zelst, Jan; Geppert, Christian; Karssemeijer, Nico; Platel, Bram

    2014-09-01

    The use of breast magnetic resonance imaging (MRI) as screening tool has been stalled by high examination costs. Scan protocols have lengthened to optimize specificity. Modern view-sharing sequences now enable ultrafast dynamic whole-breast MRI, allowing much shorter and more cost-effective procedures. This study evaluates whether dynamic information from ultrafast breast MRI can be used to replace standard dynamic information to preserve accuracy. We interleaved 20 ultrafast time-resolved angiography with stochastic trajectory (TWIST) acquisitions (0.9 × 1 × 2.5 mm, temporal resolution, 4.3 seconds) during contrast inflow in a regular high-resolution dynamic MRI protocol. A total of 160 consecutive patients with 199 enhancing abnormalities (95 benign and 104 malignant) were included. The maximum slope of the relative enhancement versus time curve (MS) obtained from the TWIST and curve type obtained from the regular dynamic sequence as defined in the breast imaging reporting and data system (BIRADS) lexicon were recorded. Diagnostic performance was compared using receiver operating characteristic analysis. All lesions were visible on both the TWIST and standard series. Maximum slope allows discrimination between benign and malignant disease with high accuracy (area under the curve, 0.829). Types of MS were defined in analogy to BIRADS curve types: MS type 3 implies a high risk of malignancy (MS >13.3%/s; specificity, 85%), MS type 2 yields intermediate risk (MS 6.4%/s), and MS type 1 implies a low risk (MS BIRADS curve type analysis does (area under the curve, 0.812 vs 0.692; P = 0.0061). Ultrafast dynamic breast MRI allows detection of breast lesions and classification with high accuracy using MS. This allows substantial shortening of scan protocols and hence reduces imaging costs, which is beneficial especially for screening.

  18. Prognostic value of DCE-MRI in breast cancer patients undergoing neoadjuvant chemotherapy: a comparison with traditional survival indicators

    Energy Technology Data Exchange (ETDEWEB)

    Pickles, Martin D.; Lowry, Martin; Turnbull, Lindsay W. [Hull York Medical School at University of Hull, Hull Royal Infirmary, Centre for Magnetic Resonance Investigations, Hull (United Kingdom); Manton, David J. [Hull and East Yorkshire Hospitals NHS Trust, Radiation Physics Department, Hull (United Kingdom)

    2015-04-01

    To determine associations between dynamic contrast-enhanced MR imaging (DCE-MRI) parameters and survival intervals in patients with locally advanced breast cancer treated with neoadjuvant chemotherapy (NAC), surgery, and adjuvant therapies. Further, to compare the prognostic value of DCE-MRI parameters against traditional survival indicators. DCE-MRI and MR tumour volume measures were obtained prior to treatment and post 2nd NAC cycle. To demonstrate which parameters were associated with survival, Cox's proportional hazards models (CPHM) were employed. To avoid over-parameterisation, only those MR parameters with at least a borderline significant result were entered into the final CPHM. When considering disease-free survival positive axillary nodal status (hazard ratio [HR] 6.79), younger age (HR 3.37), negative oestrogen receptor status (HR 3.24), pre-treatment Maximum Enhancement Index (MaxEI) (HR 6.51), and percentage change in MaxEI (HR 1.02) represented the retained CPHM covariates. Similarly, positive axillary nodal status (HR 11.47), negative progesterone receptor status (HR 4.37) and percentage change in AUC{sub 90} (HR 1.01) represented the retained predictive variables for overall survival. Multivariate survival analysis has demonstrated that DCE-MRI parameters obtained prior to NAC and/or post 2nd cycle can provide independent prognostic information that can complement traditional prognostic indicators available prior to treatment. (orig.)

  19. Which factors influence MRI-pathology concordance of tumour size measurements in breast cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Rominger, M.; Frauenfelder, T. [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Berg, D. [Urbankrankenhaus Berlin, Anesthesiology, Berlin (Germany); Ramaswamy, A. [University Hospital Marburg, Pathology, Marburg (Germany); Timmesfeld, N. [Philipps University Marburg, Institute for Medical Biometry and Epidemiology, Marburg (Germany)

    2016-05-15

    To assess MRI-pathology concordance and factors influencing tumour size measurement in breast cancer. MRI tumour size (greatest diameter in anatomical planes (MRI-In-Plane) and greatest diameter along main tumour axis (MRI-MPR)) of 115 consecutive breast lesions (59 invasive lobular carcinoma, 46 invasive ductal carcinoma, and 10 ductal carcinoma in situ) was retrospectively compared to size measured at histopathology (pT size (Path-TNM) and greatest tumour diameter as relevant for excision (Path-Diameter; reference standard)). Histopathological tumour types, preoperative palpability, surgical management, additional high-risk lesions, and BI-RADS lesion type (mass versus non-mass enhancements) were assessed as possible influencing factors. Systematic errors were most pronounced between MRI-MPR and Path-TNM (7.1 mm, limits of agreement (LoA) [-21.7; 35.9]), and were lowest between MRI-In-Plane and Path-Diameter (0.2 mm, LoA [-19.7; 20.1]). Concordance rate of MRI-In-Plane with Path-Diameter was 86 % (97/113), overestimation 9 % (10/113) and underestimation 5 % (6/113); BI-RADS mass lesions were overestimated in 7 % (6/81) versus 41 % (13/32) for non-mass enhancements. On multivariate analysis only BI-RADS lesion type significantly influenced MRI-pathology concordance (p < 0.001). 2/59 (3 %) ILC did not enhance. Concordance rate varies according to the execution of MRI and histopathological measurements. Beyond this only non-mass enhancement significantly predicted discordance. (orig.)

  20. Breast tumor characteristics of BRCA1 and BRCA2 gene mutation carriers on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Veltman, J.; Mann, R.; Blickman, J.G.; Boetes, C. [University Medical Center, 430 Department of Radiology, P.O. Box 9101, Nijmegen (Netherlands); Kok, T. [University Medical Center, Department of Radiology, Groningen (Netherlands); Obdeijn, I.M. [Erasmus Medical Center Daniel den Hoed Cancer Center, Department of Radiology, Rotterdam (Netherlands); Hoogerbrugge, N. [University Medical Center, Department of Human Genetics, Nijmegen (Netherlands)

    2008-05-15

    The appearance of malignant lesions in BRCA1 and BRCA2 mutation carriers (BRCA-MCs) on mammography and magnetic resonance imaging (MRI) was evaluated. Thus, 29 BRCA-MCs with breast cancer were retrospectively evaluated and the results compared with an age, tumor size and tumor type matched control group of 29 sporadic breast cancer cases. Detection rates on both modalities were evaluated. Tumors were analyzed on morphology, density (mammography), enhancement pattern and kinetics (MRI). Overall detection was significantly better with MRI than with mammography (55/58 vs 44/57, P = 0.021). On mammography, lesions in the BRCA-MC group were significantly more described as rounded (12//19 vs 3/13, P = 0.036) and with sharp margins (9/19 vs 1/13, P = 0.024). On MRI lesions in the BRCA-MC group were significantly more described as rounded (16/27 vs 7/28, P = 0.010), with sharp margins (20/27 vs 7/28, P < 0.001) and with rim enhancement (7/27 vs 1/28, P = 0.025). No significant difference was found for enhancement kinetics (P = 0.667). Malignant lesions in BRCA-MC frequently have morphological characteristics commonly seen in benign lesions, like a rounded shape or sharp margins. This applies for both mammography and MRI. However the possibility of MRI to evaluate the enhancement pattern and kinetics enables the detection of characteristics suggestive for a malignancy. (orig.)

  1. Is there any correlation between model-based perfusion parameters and model-free parameters of time-signal intensity curve on dynamic contrast enhanced MRI in breast cancer patients?

    Energy Technology Data Exchange (ETDEWEB)

    Yi, Boram; Kang, Doo Kyoung; Kim, Tae Hee [Ajou University School of Medicine, Department of Radiology, Suwon, Gyeonggi-do (Korea, Republic of); Yoon, Dukyong [Ajou University School of Medicine, Department of Biomedical Informatics, Suwon (Korea, Republic of); Jung, Yong Sik; Kim, Ku Sang [Ajou University School of Medicine, Department of Surgery, Suwon (Korea, Republic of); Yim, Hyunee [Ajou University School of Medicine, Department of Pathology, Suwon (Korea, Republic of)

    2014-05-15

    To find out any correlation between dynamic contrast-enhanced (DCE) model-based parameters and model-free parameters, and evaluate correlations between perfusion parameters with histologic prognostic factors. Model-based parameters (Ktrans, Kep and Ve) of 102 invasive ductal carcinomas were obtained using DCE-MRI and post-processing software. Correlations between model-based and model-free parameters and between perfusion parameters and histologic prognostic factors were analysed. Mean Kep was significantly higher in cancers showing initial rapid enhancement (P = 0.002) and a delayed washout pattern (P = 0.001). Ve was significantly lower in cancers showing a delayed washout pattern (P = 0.015). Kep significantly correlated with time to peak enhancement (TTP) (ρ = -0.33, P < 0.001) and washout slope (ρ = 0.39, P = 0.002). Ve was significantly correlated with TTP (ρ = 0.33, P = 0.002). Mean Kep was higher in tumours with high nuclear grade (P = 0.017). Mean Ve was lower in tumours with high histologic grade (P = 0.005) and in tumours with negative oestrogen receptor status (P = 0.047). TTP was shorter in tumours with negative oestrogen receptor status (P = 0.037). We could acquire general information about the tumour vascular physiology, interstitial space volume and pathologic prognostic factors by analyzing time-signal intensity curve without a complicated acquisition process for the model-based parameters. (orig.)

  2. Radiogenomic analysis of breast cancer: dynamic contrast enhanced - magnetic resonance imaging based features are associated with molecular subtypes

    Science.gov (United States)

    Wang, Shijian; Fan, Ming; Zhang, Juan; Zheng, Bin; Wang, Xiaojia; Li, Lihua

    2016-03-01

    Breast cancer is one of the most common malignant tumor with upgrading incidence in females. The key to decrease the mortality is early diagnosis and reasonable treatment. Molecular classification could provide better insights into patient-directed therapy and prognosis prediction of breast cancer. It is known that different molecular subtypes have different characteristics in magnetic resonance imaging (MRI) examination. Therefore, we assumed that imaging features can reflect molecular information in breast cancer. In this study, we investigated associations between dynamic contrasts enhanced MRI (DCE-MRI) features and molecular subtypes in breast cancer. Sixty patients with breast cancer were enrolled and the MR images were pre-processed for noise reduction, registration and segmentation. Sixty-five dimensional imaging features including statistical characteristics, morphology, texture and dynamic enhancement in breast lesion and background regions were semiautomatically extracted. The associations between imaging features and molecular subtypes were assessed by using statistical analyses, including univariate logistic regression and multivariate logistic regression. The results of multivariate regression showed that imaging features are significantly associated with molecular subtypes of Luminal A (p=0.00473), HER2-enriched (p=0.00277) and Basal like (p=0.0117), respectively. The results indicated that three molecular subtypes are correlated with DCE-MRI features in breast cancer. Specifically, patients with a higher level of compactness or lower level of skewness in breast lesion are more likely to be Luminal A subtype. Besides, the higher value of the dynamic enhancement at T1 time in normal side reflect higher possibility of HER2-enriched subtype in breast cancer.

  3. Feasibility of dynamic MRI for evaluating velopharyngeal insufficiency in children

    Energy Technology Data Exchange (ETDEWEB)

    Drissi, C. [St Vincent de Paul Hospital, Pediatric Radiology, 82 av Denfert Rochereau, 75674, Paris Cedex 14 (France); Institut National de Neurologie, Radiology Department, Tunis (Tunisia); Mitrofanoff, M.; Talandier, C. [St Vincent de Paul Hospital, Plastic Surgery, Paris Cedex 14 (France); Falip, C. [St Vincent de Paul Hospital, Pediatric Radiology, 82 av Denfert Rochereau, 75674, Paris Cedex 14 (France); Paris Descartes University, Paris Cedex (France); Couls, V. le [Siemens, St Denis (France); Adamsbaum, C. [St Vincent de Paul Hospital, Pediatric Radiology, 82 av Denfert Rochereau, 75674, Paris Cedex 14 (France); Paris Descartes University, Paris Cedex (France); St Vincent de Paul Hospital, AP-HP - Pediatric Imaging, Paris (France)

    2011-07-15

    To demonstrate the feasibility of dynamic MRI with near-real-time temporal resolution for analysing velopharyngeal closure. Eleven children and young adults (seven girls, four boys, mean age: 8.4 years) with suspected velopharyngeal insufficiency (VPI), and one healthy volunteer underwent MRI (1.5 Tesla) using T2 fast imaging sequences. Imaging was done without any sedation at rest and during various phonations in the axial and sagittal planes. Images were analysed by two radiologists, a plastic surgeon and a speech therapist. The MRI examinations were well tolerated by even the youngest patient. A qualitative analysis found that the sagittal dynamic sequences during phonation were in relation to the clinical data in all patients. A quantitative analysis enabled calculation of the elevation angle of the soft palate in relation to the hard palate, the velar eminence angle and the percentage of reduction of the antero-posterior diameter of the pharyngeal lumen. Dynamic MRI is a non-invasive, rapid and repeatable method. It can be considered a complementary tool to endoscopy and fluoroscopy, particularly in children, for assessing VPI without any sedation or radiation exposure. (orig.)

  4. Computer-Aided Evaluation of Breast MRI for the Residual Tumor Extent and Response Monitoring in Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Lyou, Chae Yeon; Cho, Nariya; Moon, Woo Kyung [Seoul National University Hospital and the Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul (Korea, Republic of); Kim, Sun Mi; Jang, Mi Jung [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Park, Jeong Seon [Hanyang University College of Medicine, Hanyang University Hospital, Seoul (Korea, Republic of); Baek, Seung Yon [School of Medicine, Ewha Womans University, Seoul (Korea, Republic of)

    2011-02-15

    To evaluate the accuracy of a computer-aided evaluation program (CAE) of breast MRI for the assessment of residual tumor extent and response monitoring in breast cancer patients receiving neoadjuvant chemotherapy. Fifty-seven patients with breast cancers who underwent neoadjuvant chemotherapy before surgery and dynamic contrast enhanced MRI before and after chemotherapy were included as part of this study. For the assessment of residual tumor extent after completion of chemotherapy, the mean tumor diameters measured by radiologists and CAE were compared to those on histopathology using a paired student t-test. Moreover, the agreement between unidimensional (1D) measurement by radiologist and histopathological size or 1D measurement by CAE and histopathological size was assessed using the Bland-Altman method. For chemotherapy monitoring, we evaluated tumor response through the change in the 1D diameter by a radiologist and CAE and three-dimensional (3D) volumetric change by CAE based on Response Evaluation Criteria in Solid Tumors (RECIST). Agreement between the 1D response by the radiologist versus the 1D response by CAE as well as by the 3D response by CAE were evaluated using weighted kappa (k) statistics. For the assessment of residual tumor extent after chemotherapy, the mean tumor diameter measured by radiologists (2.0 {+-} 1.7 cm) was significantly smaller than the mean histological diameter (2.6 {+-} 2.3 cm) (p = 0.01), whereas, no significant difference was found between the CAE measurements (mean = 2.2 {+-} 2.0 cm) and histological diameter (p = 0.19). The mean difference between the 1D measurement by the radiologist and histopathology was 0.6 cm (95% confidence interval: -3.0, 4.3), whereas the difference between CAE and histopathology was 0.4 cm (95% confidence interval: -3.9, 4.7). For the monitoring of response to chemotherapy, the 1D measurement by the radiologist and CAE showed a fair agreement (k = 0.358), while the 1D measurement by the radiologist

  5. Identifying metastatic breast tumors using textural kinetic features of a contrast based habitat in DCE-MRI

    Science.gov (United States)

    Chaudhury, Baishali; Zhou, Mu; Goldgof, Dmitry B.; Hall, Lawrence O.; Gatenby, Robert A.; Gillies, Robert J.; Drukteinis, Jennifer S.

    2015-03-01

    The ability to identify aggressive tumors from indolent tumors using quantitative analysis on dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) would dramatically change the breast cancer treatment paradigm. With this prognostic information, patients with aggressive tumors that have the ability to spread to distant sites outside of the breast could be selected for more aggressive treatment and surveillance regimens. Conversely, patients with tumors that do not have the propensity to metastasize could be treated less aggressively, avoiding some of the morbidity associated with surgery, radiation and chemotherapy. We propose a computer aided detection framework to determine which breast cancers will metastasize to the loco-regional lymph nodes as well as which tumors will eventually go on to develop distant metastses using quantitative image analysis and radiomics. We defined a new contrast based tumor habitat and analyzed textural kinetic features from this habitat for classification purposes. The proposed tumor habitat, which we call combined-habitat, is derived from the intersection of two individual tumor sub-regions: one that exhibits rapid initial contrast uptake and the other that exhibits rapid delayed contrast washout. Hence the combined-habitat represents the tumor sub-region within which the pixels undergo both rapid initial uptake and rapid delayed washout. We analyzed a dataset of twenty-seven representative two dimensional (2D) images from volumetric DCE-MRI of breast tumors, for classification of tumors with no lymph nodes from tumors with positive number of axillary lymph nodes. For this classification an accuracy of 88.9% was achieved. Twenty of the twenty-seven patients were analyzed for classification of distant metastatic tumors from indolent cancers (tumors with no lymph nodes), for which the accuracy was 84.3%.

  6. The impact of bilateral salpingo-oophorectomy on breast MRI background parenchymal enhancement and fibroglandular tissue

    Energy Technology Data Exchange (ETDEWEB)

    Price, E.R. [University of California, San Francisco, Department of Radiology and Biomedical Imaging, Division of Women' s Imaging, San Francisco, California (United States); Brooks, J.D. [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Watson, E.J.; Brennan, S.B.; Morris, E.A. [Department of Radiology, Breast Imaging Section, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Comen, E.A. [Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

    2014-01-15

    The objective of this study was to evaluate the effect of bilateral salpingo-oophorectomy (BSO) on background parenchymal enhancement (BPE) and the amount of fibroglandular tissue (FGT) seen on breast MRI. Retrospective review identified 21 BRCA mutation carriers who underwent breast MRI before and after elective BSO. After exclusion of patients placed on postoperative hormone replacement therapy, there were 18 eligible patients. Blinded to surgical status, three independent readers used categorical scales to rate BPE (minimal, mild, moderate, marked) and the amount of FGT (fatty, scattered, heterogeneously dense, dense) on pre- and post-BSO MRI examinations. The sign test was used to assess for changes in the categorical ratings of BPE and FGT. Significant proportions of women demonstrated decreases in BPE and in the amount of FGT following oophorectomy (P = 0.004 and 0.02, respectively.) BPE decreases were larger and seen earlier than FGT changes. There was no significant relationship between age/body mass index and changes in BPE and FGT. BPE and the amount of FGT seen on breast MRI are significantly decreased by oophorectomy; BPE decreases to a greater extent and earlier than FGT. (orig.)

  7. Background parenchymal enhancement in breast MRI before and after neoadjuvant chemotherapy: correlation with tumour response

    Energy Technology Data Exchange (ETDEWEB)

    Preibsch, H.; Wanner, L.; Bahrs, S.D.; Wietek, B.M.; Nikolaou, K.; Wiesinger, B. [University Hospital Tuebingen, Diagnostic and Interventional Radiology, Tuebingen (Germany); Siegmann-Luz, K.C. [Diagnostic Center for Breast Cancer and Screening Mammography Brandenburg Ost, Koenigs Wusterhausen (Germany); Oberlecher, E.; Hahn, M. [University Hospital Tuebingen, Department of Gynecology and Obstetrics, Tuebingen (Germany); Staebler, A. [University Hospital Tuebingen, Institute of Pathology and Neuropathology, Tuebingen (Germany)

    2016-06-15

    To correlate the decrease in background parenchymal enhancement (BPE) and tumour response measured with MRI in breast cancer patients treated with neoadjuvant chemotherapy (NAC). One hundred and forty-six MRI examinations of 73 patients with 80 biopsy-proven breast cancers who underwent breast MRI before and after NAC were retrospectively analysed. All images were reviewed by two blinded readers, who classified BPE into categories (BEC; 1 = minimal, 2 = mild, 3 = moderate, 4 = marked) before and after NAC. Histopathological and morphological tumour responses were analysed and compared. The distribution of BEC 1/2/3/4 was 25/46/18/11 % before and 78/20/2/0 % after NAC. On average, BPE decreased by 0.87 BEC. Cohen's kappa showed substantial agreement (k = 0.73-0.77) before and moderate agreement (k = 0.43-0.60) after NAC and moderate agreement (k = 0.62-0.60) concerning the change in BEC. Correlating the change in BPE with tumour response, the average decrease in BEC was 1.3 in cases of complete remission, 0.83 in cases with partial response, 0.85 in cases with stable disease and 0.40 in cases with progressive disease. Correlation analysis showed a significant correlation between the decrease in BEC and tumour response (r = -0.24, p = 0.03). BPE decreased by, on average, 0.87 BEC following NAC for breast cancer. The degree of BPE reduction seemed to correlate with tumour response. (orig.)

  8. Computer-aided detection in breast MRI: a systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Dorrius, Monique D.; Weide, Marijke C.J. der; Ooijen, Peter M.A. van; Pijnappel, Ruud M.; Oudkerk, Matthijs [University Medical Center Groningen, Department of Radiology, Center for Medical Imaging, Hanzeplein 1, PO box 30.001, Groningen (Netherlands)

    2011-08-15

    To evaluate the additional value of computer-aided detection (CAD) in breast MRI by assessing radiologists' accuracy in discriminating benign from malignant breast lesions. A literature search was performed with inclusion of relevant studies using a commercially available CAD system with automatic colour mapping. Two independent researchers assessed the quality of the studies. The accuracy of the radiologists' performance with and without CAD was presented as pooled sensitivity and specificity. Of 587 articles, 10 met the inclusion criteria, all of good methodological quality. Experienced radiologists reached comparable pooled sensitivity and specificity before and after using CAD (sensitivity: without CAD: 89%; 95% CI: 78-94%, with CAD: 89%; 95%CI: 81-94%) (specificity: without CAD: 86%; 95% CI: 79-91%, with CAD: 82%; 95% CI: 76-87%). For residents the pooled sensitivity increased from 72% (95% CI: 62-81%) without CAD to 89% (95% CI: 80-94%) with CAD, however, not significantly. Concerning specificity, the results were similar (without CAD: 79%; 95% CI: 69-86%, with CAD: 78%; 95% CI: 69-84%). CAD in breast MRI has little influence on the sensitivity and specificity of experienced radiologists and therefore their interpretation remains essential. However, residents or inexperienced radiologists seem to benefit from CAD concerning breast MRI evaluation. (orig.)

  9. LHRH-functionalized superparamagnetic iron oxide nanoparticles for breast cancer targeting and contrast enhancement in MRI

    Energy Technology Data Exchange (ETDEWEB)

    Meng, J.; Fan, J. [Princeton Institute of Science and Technology of Materials and the Department of Mechanical and Aerospace Engineering, Princeton University, Princeton, NJ 08544 (United States); Galiana, G. [Department of Chemistry, Princeton University, Princeton, NJ 08544 (United States); Branca, R.T. [Department of Chemistry, Duke University, Durham, NC 27708-0354 (United States); Clasen, P.L.; Ma, S. [Center for Advanced Materials and Nanotechnology, Lehigh University, Bethlehem, PA 18015-3195 (United States); Zhou, J. [Princeton Institute of Science and Technology of Materials and the Department of Mechanical and Aerospace Engineering, Princeton University, Princeton, NJ 08544 (United States); Leuschner, C. [Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808 (United States); Kumar, C.S.S.R.; Hormes, J. [Center for Advanced Microstructures and Devices, Louisiana State University, 6980 Jefferson Hwy, Baton Rouge, LA 70806 (United States); Otiti, T. [Department of Physics, Makerere University, Kampala (Uganda); Beye, A.C. [Department of Physics, Cheikh Anta Diop University, Dakar (Senegal); Harmer, M.P.; Kiely, C.J. [Center for Advanced Materials and Nanotechnology, Lehigh University, Bethlehem, PA 18015-3195 (United States); Warren, W. [Department of Chemistry, Duke University, Durham, NC 27708-0354 (United States); Haataja, M.P. [Princeton Institute of Science and Technology of Materials and the Department of Mechanical and Aerospace Engineering, Princeton University, Princeton, NJ 08544 (United States); Soboyejo, W.O., E-mail: soboyejo@princeton.edu [Princeton Institute of Science and Technology of Materials and the Department of Mechanical and Aerospace Engineering, Princeton University, Princeton, NJ 08544 (United States)

    2009-05-05

    This paper shows that superparamagnetic iron oxide nanoparticles (SPIONs) conjugated to luteinizing hormone releasing hormone (LHRH) (LHRH-SPIONs), can be used to target breast cancer cells. They also act as contrast enhancement agents during the magnetic resonance imaging of breast cancer xenografts. A combination of transmission electron microscopy (TEM) and spectrophotometric analysis was used in our experiments, to investigate the specific accumulation of the functionalized superparamagnetic iron oxide nanoparticles (SPIONs) in cancer cells. The contrast enhancement of conventional T2 images obtained from the tumor tissue and of breast cancer xenograft bearing mice is shown to be much greater than that in saline controls, when the tissues were injected with LHRH-SPIONs. Magnetic anisotropy multi-CRAZED images of tissues extracted from mice injected with SPIONs were also found to have enhanced MRI contrast in breast cancer xenografts and metastases in the lungs.

  10. The MR imaging features of breast nipple diseases%乳腺乳头病变的 MRI 特点

    Institute of Scientific and Technical Information of China (English)

    赵亚娥; 王丽君; 罗冉; 汪登斌

    2015-01-01

    目的:回顾性分析良恶性乳头病变的乳腺 MRI 特点,以提高诊断正确率。方法:搜集2012年9月-2015年9月本院经手术病理证实且术前行 MRI 检查的13例乳头病变患者的病例资料,分析病灶的形态学特征及强化特点。所有病例 MRI 表现由2名从事乳腺影像诊断的放射科医师共同阅片,讨论达成一致诊断意见。结果:13例患者的病理结果分别为:软纤维瘤2例,乳头腺瘤2例,乳腺炎性病变累及乳头3例,乳头派杰病(PD)6例。在 MRI 上,2例乳头软纤维瘤均表现为乳头上小结节,轻度强化。2例乳头腺瘤 MRI 表现为乳头增大伴乳头内强化结节。3例乳头炎性病变中,1例MRI 上表现为乳头内环形强化结节,乳腺内未见异常强化;另外2例 MRI 上表现为乳头轻度或明显异常强化,乳腺内可见异常强化炎性灶。6例乳头 PD 中,乳腺内均有异常强化恶性病灶;其中5例 MRI 上表现为患侧乳头明显不均匀强化,另1例患侧乳头未见异常强化。结论:乳腺乳头病变在 MRI 上多发表现为乳头内强化结节或乳头不均匀强化,结合乳头病变强化特点及乳腺内有无可疑恶性病灶,有助于鉴别诊断。%Objective:The purpose of this study was to evaluate magnetic resonance imaging (MRI)features of benign and malignant nipple diseases in order to improve the diagnostic accuracy.Methods:Thirteen patients with pathologically confirmed nipple diseases in our hospital between September 2012 and September 2015 was retrospectively studied.All the patients underwent MRI examination before operation.Morphological characteristics and dynamic contrast enhancement characteristics of the lesions were reviewed.MRI features of all the lesions were reviewed by two radiologists specialized in breast diseases in consensus.Results:The pathological results of the 13 patients were soft fibroma (n=2),nipple adenoma (n=2),breast

  11. A fast alignment method for breast MRI follow-up studies using automated breast segmentation and current-prior registration

    Science.gov (United States)

    Wang, Lei; Strehlow, Jan; Rühaak, Jan; Weiler, Florian; Diez, Yago; Gubern-Merida, Albert; Diekmann, Susanne; Laue, Hendrik; Hahn, Horst K.

    2015-03-01

    In breast cancer screening for high-risk women, follow-up magnetic resonance images (MRI) are acquired with a time interval ranging from several months up to a few years. Prior MRI studies may provide additional clinical value when examining the current one and thus have the potential to increase sensitivity and specificity of screening. To build a spatial correlation between suspicious findings in both current and prior studies, a reliable alignment method between follow-up studies is desirable. However, long time interval, different scanners and imaging protocols, and varying breast compression can result in a large deformation, which challenges the registration process. In this work, we present a fast and robust spatial alignment framework, which combines automated breast segmentation and current-prior registration techniques in a multi-level fashion. First, fully automatic breast segmentation is applied to extract the breast masks that are used to obtain an initial affine transform. Then, a non-rigid registration algorithm using normalized gradient fields as similarity measure together with curvature regularization is applied. A total of 29 subjects and 58 breast MR images were collected for performance assessment. To evaluate the global registration accuracy, the volume overlap and boundary surface distance metrics are calculated, resulting in an average Dice Similarity Coefficient (DSC) of 0.96 and root mean square distance (RMSD) of 1.64 mm. In addition, to measure local registration accuracy, for each subject a radiologist annotated 10 pairs of markers in the current and prior studies representing corresponding anatomical locations. The average distance error of marker pairs dropped from 67.37 mm to 10.86 mm after applying registration.

  12. MRI of the breast in patients with DCIS to exclude the presence of invasive disease

    Energy Technology Data Exchange (ETDEWEB)

    Deurloo, Eline E. [Academic Medical Center, Department of Radiology, Amsterdam (Netherlands); Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Department of Radiology, Amsterdam (Netherlands); Sriram, Jincey D.; Rutgers, Emiel J.T. [Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Department of Surgery, Amsterdam (Netherlands); Teertstra, Hendrik J.; Loo, Claudette E. [Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Department of Radiology, Amsterdam (Netherlands); Wesseling, Jelle [Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Department of Pathology, Amsterdam (Netherlands); Gilhuijs, Kenneth G.A. [Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Department of Radiology, Amsterdam (Netherlands); University Medical Center Utrecht, Department of Radiology, Image Sciences Institute, Utrecht (Netherlands)

    2012-07-15

    Core biopsy underestimates invasion in more than 20% of patients with preoperatively diagnosed ductal carcinoma in situ (DCIS) without evidence of invasion (pure DCIS). The aim of the current study was to evaluate the efficacy of preoperative magnetic resonance imaging (MRI) to discriminate between patients with DCIS who are at high risk of invasive breast cancer and patients at low risk. One hundred and twenty-five patients, preoperatively diagnosed with pure DCIS (128 lesions; 3 bilateral) by core-needle biopsy, were prospectively included. Clinical, mammographic, histological (core biopsy) and MRI features were assessed. All patients underwent breast surgery. Analyses were performed to identify features associated with presence of invasion. Eighteen lesions (14.1%) showed invasion on final histology. Seventy-three lesions (57%) showed suspicious enhancement on MRI with a type 1 (n = 12, 16.4%), type 2 (n = 19, 26.0%) or type 3 curve, respectively (n = 42, 57.5%). At multivariate analysis, the most predictive features for excluding presence of invasive disease were absence of enhancement or a type 1 curve on MRI (negative predictive value 98.5%; A{sub Z} 0.80, P = 0.00006). Contrast medium uptake kinetics at MRI provide high negative predictive value to exclude presence of invasion and may be useful in primary surgical planning in patients with a preoperative diagnosis of pure DCIS. (orig.)

  13. Bevacizumab Inhibits Breast Cancer-Induced Osteolysis, Surrounding Soft Tissue Metastasis, and Angiogenesis in Rats as Visualized by VCT and MRI

    Directory of Open Access Journals (Sweden)

    Tobias Bäuerle

    2008-05-01

    Full Text Available The aim of this study was to evaluate the effect of an antiangiogenic treatment with the vascular endothelial growth factor antibody bevacizumab in an experimental model of breast cancer bone metastasis and to monitor osteolysis, soft tissue tumor, and angiogenesis in bone metastasis noninvasively by volumetric computed tomography (VCT and magnetic resonance imaging (MRI. After inoculation of MDA-MB-231 human breast cancer cells into nude rats, bone metastasis was monitored with contrast-enhanced VCT and MRI from day 30 to day 70 after tumor cell inoculation, respectively. Thereby, animals of the treatment group (10 mg/kg bevacizumab IV weekly, n = 15 were compared with sham-treated animals (n = 17. Treatment with bevacizumab resulted in a significant difference versus control in osteolytic as well as soft tissue lesion sizes (days 50 to 70 and 40 to 70 after tumor cell inoculation, respectively; P < .05. This observation was paralleled with significantly reduced vascularization in the treatment group as shown by reduced increase in relative signal intensity in dynamic contrast-enhanced MRI from days 40 to 70 (P < .05. Contrast-enhanced VCT and histology confirmed decreased angiogenesis as well as new bone formation after application of bevacizumab. In conclusion, bevacizumab significantly inhibited osteolysis, surrounding soft tissue tumor growth, and angiogenesis in an experimental model of breast cancer bone metastasis as visualized by VCT and MRI.

  14. Breast Lesions: Correlation of Dynamic Contrast Enhancement Patterns on MR images with Tumor Angiogenesis

    Institute of Scientific and Technical Information of China (English)

    PeifangLiu; RunxianBao; YunNiu; YongYu

    2004-01-01

    OBJECTIVE To determine whether dynamic contrast-enhanced MRI features of the early -phase enhancement rate, enhancement amplitude, and signal-intensity (SI) time course are associated with the microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression of malignant and benign breast lesions. METHODS Sixty patients with breast lesions, detected with physical examination or conventional mammography, were examined pre-operatively with dynamic contrast-enhanced MRI from December 1998 to June 2000. Of these 60 patients, histopathological correlation was available in 38. These 38 patients(aged 29-73 years) formed the basis of this study. SI changes during dynamic scanning were assessed quantitatively. Early-phase enhancement rate and enhancement amplitude were calculated. Time-Sl curves of the lesions were obtained and classified according to their shapes as type I (which was steady enhancement to the end of the dynamic data acquisition at 7.5rain.), type Ⅱ (plateau of SI after avid initial contrast enhancement), or type Ⅲ (washout of SI after avid initial contrast enhancement). The mean MVD and VEGF expression of the lesions were measured with immunohistochemical staining methods in all the pathologic specimens by a pathologist without knowledge of the results of the MR examination. Care was taken to ensure identical location in the plane of the MR image and pathologic specimens. The relationships among dynamic contrast-enhanced MRI features, MVD, and VEGF expression of benign and malignant breast lesions were analyzed. RESULTS Histology revealed 21 malignancies and 17 benign lesions. The mean MVD and VEGF expression for the 21 malignant lesions were significantly higher than the mean MVD and VEGF expression for the 17 benign lesions (P60%) MR early-phase enhancement rate and time-SI curve type Ⅱ or Ⅲ showed a significant association with MVD and VEGF expression. All the differences mentioned above showed statistical significance (P 0

  15. Evaluation of kinetic entropy of breast masses initially found on MRI using whole-lesion curve distribution data: Comparison with the standard kinetic analysis

    Energy Technology Data Exchange (ETDEWEB)

    Shimauchi, Akiko [University of Chicago, Department of Radiology, Chicago, IL (United States); Tohoku University, Department of Diagnostic Radiology, Graduate School of Medicine, Sendai, Miyagi (Japan); Abe, Hiroyuki; Schacht, David V.; Yulei, Jian; Pineda, Federico D.; Jansen, Sanaz A.; Ganesh, Rajiv; Newstead, Gillian M. [University of Chicago, Department of Radiology, Chicago, IL (United States)

    2015-08-15

    To quantify kinetic heterogeneity of breast masses that were initially detected with dynamic contrast-enhanced MRI, using whole-lesion kinetic distribution data obtained from computer-aided evaluation (CAE), and to compare that with standard kinetic curve analysis. Clinical MR images from 2006 to 2011 with breast masses initially detected with MRI were evaluated with CAE. The relative frequencies of six kinetic patterns (medium-persistent, medium-plateau, medium-washout, rapid-persistent, rapid-plateau, rapid-washout) within the entire lesion were used to calculate kinetic entropy (KE), a quantitative measure of enhancement pattern heterogeneity. Initial uptake (IU) and signal enhancement ratio (SER) were obtained from the most-suspicious kinetic curve. Mann-Whitney U test and ROC analysis were conducted for differentiation of malignant and benign masses. Forty benign and 37 malignant masses comprised the case set. IU and SER were not significantly different between malignant and benign masses, whereas KE was significantly greater for malignant than benign masses (p = 0.748, p = 0.083, and p < 0.0001, respectively). Areas under ROC curve for IU, SER, and KE were 0.479, 0.615, and 0.662, respectively. Quantification of kinetic heterogeneity of whole-lesion time-curve data with KE has the potential to improve differentiation of malignant from benign breast masses on breast MRI. (orig.)

  16. Epithelioid Myofibroblastoma in an Old-Male Breast: A Case Report with MRI Findings

    Directory of Open Access Journals (Sweden)

    Seyma Yildiz

    2015-01-01

    Full Text Available Myofibroblastoma of the breast (MFB is a very rare benign stromal tumor. In recent years, increase in mammographic screenings has resulted in increased diagnosis of MFB. Most cases are old males and postmenopausal women. MFB may be confused as malignant, clinically, morphologically, or by imaging. Immunohistochemistry is essential for final diagnosis in these cases. We report a case of a pathologically diagnosed MFB in an 80-year-old male patient who had coexisting prostate cancer and describe its imaging characteristics, especially magnetic resonance imaging (MRI. In this paper, histopathological and MRI findings of the MFB were discussed.

  17. 乳腺癌的MRI临床诊断研究%MRI diagnosis of breast cancer

    Institute of Scientific and Technical Information of China (English)

    陈俐君; 杨晓萍

    2015-01-01

    乳腺癌是妇女最常见的恶性肿瘤之一。早期、准确地诊断乳腺疾病的病变性质,评估疗效对治疗和预后有重要意义。磁共振成像在乳腺病变的诊断方面具有明显的优势,是乳腺影像学检查的重要手段。介绍了磁共振成像(magnetic resonance imaging,MRI)的各种检查方式在诊断乳腺癌方面的应用,尤其在高危人群中的应用,分析了MRI应用的局限性,论述了MRI在乳腺癌分期、术前检查、放化疗疗效评估以及乳腺癌肿瘤标记物与影像学表现之间关系等方面的研究进展。%Breast cancer is one of the most common malignant tumor for women, and early and accurate diagnosis of the breast diseases may improve the therapy and prognosis. MRI gains advantages in the diagnosis of the breast diseases, and thus is an important tool for the imaging diagnosis of the breast. The examination modes of MRI were introduced for the diagnosis of the breast cancer, especially the application in high risk population. The limit and research progress of MRI were analyzed for breast cancer staging, pre-operative examination, therapeutic effect assessment for radiotherapy and chemotherapy, the relationship between the markers and imaging findings.

  18. Q uantitative dynamic oc nt rats enhanced MRI in th e response prediction of breast cancer patients undergoing neoadjuvant chemo-therapy%MRI动态增强定量分析早期预测乳腺癌患者NAC疗效的可行性

    Institute of Scientific and Technical Information of China (English)

    姜金杰; 席芊

    2014-01-01

    Objective To investigate whether quantitative dynamic contrast enhanced MRI could predict final pathologic response in primary breast cancer patients undergoing neoadjuvant chemotherapy ( NAC) .Methods Fifty five female patients who were pathologically proved infiltrating ductal carcinoma with core needle puncture biopsy were examined by DCE -MRI before NAC and after four to six cycles of treatment.Patients were divided into two groups by the results of the pathological presence of cancer invasion :the group of pathological com-plete response ( after chemotherapy cancer with no invasion ) and incomplete response ( after chemotherapy cancer with invasion ) .Two groups of patients with extracellular blood vessels outside the clearance volume ratio ( Ve) ,transfer constant capacity ( volume transfer constant , Ktrans) ,rate constant (rate constant, Kep) and the changes in values of the three parameters were compared before and after chemothera -py.The sensitivity, specificity, positive predictive value , negative predictive value of DCE -MRI after chemotherapy in patients with breast cancer were analyzed .Results The DCE-MRI parameters before chemotherapy of patients between two groups had no significant difference (P>0.05).After four cycles of treatment, the changes of Ktrans, Kep in complete response group were greater than those in imcomplete re-sponse group〔(1.60±0.25) vs (1.80±0.20)/min;(3.01±0.96) vs (2.87±0.88)/min〕, but the changes of vein pathological complete response group was less than that in pathological imcomplete response group〔(0.62±0.14) vs( 0.67±0.10)/min〕.The difference was sta-tistically significant between the two groups (P<0.05).The sensitivity, specificity, positive predictive value, negative predictive value of DCE-MRI after chemotherapy in patients with breast cancer were 60.0%,85.7%,70.6%,78.9%respectively.Conclusions Quantitative dynamic contrast enhanced MRI predicting final pathologic response in primary breast cancer

  19. Longitudinal MRI evaluation of intracranial development and vascular characteristics of breast cancer brain metastases in a mouse model.

    Directory of Open Access Journals (Sweden)

    Heling Zhou

    Full Text Available Longitudinal MRI was applied to monitor intracranial initiation and development of brain metastases and assess tumor vascular volume and permeability in a mouse model of breast cancer brain metastases. Using a 9.4T system, high resolution anatomic MRI and dynamic susceptibility contrast (DSC perfusion MRI were acquired at different time points after an intracardiac injection of brain-tropic breast cancer MDA-MB231BR-EGFP cells. Three weeks post injection, multifocal brain metastases were first observed with hyperintensity on T2-weighted images, but isointensity on T1-weighted post contrast images, indicating that blood-tumor-barrier (BTB at early stage of brain metastases was impermeable. Follow-up MRI revealed intracranial tumor growth and increased number of metastases that distributed throughout the whole brain. At the last scan on week 5, T1-weighted post contrast images detected BTB disruption in 160 (34% of a total of 464 brain metastases. Enhancement in some of the metastases was only seen in partial regions of the tumor, suggesting intratumoral heterogeneity of BTB disruption. DSC MRI measurements of relative cerebral blood volume (rCBV showed that rCBV of brain metastases was significantly lower (mean= 0.89±0.03 than that of contralateral normal brain (mean= 1.00±0.03; p<0.005. Intriguingly, longitudinal measurements revealed that rCBV of individual metastases at early stage was similar to, but became significantly lower than that of contralateral normal brain with tumor growth (p<0.05. The rCBV data were concordant with histological analysis of microvascular density (MVD. Moreover, comprehensive analysis suggested no significant correlation among tumor size, rCBV and BTB permeability. In conclusion, longitudinal MRI provides non-invasive in vivo assessments of spatial and temporal development of brain metastases and their vascular volume and permeability. The characteristic rCBV of brain metastases may have a diagnostic value.

  20. Contrast-enhanced spectral mammography versus MRI: Initial results in the detection of breast cancer and assessment of tumour size

    Energy Technology Data Exchange (ETDEWEB)

    Fallenberg, E.M.; Renz, D.M. [Charite - Universitaetsmedizin Berlin, Clinic of Radiology, Berlin (Germany); Dromain, C. [Institut Gustave Roussy, Department of Radiology, Villejuif cedex (France); Diekmann, F. [St. Joseph-Stift Bremen, Department of Medical Imaging, Bremen (Germany); Engelken, F.; Krohn, M.; Singh, J.M.; Bick, U. [Charite - Universitaetsmedizin Berlin, Department of Radiology, Berlin (Germany); Ingold-Heppner, B. [Charite - Universitaetsmedizin Berlin, Institute of Pathology, Berlin (Germany); Winzer, K.J. [Charite - Universitaetsmedizin Berlin, Breast Center, Department of Gynecology, Berlin (Germany)

    2014-01-15

    To compare mammography (MG), contrast-enhanced spectral mammography (CESM), and magnetic resonance imaging (MRI) in the detection and size estimation of histologically proven breast cancers using postoperative histology as the gold standard. After ethical approval, 80 women with newly diagnosed breast cancer underwent MG, CESM, and MRI examinations. CESM was reviewed by an independent experienced radiologist, and the maximum dimension of suspicious lesions was measured. For MG and MRI, routine clinical reports of breast specialists, with judgment based on the BI-RADS lexicon, were used. Results of each imaging technique were correlated to define the index cancer. Fifty-nine cases could be compared to postoperative histology for size estimation. Breast cancer was visible in 66/80 MG, 80/80 CESM, and 77/79 MRI examinations. Average lesion largest dimension was 27.31 mm (SD 22.18) in MG, 31.62 mm (SD 24.41) in CESM, and 27.72 mm (SD 21.51) in MRI versus 32.51 mm (SD 29.03) in postoperative histology. No significant difference was found between lesion size measurement on MRI and CESM compared with histopathology. Our initial results show a better sensitivity of CESM and MRI in breast cancer detection than MG and a good correlation with postoperative histology in size assessment. (orig.)

  1. Background parenchymal enhancement on baseline screening breast MRI: impact on biopsy rate and short-interval follow-up.

    LENUS (Irish Health Repository)

    Hambly, Niamh M

    2011-01-01

    Background parenchymal enhancement on breast MRI refers to normal enhancement of the patient\\'s fibroglandular tissue. The aim of this study was to determine the effect of background parenchymal enhancement on short-interval follow-up, biopsy, and cancer detection rate on baseline screening MRI in a high-risk group.

  2. Interventional MRI of the breast: minimally invasive therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hall-Craggs, M.A. [MR Unit, Middlesex Hospital, London (United Kingdom)

    2000-01-01

    In recent years a variety of minimally invasive therapies have been applied to the treatment of breast lesions. These therapies include thermal treatments (interstitial laser coagulation, focused ultrasound, radiofrequency and cryotherapy), percutaneous excision, and interstitial radiotherapy. Magnetic resonance has been used in these treatments to visualize lesions before, during and after therapy and to guide interventions. ''Temperature-sensitive'' sequences have shown changes with thermal ablation which broadly correlate with areas of tumour necrosis. Consequently, MR has the potential to monitor treatment at the time of therapy. To date, experience in the treatment of breast cancer has been restricted to small studies. Large controlled studies are required to validate the efficacy and safety of these therapies in malignant disease. (orig.)

  3. [Non-masslike enhancement on breast MRI: interpretation pearls].

    Science.gov (United States)

    Thomassin-Naggara, I; Salem, C; Darai, E; Bazot, M; Uzan, S; Marsault, C; Chopier, J

    2009-03-01

    The MR Breast Imaging Reporting and Data System (BI-RADS) lexicon of the American College of Radiology (ACR) includes a new lesion category defined as non-masslike enhancement. The purpose of this paper is to review the definition of this new entity, illustrate the main imaging features described in the BI-RADS lexicon and to propose a diagnostic approach based on data from the literature in order to achieve diagnosis and optimal patient management.

  4. A new background distribution-based active contour model for three-dimensional lesion segmentation in breast DCE-MRI

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Hui; Liu, Yiping; Qiu, Tianshuang [Department of Biomedical Engineering, Dalian University of Technology, Dalian 116024 (China); Zhao, Zuowei, E-mail: liuhui@dlut.edu.cn [Second Affiliated Hospital, Dalian Medical University, Dalian 116027 (China); Zhang, Lina [Department of Radiology, First Affiliated Hospital, Dalian Medical University, Dalian 116027 (China)

    2014-08-15

    Purpose: To develop and evaluate a computerized semiautomatic segmentation method for accurate extraction of three-dimensional lesions from dynamic contrast-enhanced magnetic resonance images (DCE-MRIs) of the breast. Methods: The authors propose a new background distribution-based active contour model using level set (BDACMLS) to segment lesions in breast DCE-MRIs. The method starts with manual selection of a region of interest (ROI) that contains the entire lesion in a single slice where the lesion is enhanced. Then the lesion volume from the volume data of interest, which is captured automatically, is separated. The core idea of BDACMLS is a new signed pressure function which is based solely on the intensity distribution combined with pathophysiological basis. To compare the algorithm results, two experienced radiologists delineated all lesions jointly to obtain the ground truth. In addition, results generated by other different methods based on level set (LS) are also compared with the authors’ method. Finally, the performance of the proposed method is evaluated by several region-based metrics such as the overlap ratio. Results: Forty-two studies with 46 lesions that contain 29 benign and 17 malignant lesions are evaluated. The dataset includes various typical pathologies of the breast such as invasive ductal carcinoma, ductal carcinomain situ, scar carcinoma, phyllodes tumor, breast cysts, fibroadenoma, etc. The overlap ratio for BDACMLS with respect to manual segmentation is 79.55% ± 12.60% (mean ± s.d.). Conclusions: A new active contour model method has been developed and shown to successfully segment breast DCE-MRI three-dimensional lesions. The results from this model correspond more closely to manual segmentation, solve the weak-edge-passed problem, and improve the robustness in segmenting different lesions.

  5. Dynamic contrast enhanced MRI and diffusion weighted imaging features of granulomatous mastitis: compared with breast cancer%肉芽肿性乳腺炎的动态增强MRI和扩散加权成像表现及其与乳腺癌的鉴别

    Institute of Scientific and Technical Information of China (English)

    周长玉; 许茂盛; 喻迎星; 刘玉凤; 丁雪委; 葛敏

    2014-01-01

    Objective To investigate the radiological features of granulomatous mastitis (GM) in dynamic contrast enhanced MRI (DCE-MRI) and DWI and to differentiate it from the breast cancer in diagnose.Methods Forty five cases of GM and 64 cases of breast cancer confirmed by surgical histopathology or biopsy were retrospectively analyzed in the study.All of the patients were examined preoperatively by DCE-MRI and DWI.Including lesion type,location,enhancement pattern,nipple retraction,supplying arteries,skin thickening and axillary adenopathy in the two groups were evaluated and analyzed by using x2 test.One-way ANOVA was employed to compare the ADC values between the abscess area of GM and non-abscess area,and the difference among the breast cancer lesion area.Dynamic enhancement MR pharmacokinetic parameters were used to measure including early-phase enhancement rate (EER),peak enhancement ratio(Emax),and time to peak ehhancement(Tmax).The statistical differences of EER,Emax and Tmax between the two groups were calculated by using Wilcoxon test.Results In 45 cases of GM,DCE MR images showed nonmass-like lesions (43 patients) and mass-like lesions (2 patients); the nipple involved(16 patients) and segment involved (29 patients);rim-like with heterogeneous enhancement (40 patients) and heterogeneous enhancement (5 patients); nipple retraction (24 patients) supplying arteries dilatation (42 patients),skin thickening (29 patients),and axillary adenopathy (17 patients).Corresponding to the radiological features above,in the 64 breast cancer cases,it showed 54,10,5,59,30,34,16,51,12 and 20,respectively.There were statistical significance between GM and breast cancer in lesion type,location,enhancement pattern,and nipple retraction (x2=67.574,13.075,20.297,20.398 and 23.510,respectively,all P<0.01).But no differences were existed between 2 groups in supplying arteries and axillary adenopathy(x2=3.928 and 0.502,P>0.05).EER,Emax and Tmaxin GM were 146.58%,191.13%,195.00 s

  6. Motion correction of dynamic contrast enhanced MRI of the liver

    Science.gov (United States)

    Jansen, Mariëlle J. A.; Veldhuis, Wouter B.; van Leeuwen, Maarten S.; Pluim, Josien P. W.

    2017-02-01

    Motion correction of dynamic contrast enhanced magnetic resonance images (DCE-MRI) is a challenging task, due to changes in image appearance. In this study a groupwise registration, using a principle component analysis (PCA) based metric, is evaluated for clinical DCE MRI of the liver. The groupwise registration transforms the images to a common space, rather than to a reference volume as conventional pairwise methods do, and computes the similarity metric on all volumes simultaneously. This groupwise registration method is compared to a pairwise approach using a mutual information metric. Clinical DCE MRI of the abdomen of eight patients were included. Per patient one lesion in the liver was manually segmented in all temporal images (N=16). The registered images were compared for accuracy, spatial and temporal smoothness after transformation, and lesion volume change. Compared to a pairwise method or no registration, groupwise registration provided better alignment. In our recently started clinical study groupwise registered clinical DCE MRI of the abdomen of nine patients were scored by three radiologists. Groupwise registration increased the assessed quality of alignment. The gain in reading time for the radiologist was estimated to vary from no difference to almost a minute. A slight increase in reader confidence was also observed. Registration had no added value for images with little motion. In conclusion, the groupwise registration of DCE MR images results in better alignment than achieved by pairwise registration, which is beneficial for clinical assessment.

  7. MRI-guided breast biopsy at 3T using a dedicated large core biopsy set: Feasibility and initial results

    Energy Technology Data Exchange (ETDEWEB)

    Meeuwis, Carla, E-mail: cmeeuwis@alysis.nl [Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein-Zuid 10, 6525GA Nijmegen (Netherlands); Department of Radiology, Rijnstate Hospital, Alysis Zorggroep, Wagnerlaan 55, 6815 AD Arnhem (Netherlands); Mann, Ritse M., E-mail: r.mann@rad.umcn.nl [Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein-Zuid 10, 6525GA Nijmegen (Netherlands); Mus, Roel D.M., E-mail: r.mus@rad.umcn.nl [Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein-Zuid 10, 6525GA Nijmegen (Netherlands); Winkel, Axel, E-mail: awinkel@invivocorp.de [Interventional Instruments, INVIVO Germany GMBH, Schwerin (Germany); Boetes, Carla, E-mail: c.boetes@mumc.nl [Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein-Zuid 10, 6525GA Nijmegen (Netherlands); Department of Radiology, Maastricht University Medical Center (Netherlands); Barentsz, Jelle O., E-mail: j.barentsz@rad.umcn.nl [Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein-Zuid 10, 6525GA Nijmegen (Netherlands); Veltman, Jeroen, E-mail: veltman@rad.umcn.nl [Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein-Zuid 10, 6525GA Nijmegen (Netherlands)

    2011-08-15

    Objective: The increasing importance of breast MRI in the diagnostic processes concerning breast cancer yield often lesions that are visible on MRI only. To assess the nature of these lesions, pathologic analysis is necessary. Therefore, MR-guided biopsy should be available. Breast MRI at 3T has shown advantage over 1.5T. Unfortunately, current equipment for MR-guided biopsy is better suited for intervention at 1.5T due to the danger of heating titanium co-axial sleeves and large susceptibility artifacts. We evaluated a dedicated 3T breast biopsy set that uses plastic coaxial needles to overcome these problems. Materials and methods: We performed MRI-guided breast biopsy in 23 women with 24 MRI-only visible breast lesions at 3T. Biopsy procedures were performed with plastic coaxial needles in a closed bore 3T clinical MR system on a dedicated phased array breast coil with a commercially available add-on stereotactic biopsy device. Results: Width of the needle artifact was 2 mm in all 24 cases. Biopsy procedure was completed between 35 and 67 min. The procedure was judged moderately easy in 12 and normal in 10 cases. One procedure was judged difficult and there was one technical failure. Conclusion: MRI-guided breast biopsy at 3T is a fast and accurate procedure. The plastic coaxial needles reduce the susceptibility artifact largely and do not increase the difficulty of the procedure. The diagnostic yield is at least equal to the diagnostic yield of the same procedure at 1.5T. Therefore, this technique can be safely used for lesions only visible at 3T MRI.

  8. Infimal convolution of total generalized variation functionals for dynamic MRI.

    Science.gov (United States)

    Schloegl, Matthias; Holler, Martin; Schwarzl, Andreas; Bredies, Kristian; Stollberger, Rudolf

    2017-07-01

    To accelerate dynamic MR applications using infimal convolution of total generalized variation functionals (ICTGV) as spatio-temporal regularization for image reconstruction. ICTGV comprises a new image prior tailored to dynamic data that achieves regularization via optimal local balancing between spatial and temporal regularity. Here it is applied for the first time to the reconstruction of dynamic MRI data. CINE and perfusion scans were investigated to study the influence of time dependent morphology and temporal contrast changes. ICTGV regularized reconstruction from subsampled MR data is formulated as a convex optimization problem. Global solutions are obtained by employing a duality based non-smooth optimization algorithm. The reconstruction error remains on a low level with acceleration factors up to 16 for both CINE and dynamic contrast-enhanced MRI data. The GPU implementation of the algorithm suites clinical demands by reducing reconstruction times of one dataset to less than 4 min. ICTGV based dynamic magnetic resonance imaging reconstruction allows for vast undersampling and therefore enables for very high spatial and temporal resolutions, spatial coverage and reduced scan time. With the proposed distinction of model and regularization parameters it offers a new and robust method of flexible decomposition into components with different degrees of temporal regularity. Magn Reson Med 78:142-155, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

  9. MRI-guided vacuum-assisted breast biopsy: comparison with stereotactically guided and ultrasound-guided techniques.

    Science.gov (United States)

    Imschweiler, Thomas; Haueisen, Harald; Kampmann, Gert; Rageth, Luzi; Seifert, Burkhardt; Rageth, Christoph; Freiwald, Bianka; Kubik-Huch, Rahel A

    2014-01-01

    To analyse the development of MRI-guided vacuum-assisted biopsy (VAB) in Switzerland and to compare the procedure with stereotactically guided and ultrasound-guided VAB. We performed a retrospective analysis of VABs between 2009 and 2011. A total of 9,113 VABs were performed. Of these, 557 were MRI guided. MRI-guided VAB showed the highest growth rate (97 %) of all three procedures. The technical success rates for MRI-guided, stereotactically guided and ultrasound-guided VAB were 98.4 % (548/557), 99.1 % (5,904/5,960) and 99.6 % (2,585/2,596), respectively. There were no significant differences (P = 0.12) between the MRI-guided and the stereotactically guided procedures. The technical success rate for ultrasound-guided VAB was significantly higher than that for MRI-guided VAB (P VAB requiring open surgery. The malignancy diagnosis rate for MRI-guided VAB was similar to that for stereotactically guided VAB (P = 0.35). MRI-guided VAB is a safe and accurate procedure that provides insight into clinical breast findings. • Three vacuum-assisted breast biopsy (VAB) procedures were compared. • Technical success rates were high for all three VAB procedures. • Medical complications were relatively low using all three VAB procedures. • The use of MRI-guided vacuum-assisted breast biopsy is growing.

  10. Systematic optimization of MRI guided near infrared diffuse optical spectroscopy in breast

    Science.gov (United States)

    Zhao, Yan; Mastanduno, Michael A.; Jiang, Shudong; El-Ghussein, Fadi; Xu, Junqing; Gui, Jiang; Pogue, Brian W.; Paulsen, Keith D.

    2015-03-01

    A hybrid frequency domain (FD)-continuous wave (CW) MRI/NIRS system was validated in a clinical trial involving patients with at least ACR 4 radiologic findings in Xi'an, China. In this study, MRI guided nonlinear iterative reconstruction of near-infrared spectroscopy (NIRS) images with limited phase data is investigated. In addition, a systematic optimization of the system hardware design has been conducted as well. We are able to get less than 3% variation in tumor contrast to the surrounding normal tissue, by reducing the number of FD detectors from 16 to 6, showing the potential of reducing the FD detectors. Furthermore, a lookup table of the scattering properties has been made by averaging four MRI-identified breast density groups. By using this look-up table for the patient with the noisy phase data, similar AUCs and p-values are achieved for differentiating the malignant from benign patients.

  11. The differential diagnosis of breast cancer and breast fibroadenoma by DCE-MRI%乳腺癌和乳腺纤维腺瘤的DCE-MRI鉴别诊断(附49例分析)

    Institute of Scientific and Technical Information of China (English)

    李卫新; 詹浩辉; 程敬亮

    2011-01-01

    Objective To evaluate dynamic enhanced MRI (DCE-MRI) findings their differential diagnostic value between the breast carcinoma and breast fibroadenoma.Methods DCE-MRI images and contrast enhancement characteristics of 49 cases verified by histopathology were reviewed.30 patients were breast cancer and the rest were breast fibroadenoma.The morphology of lesion, the time signal intensity curve (TIC), the early enhancement ratio were analyzed respectively.Results 26 cases of breast cancer showed irregular shape or speculated margin, rough boundaries and heterogeneous enhancement or rim enhancement.Type Ⅲ and (n)TIC curves were observed in breast cancer.17 cases of breast fibroadenoma showed smooth and tidy borders.Most cases showed homogeneous enhancement or no enhancement and type land type IV TIC were observed.Morphological characteristics and the TIC types of enhancement between the breast carcinoma and breast fibroadenoma had statistical significance.Conclusions The morphology, TIC type and early enhancement rate showed in DCE-MRI were helpful in the differential diagnosis of breast carcinoma and breast fibroadenoma.%目的 探讨动态增强MRI(dynamic enhanced MRI,DCE-MRI)对乳腺癌和乳腺纤维腺瘤的鉴别诊断价值.方法 选择经病理证实的乳腺癌患者30例,乳腺纤维腺瘤患者19例,对 DCE-MRI检查资料进行回顾性分析,分析内容:病灶形态学及时间信号强度曲线(time signal intensity curve,TIC),早期强化率.结果 30例乳腺癌中,形态不规则、有毛刺、边界模糊毛糙26例,强化方式多为不均匀或环形强化,TIC曲线多为Ⅲ型和Ⅱ型.乳腺纤维腺瘤19例中,形态多呈类圆形或分叶状,边界光整,17例.强化方式多为均匀强化或无明显强化,TIC多为Ⅰ型和Ⅳ型.乳腺癌和纤维腺瘤在形态学特征、强化方式及TIC类型上差异有统计学意义.结论 DCE-MRI依据病灶的形态特征、强化方式、早期增强率及TIC类型可以很好地鉴别乳腺癌和纤维腺瘤.

  12. Whole-body MRI, dynamic contrast-enhanced MRI, and diffusion-weighted imaging for the staging of multiple myeloma

    Energy Technology Data Exchange (ETDEWEB)

    Dutoit, Julie C.; Verstraete, Koenraad L. [Ghent University Hospital, Department of Radiology, Ghent (Belgium)

    2017-06-15

    Magnetic resonance imaging (MRI) is the most sensitive imaging technique for the detection of bone marrow infiltration, and has therefore recently been included in the new diagnostic myeloma criteria, as proposed by the International Myeloma Working Group. Nevertheless, conventional MRI only provides anatomical information and is therefore only of limited use in the response assessment of patients with multiple myeloma. The additional information from functional MRI techniques, such as diffusion-weighted imaging and dynamic contrast-enhanced MRI, can improve the detection rate of bone marrow infiltration and the assessment of response. This can further enhance the sensitivity and specificity of MRI in the staging of multiple myeloma patients. This article provides an overview of the technical aspects of conventional and functional MRI techniques with practical recommendations. It reviews the diagnostic performance, prognostic value, and role in therapy assessment in multiple myeloma and its precursor stages. (orig.)

  13. Application analysis of breast magnetic resonance imaging in occult breast cancer and breast-conserving surgery%乳腺 MRI 在隐匿性乳腺癌和保乳手术中的应用分析

    Institute of Scientific and Technical Information of China (English)

    王芹; 马行天; 石岚

    2014-01-01

    Objective: To discuss application values of breast magnetic resonance imaging (MRI) in occult breast cancer and breast-conserving surgery. Methods: Breast MRI was performed in 120 grouped patients. The examination results were analyzed and summarized. Results: In the 58 cases of occult breast cancer patients with breast MRI, 32 cases were found with breast lesions, in which 19 cases were confirmed by pathology as the original site; the diagnosis rate was 32. 7% . In the 62 cases of breast cancer being performed breast-conserving surgery with breast MRI, multiple lesions was found in 25 cases, in which 23 cases gave up breast-con-serving surgery. Conclusions: Breast MRI has a higher resolution in finding the primary lesion of occult breast cancer, and has impor-tant value in the display of breast cancers with multicentric lesions and the indication of breast-conserving surgery.%目的::探讨乳腺核磁共振成像(MRI)在隐匿性乳腺癌和保乳手术中的应用价值。方法:对120例隐匿性乳腺癌及早期患者进行 MRI 检查,对检查结果进行分析和归纳。结果:入组的58例隐匿性乳腺癌患者 MRI 检查,发现乳腺病灶32例,其中19例经病理证实为原发灶,确诊率为32.7%;入组的62例拟行保乳手术的乳腺癌患者 MRI 检查,有25例发现多中心病灶,其中23例放弃保乳手术。结论:MRI 检查对检出隐匿性乳腺癌原发灶有着有较高的分辨率,对多中心乳腺癌的显示以及明确乳腺癌的保乳适应症,有着重要的临床价值。

  14. Metastasis of Breast Carcinoma to Intercostal Muscle Detected by Breast MRI: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Kyung Eun; Son, Eun Ju; Kim, Jeong Ah; Youk, Ji Hyun; Kim, Eun Kyung; Kwak, Jin Young; Jeong, Joon [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2010-08-15

    Breast cancer can metastasize to any organ; however, distant metastases are unusual at the time of diagnosis. Furthermore metastasis to skeletal muscle is an uncommon manifestation of malignancy. We report a case of a 45-year-old woman diagnosed with cancer of the left breast with metastases to the ipsilateral intercostal muscle. To the best of our knowledge this is the first report of intercostal muscle metastasis from breast cancer in the English literature

  15. Accuracy of 3 T versus 1.5 T breast MRI for pre-operative assessment of extent of disease in newly diagnosed DCIS

    Energy Technology Data Exchange (ETDEWEB)

    Rahbar, Habib, E-mail: hrahbar@uw.edu; DeMartini, Wendy B.; Lee, Amie Y.; Partridge, Savannah C.; Peacock, Sue; Lehman, Constance D.

    2015-04-15

    Highlights: •We compared sizes of known ductal carcinoma in situ (DCIS) on pre-operative breast MRI at 3 T and 1.5 T with final pathology sizes. •DCIS sizes on 3 T MRI correlated better with pathologic sizes than 1.5 T MRI. •Imaging features of DCIS, including morphology and kinetics, were similar at 3 T and 1.5 T MRI. -- Abstract: Objectives: While 3 T breast magnetic resonance imaging has increased in use over the past decade, there is little data comparing its use for assessing ductal carcinoma in situ (DCIS) versus 1.5 T. We sought to compare the accuracies of DCIS extent of disease measures on pre-operative 3 T versus 1.5 T MRI. Methods: This institutional review board-approved prospective study included 20 patients with ductal carcinoma in situ diagnosed by core needle biopsy (CNB) who underwent pre-operative breast MRI at both 3 T (resolution = 0.5 mm × 0.5 mm × 1.3 mm) and 1.5 T (0.85 mm × 0.85 mm × 1.6 mm). All patients provided informed consent, and the study was HIPPA compliant. Lesion sizes and imaging characteristics (morphologic and kinetic enhancement) were recorded for the 3 T and 1.5 T examinations. Lesion size measures at both field strengths were correlated to final pathology, and imaging characteristics also were compared. Results: Of the initial cohort of 20 patients with CNB-diagnosed DCIS, 19 underwent definitive surgery. Median DCIS sizes of these 19 patients were 6 mm (range: 0–67 mm) on 3 T, 13 mm (0–60 mm) on 1.5 T, and 6 mm (0–55 mm) on surgical pathology. Size correlation between MRI and pathology was higher for 3 T (Spearman's ρ = 0.66, p = 0.002) than 1.5 T (ρ = 0.36, p = 0.13). In 10 women in which a residual area of suspicious enhancement was identified on both field strengths, there was agreement of morphologic description (NME vs. mass) in nine, and no significant difference in dynamic contrast enhanced kinetics at 3 T compared to 1.5 T. Conclusions: Pre-operative breast MRI at 3 T provided higher

  16. Quantitative evaluation of the reticuloendothelial system function with dynamic MRI.

    Directory of Open Access Journals (Sweden)

    Ting Liu

    Full Text Available PURPOSE: To evaluate the reticuloendothelial system (RES function by real-time imaging blood clearance as well as hepatic uptake of superparamagnetic iron oxide nanoparticle (SPIO using dynamic magnetic resonance imaging (MRI with two-compartment pharmacokinetic modeling. MATERIALS AND METHODS: Kinetics of blood clearance and hepatic accumulation were recorded in young adult male 01b74 athymic nude mice by dynamic T2* weighted MRI after the injection of different doses of SPIO nanoparticles (0.5, 3 or 10 mg Fe/kg. Association parameter, Kin, dissociation parameter, Kout, and elimination constant, Ke, derived from dynamic data with two-compartment model, were used to describe active binding to Kupffer cells and extrahepatic clearance. The clodrosome and liposome were utilized to deplete macrophages and block the RES function to evaluate the capability of the kinetic parameters for investigation of macrophage function and density. RESULTS: The two-compartment model provided a good description for all data and showed a low sum squared residual for all mice (0.27±0.03. A lower Kin, a lower Kout and a lower Ke were found after clodrosome treatment, whereas a lower Kin, a higher Kout and a lower Ke were observed after liposome treatment in comparison to saline treatment (P<0.005. CONCLUSION: Dynamic SPIO-enhanced MR imaging with two-compartment modeling can provide information on RES function on both a cell number and receptor function level.

  17. Reactive intramammary lymph node mimicking recurrence on MRI study in a patient with prior breast conservation therapy

    Directory of Open Access Journals (Sweden)

    Seema A Kembhavi

    2013-01-01

    Full Text Available Breast conservative therapy (BCT is a well accepted form of treatment for patients with early stage breast cancer. The incidence of ipsilateral breast tumor recurrence is higher in patients undergoing BCT than in those patients undergoing Modified Radical Mastectomy (MRM without any adverse effect on survival. Patients treated with BCT are put on active surveillance using clinical breast examination and mammography. The radiologist reading the follow-up mammograms is on high alert and any neo-density is viewed with suspicion. MRI may be used as a problem solving tool. At such a time, an innocuous intra-mammary node can mimic malignancy on MRI. We want to showcase one such typical example with histological proof and highlight that type III curve may be seen in an intramammary node. Our case also reinforces the utility of second look ultrasound which is a faster, cheaper and easier method for localization and biopsy of abnormalities seen on MRI.

  18. Supine MRI for regional breast radiotherapy: imaging axillary lymph nodes before and after sentinel-node biopsy

    Science.gov (United States)

    van Heijst, Tristan C. F.; Eschbach-Zandbergen, Debora; Hoekstra, Nienke; van Asselen, Bram; Lagendijk, Jan J. W.; Verkooijen, Helena M.; Pijnappel, Ruud M.; de Waard, Stephanie N.; Witkamp, Arjen J.; van Dalen, Thijs; Desirée van den Bongard, H. J. G.; Philippens, Marielle E. P.

    2017-08-01

    Regional radiotherapy (RT) is increasingly used in breast cancer treatment. Conventionally, computed tomography (CT) is performed for RT planning. Lymph node (LN) target levels are delineated according to anatomical boundaries. Magnetic resonance imaging (MRI) could enable individual LN delineation. The purpose was to evaluate the applicability of MRI for LN detection in supine treatment position, before and after sentinel-node biopsy (SNB). Twenty-three female breast cancer patients (cTis-3N0M0) underwent 1.5 T MRI, before and after SNB, in addition to CT. Endurance for MRI was monitored. Axillary levels were delineated. LNs were identified and delineated on MRI from before and after SNB, and on CT, and compared by Wilcoxon signed-rank tests. LN locations and LN-based volumes were related to axillary delineations and associated volumes. Although postoperative effects were visible, LN numbers on postoperative MRI (median 26 LNs) were highly reproducible compared to preoperative MRI when adding excised sentinel nodes, and higher than on CT (median 11, p  <  0.001). LN-based volumes were considerably smaller than respective axillary levels. Supine MRI of LNs is feasible and reproducible before and after SNB. This may lead to more accurate RT target definition compared to CT, with potentially lower toxicity. With the MRI techniques described here, initiation of novel MRI-guided RT strategies aiming at individual LNs could be possible.

  19. Localized-atlas-based segmentation of breast MRI in a decision-making framework.

    Science.gov (United States)

    Fooladivanda, Aida; Shokouhi, Shahriar B; Ahmadinejad, Nasrin

    2017-01-23

    Breast-region segmentation is an important step for density estimation and Computer-Aided Diagnosis (CAD) systems in Magnetic Resonance Imaging (MRI). Detection of breast-chest wall boundary is often a difficult task due to similarity between gray-level values of fibroglandular tissue and pectoral muscle. This paper proposes a robust breast-region segmentation method which is applicable for both complex cases with fibroglandular tissue connected to the pectoral muscle, and simple cases with high contrast boundaries. We present a decision-making framework based on geometric features and support vector machine (SVM) to classify breasts in two main groups, complex and simple. For complex cases, breast segmentation is done using a combination of intensity-based and atlas-based techniques; however, only intensity-based operation is employed for simple cases. A novel atlas-based method, that is called localized-atlas, accomplishes the processes of atlas construction and registration based on the region of interest (ROI). Atlas-based segmentation is performed by relying on the chest wall template. Our approach is validated using a dataset of 210 cases. Based on similarity between automatic and manual segmentation results, the proposed method achieves Dice similarity coefficient, Jaccard coefficient, total overlap, false negative, and false positive values of 96.3, 92.9, 97.4, 2.61 and 4.77%, respectively. The localization error of the breast-chest wall boundary is 1.97 mm, in terms of averaged deviation distance. The achieved results prove that the suggested framework performs the breast segmentation with negligible errors and efficient computational time for different breasts from the viewpoints of size, shape, and density pattern.

  20. MRI fused with prone FDG PET/CT improves the primary tumour staging of patients with breast cancer.

    Science.gov (United States)

    Garcia-Velloso, Maria J; Ribelles, Maria J; Rodriguez, Macarena; Fernandez-Montero, Alejandro; Sancho, Lidia; Prieto, Elena; Santisteban, Marta; Rodriguez-Spiteri, Natalia; Idoate, Miguel A; Martinez-Regueira, Fernando; Elizalde, Arlette; Pina, Luis J

    2017-08-01

    Our aim was to evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) fused with prone 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in primary tumour staging of patients with breast cancer. This retrospective study evaluated 45 women with 49 pathologically proven breast carcinomas. MRI and prone PET-CT scans with time-of-flight and point-spread-function reconstruction were performed with the same dedicated breast coil. The studies were assessed by a radiologist and a nuclear medicine physician, and evaluation of fused images was made by consensus. The final diagnosis was based on pathology (90 lesions) or follow-up ≥ 24 months (17 lesions). The study assessed 72 malignant and 35 benign lesions with a median size of 1.8 cm (range 0.3-8.4 cm): 31 focal, nine multifocal and nine multicentric cases. In lesion-by-lesion analysis, sensitivity, specificity, positive and negative predictive values were 97%, 80%, 91% and 93% for MRI, 96%, 71%, 87%, and 89% for prone PET, and 97%. 94%, 97% and 94% for MRI fused with PET. Areas under the curve (AUC) were 0.953, 0.850, and 0.983, respectively (p PET is more accurate than FDG-PET in primary tumour staging of breast cancer patients and increases the specificity of MRI. • FDG PET-CT may improve the specificity of MRI in breast cancer staging. • MRI fused with prone 2-[fluorine-18]-fluoro-2-deoxy-D-glucose PET-CT has better overall diagnostic performance than MRI. • The clinical role of fused PET-MRI has not yet been established.

  1. Real-time MRI navigated ultrasound for preoperative tumor evaluation in breast cancer patients: Technique and clinical implementation

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ah Young; Seo, Bo Kyoung [Dept. of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan (Korea, Republic of)

    2016-09-15

    Real-time magnetic resonance imaging (MRI) navigated ultrasound is an image fusion technique to display the results of both MRI and ultrasonography on the same monitor. This system is a promising technique to improve lesion detection and analysis, to maximize advantages of each imaging modality, and to compensate the disadvantages of both MRI and ultrasound. In evaluating breast cancer stage preoperatively, MRI and ultrasound are the most representative imaging modalities. However, sometimes difficulties arise in interpreting and correlating the radiological features between these two different modalities. This pictorial essay demonstrates the technical principles of the real-time MRI navigated ultrasound, and clinical implementation of the system in preoperative evaluation of tumor extent, multiplicity, and nodal status in breast cancer patients.

  2. Real-Time MRI Navigated Ultrasound for Preoperative Tumor Evaluation in Breast Cancer Patients: Technique and Clinical Implementation

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ah Young; Seo, Bo Kyoung [Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan 15355 (Korea, Republic of)

    2016-11-01

    Real-time magnetic resonance imaging (MRI) navigated ultrasound is an image fusion technique to display the results of both MRI and ultrasonography on the same monitor. This system is a promising technique to improve lesion detection and analysis, to maximize advantages of each imaging modality, and to compensate the disadvantages of both MRI and ultrasound. In evaluating breast cancer stage preoperatively, MRI and ultrasound are the most representative imaging modalities. However, sometimes difficulties arise in interpreting and correlating the radiological features between these two different modalities. This pictorial essay demonstrates the technical principles of the real-time MRI navigated ultrasound, and clinical implementation of the system in preoperative evaluation of tumor extent, multiplicity, and nodal status in breast cancer patients.

  3. DCEMRI.jl: a fast, validated, open source toolkit for dynamic contrast enhanced MRI analysis.

    Science.gov (United States)

    Smith, David S; Li, Xia; Arlinghaus, Lori R; Yankeelov, Thomas E; Welch, E Brian

    2015-01-01

    We present a fast, validated, open-source toolkit for processing dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) data. We validate it against the Quantitative Imaging Biomarkers Alliance (QIBA) Standard and Extended Tofts-Kety phantoms and find near perfect recovery in the absence of noise, with an estimated 10-20× speedup in run time compared to existing tools. To explain the observed trends in the fitting errors, we present an argument about the conditioning of the Jacobian in the limit of small and large parameter values. We also demonstrate its use on an in vivo data set to measure performance on a realistic application. For a 192 × 192 breast image, we achieved run times of analysis package tested and produced comparable accuracy, even in the presence of noise.

  4. Designing a Hemispherical Breast RF Coil Array for MRI

    Institute of Scientific and Technical Information of China (English)

    XU Wen-long; ZHANG Ju-cheng; WANG Zhi-kang; LI Xing-xin; LOU Hai-fang

    2015-01-01

    In this paper, an approach to the design of hemispherical breast RF coil array is proposedThe target field method is applied to find the current density distribution on the hemisphere surface, which induces a homogeneous magnetic field in a hemispherical volumeThe components of current density are expanded into Fourier series, and the highly ill-conditioned character of the linear equation related to Fourier coefficients is solved using the Tikhonov regularization method with a minimum curvature penalty functionThe winding pattern was acquired using the stream function techniqueThe results indicate that a simple winding pattern with homogeneous magnetic field can be obtained through manually selecting the penalty factor.

  5. Let's go out of the breast: Prevalence of extra-mammary findings and their characterization on breast MRI

    Energy Technology Data Exchange (ETDEWEB)

    Moschetta, Marco, E-mail: marco.moschetta@gmail.com; Telegrafo, Michele, E-mail: mikitele@hotmail.it; Rella, Leonarda, E-mail: lea.rella@gmail.com; Stabile Ianora, Amato Antonio, E-mail: a.stabile@radiologia.uniba.it; Angelelli, Giuseppe, E-mail: g.angellelli@radiologia.uniba.it

    2014-06-15

    Purpose: The aim of this study is to assess the prevalence, the site and the nature of extra-mammary findings on breast magnetic resonance imaging (MRI) and to determine its accuracy in the characterization of the discovered lesions. Materials and methods: A retrospective review of 308 female patients (mean age 50 ± 20) who underwent breast MRI with 1.5 T device was performed. 125 out of 308 (40.5%) had a positive personal history of breast cancer (pre-operative n = 80; follow-up n = 45), while the remaining 183 without history of breast cancer (high familiar risk for breast cancer n = 80; dense breast n = 103). All incidental findings were characterized by means of additional imaging (US; Bone scintigraphy-MRI; CT-PET-CT). Results: 59 incidental findings were found in 53/308 (17%) examined patients. 9/59 incidental findings (15%) were confirmed to be malignant while the remaining 50/59 (84%) benign. The most common site was the liver (33/59; 55.8%), followed by the lung (6/59; 10.1%), bone (6/59; 10.1%), diaphragm (6/59; 10.1%) spleen (3/59; 5%), kidney (2/59; 3.4%), gall bladder (1/5; 1.5%), ascending aorta (1/59; 1.5%), thyroid (1/59; 1.5%). The incidence of malignant incidental findings resulted to be higher in the group of patients with personal breast cancer (36%) than in the other one (8%). By comparing MRI findings with the additional definitive imaging tools, breast MRI allowed a correct diagnosis in 58/59 cases with a diagnostic accuracy value of 98%. Conclusion: Incidental extramammary findings on breast MRI are common. Benign lesions represent the most frequent findings, however malignant ones need to be searched especially in patients with personal history of breast cancer because they could influence the clinical patient management. Breast MRI can characterize incidental findings with high accuracy value.

  6. Clinical Utility of Breast MRI in the Diagnosis of Malignancy After Inconclusive or Equivocal Mammographic Diagnostic Evaluation.

    Science.gov (United States)

    Giess, Catherine S; Chikarmane, Sona A; Sippo, Dorothy A; Birdwell, Robyn L

    2017-06-01

    The purpose of this study was to determine the clinical utility of breast MRI for diagnosing malignancy in women with equivocal mammographic findings but no symptoms. Retrospective review of an institutional MRI database of 7332 contrast-enhanced breast MRI examinations from January 1, 2009, through December 31, 2012, yielded the records of 296 (4.0%) examinations of 294 women without symptoms who underwent MRI for mammographic findings uncertain at diagnostic evaluation. Imaging findings, histopathologic results, and patient demographics were obtained from the electronic medical record. The mean patient age was 55 years (range, 29-83 years). Mammographic lesion type (n = 294) included 89 focal asymmetries, 76 asymmetries, 64 masses, 44 architectural distortions, 17 surgical scar versus lesion, and four miscellaneous lesions. Diagnostic ultrasound, performed on 286 of 294 (97.3%) lesions at mammographic evaluation, showed an ultrasound correlate in 37 (12.9%) lesions, equivocal correlate in 48 (16.8%), and no ultrasound correlate in 201 (70.3%). MRI examination of 294 index lesions showed a correlate in 133 (45.2%) and no correlate in 161 (54.8%). Forty of 294 (13.6%) index lesions were malignant, 37 (92.5%) with an MRI correlate and three (7.5%) without an MRI correlate. Among 250 patients who underwent biopsy or had 2 or more years of imaging stability, the sensitivity, specificity, negative predictive value, and positive predictive value of breast MRI for malignancy were 92.5%, 62.4%, 97.8%, and 31.9%. Forty-four of 294 (15.0%) patients had lesions incidentally found at MRI; 7 of 41 (17.1%) lesions that were biopsied or were stable for at least 1 year were malignant. Problem-solving breast MRI for inconclusive mammographic findings helps identify malignancies with high sensitivity and a high negative predictive value.

  7. Medial tibial pain: a dynamic contrast-enhanced MRI study.

    Science.gov (United States)

    Mattila, K T; Komu, M E; Dahlström, S; Koskinen, S K; Heikkilä, J

    1999-09-01

    The purpose of this study was to compare the sensitivity of different magnetic resonance imaging (MRI) sequences to depict periosteal edema in patients with medial tibial pain. Additionally, we evaluated the ability of dynamic contrast-enhanced imaging (DCES) to depict possible temporal alterations in muscular perfusion within compartments of the leg. Fifteen patients with medial tibial pain were examined with MRI. T1-, T2-weighted, proton density axial images and dynamic and static phase post-contrast images were compared in ability to depict periosteal edema. STIR was used in seven cases to depict bone marrow edema. Images were analyzed to detect signs of compartment edema. Region-of-interest measurements in compartments were performed during DCES and compared with controls. In detecting periosteal edema, post-contrast T1-weighted images were better than spin echo T2-weighted and proton density images or STIR images, but STIR depicted the bone marrow edema best. DCES best demonstrated the gradually enhancing periostitis. Four subjects with severe periosteal edema had visually detectable pathologic enhancement during DCES in the deep posterior compartment of the leg. Percentage enhancement in the deep posterior compartment of the leg was greater in patients than in controls. The fast enhancement phase in the deep posterior compartment began slightly slower in patients than in controls, but it continued longer. We believe that periosteal edema in bone stress reaction can cause impairment of venous flow in the deep posterior compartment. MRI can depict both these conditions. In patients with medial tibial pain, MR imaging protocol should include axial STIR images (to depict bone pathology) with T1-weighted axial pre and post-contrast images, and dynamic contrast enhanced imaging to show periosteal edema and abnormal contrast enhancement within a compartment.

  8. Dynamic oxygen-enhanced MRI of cerebrospinal fluid.

    Directory of Open Access Journals (Sweden)

    Taha M Mehemed

    Full Text Available Oxygen causes an increase in the longitudinal relaxation rate of tissues through its T1-shortening effect owing to its paramagnetic properties. Due to such effects, MRI has been used to study oxygen-related signal intensity changes in various body parts including cerebrospinal fluid (CSF space. Oxygen enhancement of CSF has been mainly studied using MRI sequences with relatively longer time resolution such as FLAIR, and T1 value calculation. In this study, fifteen healthy volunteers were scanned using fast advanced spin echo MRI sequence with and without inversion recovery pulse in order to dynamically track oxygen enhancement of CSF. We also focused on the differences of oxygen enhancement at sulcal and ventricular CSF. Our results revealed that CSF signal after administration of oxygen shows rapid signal increase in both sulcal CSF and ventricular CSF on both sequences, with statistically significant predominant increase in sulcal CSF compared with ventricular CSF. CSF is traditionally thought to mainly form from the choroid plexus in the ventricles and is absorbed at the arachnoid villi, however, it is also believed that cerebral arterioles contribute to the production and absorption of CSF, and controversy remains in terms of the precise mechanism. Our results demonstrated rapid oxygen enhancement in sulcal CSF, which may suggest inhaled oxygen may diffuse into sulcal CSF space rapidly probably due to the abundance of pial arterioles on the brain sulci.

  9. Breast density as indicator for the use of mammography or MRI to screen women with familial risk for breast cancer (FaMRIsc: a multicentre randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Saadatmand Sepideh

    2012-10-01

    Full Text Available Abstract Background To reduce mortality, women with a family history of breast cancer often start mammography screening at a younger age than the general population. Breast density is high in over 50% of women younger than 50 years. With high breast density, breast cancer incidence increases, but sensitivity of mammography decreases. Therefore, mammography might not be the optimal method for breast cancer screening in young women. Adding MRI increases sensitivity, but also the risk of false-positive results. The limitation of all previous MRI screening studies is that they do not contain a comparison group; all participants received both MRI and mammography. Therefore, we cannot empirically assess in which stage tumours would have been detected by either test. The aim of the Familial MRI Screening Study (FaMRIsc is to compare the efficacy of MRI screening to mammography for women with a familial risk. Furthermore, we will assess the influence of breast density. Methods/Design This Dutch multicentre, randomized controlled trial, with balanced randomisation (1:1 has a parallel grouped design. Women with a cumulative lifetime risk for breast cancer due to their family history of ≥20%, aged 30–55 years are eligible. Identified BRCA1/2 mutation carriers or women with 50% risk of carrying a mutation are excluded. Group 1 receives yearly mammography and clinical breast examination (n = 1000, and group 2 yearly MRI and clinical breast examination, and mammography biennially (n = 1000. Primary endpoints are the number and stage of the detected breast cancers in each arm. Secondary endpoints are the number of false-positive results in both screening arms. Furthermore, sensitivity and positive predictive value of both screening strategies will be assessed. Cost-effectiveness of both strategies will be assessed. Analyses will also be performed with mammographic density as stratification factor. Discussion Personalized breast cancer screening

  10. A simulation tool for dynamic contrast enhanced MRI.

    Directory of Open Access Journals (Sweden)

    Nicolas Adrien Pannetier

    Full Text Available The quantification of bolus-tracking MRI techniques remains challenging. The acquisition usually relies on one contrast and the analysis on a simplified model of the various phenomena that arise within a voxel, leading to inaccurate perfusion estimates. To evaluate how simplifications in the interstitial model impact perfusion estimates, we propose a numerical tool to simulate the MR signal provided by a dynamic contrast enhanced (DCE MRI experiment. Our model encompasses the intrinsic R1 and R2 relaxations, the magnetic field perturbations induced by susceptibility interfaces (vessels and cells, the diffusion of the water protons, the blood flow, the permeability of the vessel wall to the the contrast agent (CA and the constrained diffusion of the CA within the voxel. The blood compartment is modeled as a uniform compartment. The different blocks of the simulation are validated and compared to classical models. The impact of the CA diffusivity on the permeability and blood volume estimates is evaluated. Simulations demonstrate that the CA diffusivity slightly impacts the permeability estimates (< 5% for classical blood flow and CA diffusion. The effect of long echo times is investigated. Simulations show that DCE-MRI performed with an echo time TE = 5 ms may already lead to significant underestimation of the blood volume (up to 30% lower for brain tumor permeability values. The potential and the versatility of the proposed implementation are evaluated by running the simulation with realistic vascular geometry obtained from two photons microscopy and with impermeable cells in the extravascular environment. In conclusion, the proposed simulation tool describes DCE-MRI experiments and may be used to evaluate and optimize acquisition and processing strategies.

  11. Vascular Differences Detected by MRI for Metastatic Versus Nonmetastatic Breast and Prostate Cancer Xenografts

    Directory of Open Access Journals (Sweden)

    Zaver M. Bhujwalla

    2001-01-01

    Full Text Available Several studies have linked vascular density, identified in histologic sections, to “metastatic risk.” Functional information of the vasculature, not readily available from histologic sections, can be obtained with contrast-enhanced MRI to exploit for therapy or metastasis prevention. Our aims were to determine if human breast and prostate cancer xenograffs preselected for differences in invasive and metastatic characteristics established correspondingly different vascular volume and permeability, quantified here with noninvasive MRI of the intravascular contrast agent albumin-GdDTPA. Tumor vascular volume and permeability of human breast and prostate cancer xenografts were characterized using MRI. Parallel studies confirmed the invasive behavior of these cell lines. Vascular endothelial growth factor (VEGF expression in the cell lines was measured using ELISA and Western blots. Metastasis to the lungs was evaluated with spontaneous as well as experimental assay. Metastatic tumors formed vasculature with significantly higher permeability or vascular volume (P < .05, two-sided unpaired t test. The permeability profile matched VEGF expression. Within tumors, regions of high vascular volume usually exhibited low permeability whereas regions of low vascular volume exhibited high permeability. We observed that although invasion was necessary, without adequate vascularization it was not sufficient for metastasis to occur.

  12. Multifractal analysis of dynamic infrared imaging of breast cancer

    Science.gov (United States)

    Gerasimova, E.; Audit, B.; Roux, S. G.; Khalil, A.; Argoul, F.; Naimark, O.; Arneodo, A.

    2013-12-01

    The wavelet transform modulus maxima (WTMM) method was used in a multifractal analysis of skin breast temperature time-series recorded using dynamic infrared (IR) thermography. Multifractal scaling was found for healthy breasts as the signature of a continuous change in the shape of the probability density function (pdf) of temperature fluctuations across time scales from \\sim0.3 to 3 s. In contrast, temperature time-series from breasts with malignant tumors showed homogeneous monofractal temperature fluctuations statistics. These results highlight dynamic IR imaging as a very valuable non-invasive technique for preliminary screening in asymptomatic women to identify those with risk of breast cancer.

  13. Ex vivo MRI of axillary lymph nodes in breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Luciani, Alain [Department of Radiology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France)], E-mail: luciani@hmn.ap-hop-paris.fr; Pigneur, Frederic [Department of Radiology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Ghozali, Faridah [Department of Pathology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Dao, Thu-Ha [Department of Radiology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Cunin, Patrick [Unite de Recherche Clinique, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Meyblum, Evelyne [Department of Radiology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); De Baecque-Fontaine, Cecile [Department of Pathology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Alamdari, Ali [Department of Plastic Surgery, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Maison, Patrick [Unite de Recherche Clinique, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Deux, Jean Francois [Department of Radiology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Lagrange, Jean Leon [Department of Radiotherapy, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Lantieri, Laurent [Department of Plastic Surgery, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France); Rahmouni, Alain [Department of Radiology, AP-HP, Groupe Henri Mondor-Albert Chenevier, 94010 Creteil (France)

    2009-01-15

    Purpose: To provide a strategy for precise co-localization of lymph nodes on axillary lymph-node dissection (ALND) specimens both on pathology and MR. To identify nodal features suggestive of metastatic involvement on a node-to-node basis. Materials and methods: National Institutional review-board approved this prospective study of 18 patients with breast cancer referred for ALND. Ex vivo T1 and inversion recovery (IR) T2 WI of ALND specimens tightly positioned within scaled plastic cranes was performed immediately after surgery. The correspondence of MR-based or pathologically based nodes location was assessed. The MR size and morphological presentation of metastatic and normal nodes were compared (Student's t-test or Mann-Whitney test). Quantitative variables were compared using Pearson coefficient. Results: 207 nodes were retrieved on pathology and 165 on MR. MR-pathological correlation of nodes location was high regarding MR-identified nodes (r = 0.755). An MR short axis threshold of 4 mm yielded the best predictive value for metastatic nodal involvement (Se = 78.6%; Sp = 62.3%). Irregular contours (Se = 35.7%; Sp = 96.7%), central nodal hyper-intensity on IR T2 WI (Se = 57.1%; Sp = 91.4%), and a cortical thickness above 3 mm (Se = 63.6%; Sp = 83.2%) were significantly associated with metastatic involvement. Conclusion: Ex vivo MR allows node-to-node correlation with pathology. Morphological MR criteria can suggest metastatic involvement.

  14. MRI结合数字化钼靶诊断乳腺癌的临床研究%Clinical study of digital mammography,contrast-enhanced MRI as well as their combination in the diagnosis of breast cancer

    Institute of Scientific and Technical Information of China (English)

    Fang Ye; Mengsu Zeng; Fuhua Yan; Wei Feng; Meiling Zhou; Renchen Li; Wenfang Chen

    2008-01-01

    Objective:To compare the effectiveness of digital mammography and MRI in the detection and diagnosis of breast cancer and to assess the value of these modalities as well as the combination of the two.Methods:Sixty-seven patients with surgery and pathology proved breast lesion (malignant,n=32; benign,n=46) underwent digital mammography and MRI,the pulse sequences included T1WI,T2Wl,diffuse weighted imaging (DWI),and dynamic contrast-enhanced MRI before surgery.Of the results of these two modalities,all lesions were classified into 5 groups according to BI-RADS classification,and the imaging findings were correlated to histopathology.The sensitivity and specificity of each modality as well as the combination of the two were calculated.Results:Of these 78 breasts lesions,The sensitivity was 78.13%% (25/32) for digital mammography and 93.75% (30/32) for MRI (P>0.05).The specificity was 73.91%% (34/46) and 89.13% (41/46) accordingly (P<0.05),both of them showed statistical difference.The sensitivity and specificity was 98.63% and 97.16% respectively as these two modalities were used in combination.Conclusion:Digital mammography in combination with MRI is helpful in the diagnosis of breast cancer,the sensitivity and specificity was enhanced when compared to that of single modality.

  15. GPU accelerated dynamic functional connectivity analysis for functional MRI data.

    Science.gov (United States)

    Akgün, Devrim; Sakoğlu, Ünal; Esquivel, Johnny; Adinoff, Bryon; Mete, Mutlu

    2015-07-01

    Recent advances in multi-core processors and graphics card based computational technologies have paved the way for an improved and dynamic utilization of parallel computing techniques. Numerous applications have been implemented for the acceleration of computationally-intensive problems in various computational science fields including bioinformatics, in which big data problems are prevalent. In neuroimaging, dynamic functional connectivity (DFC) analysis is a computationally demanding method used to investigate dynamic functional interactions among different brain regions or networks identified with functional magnetic resonance imaging (fMRI) data. In this study, we implemented and analyzed a parallel DFC algorithm based on thread-based and block-based approaches. The thread-based approach was designed to parallelize DFC computations and was implemented in both Open Multi-Processing (OpenMP) and Compute Unified Device Architecture (CUDA) programming platforms. Another approach developed in this study to better utilize CUDA architecture is the block-based approach, where parallelization involves smaller parts of fMRI time-courses obtained by sliding-windows. Experimental results showed that the proposed parallel design solutions enabled by the GPUs significantly reduce the computation time for DFC analysis. Multicore implementation using OpenMP on 8-core processor provides up to 7.7× speed-up. GPU implementation using CUDA yielded substantial accelerations ranging from 18.5× to 157× speed-up once thread-based and block-based approaches were combined in the analysis. Proposed parallel programming solutions showed that multi-core processor and CUDA-supported GPU implementations accelerated the DFC analyses significantly. Developed algorithms make the DFC analyses more practical for multi-subject studies with more dynamic analyses.

  16. Using quantitative image analysis to classify axillary lymph nodes on breast MRI: A new application for the Z 0011 Era

    Energy Technology Data Exchange (ETDEWEB)

    Schacht, David V., E-mail: dschacht@radiology.bsd.uchicago.edu; Drukker, Karen, E-mail: kdrukker@uchicago.edu; Pak, Iris, E-mail: irisgpak@gmail.com; Abe, Hiroyuki, E-mail: habe@radiology.bsd.uchicago.edu; Giger, Maryellen L., E-mail: m-giger@uchicago.edu

    2015-03-15

    Highlights: •Quantitative image analysis showed promise in evaluating axillary lymph nodes. •13 of 28 features performed better than guessing at metastatic status. •When all features were used in together, a considerably higher AUC was obtained. -- Abstract: Purpose: To assess the performance of computer extracted feature analysis of dynamic contrast enhanced (DCE) magnetic resonance images (MRI) of axillary lymph nodes. To determine which quantitative features best predict nodal metastasis. Methods: This institutional board-approved HIPAA compliant study, in which informed patient consent was waived, collected enhanced T1 images of the axilla from patients with breast cancer. Lesion segmentation and feature analysis were performed on 192 nodes using a laboratory-developed quantitative image analysis (QIA) workstation. The importance of 28 features were assessed. Classification used the features as input to a neural net classifier in a leave-one-case-out cross-validation and evaluated with receiver operating characteristic (ROC) analysis. Results: The area under the ROC curve (AUC) values for features in the task of distinguishing between positive and negative nodes ranged from just over 0.50 to 0.70. Five features yielded AUCs greater than 0.65: two morphological and three textural features. In cross-validation, the neural net classifier obtained an AUC of 0.88 (SE 0.03) for the task of distinguishing between positive and negative nodes. Conclusion: QIA of DCE MRI demonstrated promising performance in discriminating between positive and negative axillary nodes.

  17. Using surface markers for MRI guided breast conserving surgery: a feasibility survey

    Science.gov (United States)

    Ebrahimi, Mehran; Siegler, Peter; Modhafar, Amen; Holloway, Claire M. B.; Plewes, Donald B.; Martel, Anne L.

    2014-04-01

    Breast MRI is frequently performed prior to breast conserving surgery in order to assess the location and extent of the lesion. Ideally, the surgeon should also be able to use the image information during surgery to guide the excision and this requires that the MR image is co-registered to conform to the patient’s position on the operating table. Recent progress in MR imaging techniques has made it possible to obtain high quality images of the patient in the supine position which significantly reduces the complexity of the registration task. Surface markers placed on the breast during imaging can be located during surgery using an external tracking device and this information can be used to co-register the images to the patient. There remains the problem that in most clinical MR scanners the arm of the patient has to be placed parallel to the body whereas the arm is placed perpendicular to the patient during surgery. The aim of this study is to determine the accuracy of co-registration based on a surface marker approach and, in particular, to determine what effect the difference in a patient’s arm position makes on the accuracy of tumour localization. Obtaining a second MRI of the patient where the patient’s arm is perpendicular to body axes (operating room position) is not possible. Instead we obtain a secondary MRI scan where the patient’s arm is above the patient’s head to validate the registration. Five patients with enhancing lesions ranging from 1.5 to 80 cm3 in size were imaged using contrast enhanced MRI with their arms in two positions. A thin-plate spline registration scheme was used to match these two configurations. The registration algorithm uses the surface markers only and does not employ the image intensities. Tumour outlines were segmented and centre of mass (COM) displacement and Dice measures of lesion overlap were calculated. The relationship between the number of markers used and the COM-displacement was also studied. The lesion COM

  18. Triple-negative invasive breast cancer on dynamic contrast-enhanced and diffusion-weighted MR imaging: comparison with other breast cancer subtypes

    Energy Technology Data Exchange (ETDEWEB)

    Youk, Ji Hyun; Son, Eun Ju; Chung, Jin; Kim, Jeong-Ah; Kim, Eun-kyung [Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2012-08-15

    To determine the MRI features of triple-negative invasive breast cancer (TNBC) on dynamic contrast-enhanced MR imaging (DCE-MRI) and diffusion-weighted MR imaging (DWI) in comparison with ER-positive/HER2-negative (ER+) and HER2-positive cancer (HER2+). A total of 271 invasive cancers in 269 patients undergoing preoperative MRI and surgery were included. Two radiologists retrospectively assessed morphological and kinetic characteristics on DCE-MRI and tumour detectability on DWI. Apparent diffusion coefficient (ADC) values of lesions were measured. Clinical and MRI features of the three subtypes were compared. Compared with ER+ (n = 119) and HER2+ (n = 94), larger size, round/oval mass shape, smooth mass margin, and rim enhancement on DCE-MRI were significantly associated with TNBC (n = 58; P < 0.0001). On DWI, mean ADC value (x 10{sup -3} mm{sup 2}/s) of TNBC (1.03) was higher than the mean ADC values for ER+ and HER2+ (0.89 and 0.84; P < 0.0001). There was no difference in tumour detectability (P = 0.099). Tumour size (P = 0.009), mass margin (smooth, P < 0.0001; irregular, P = 0.020), and ADC values (P = 0.002) on DCE-MRI and DWI were independent features of TNBC. In addition to the morphological features, higher ADC values on DWI were independently associated with TNBC and could be useful in differentiating TNBC from ER+ and HER2+. (orig.)

  19. Breast MRI in the Evaluation of Locally Recurrent or New Breast Cancer in the Postoperative Patient: Correlation of Morphology and Enhancement Features with the BI-RADS Category

    Energy Technology Data Exchange (ETDEWEB)

    Seely, J.M.; Nguyen, E.T.; Jaffey, J. [Dept. of Radiology, The Ottawa Hospit al, Ottawa (Canada)

    2007-10-15

    Background: While breast magnetic resonance imaging (MRI) is a highly sensitive test for detecting breast carcinoma, its specificity is lower, and several methods have been described on how to optimize specificity. Purpose: To compare the specificity and sensitivity of the BI-RADS category with the Fischer score in breast MRI for diagnosing cancer in women previously treated for breast cancer. Material and Methods: Women referred for evaluation of possible local recurrence or new breast cancer underwent breast MRI examination. Morphologic and kinetic enhancement characteristics were evaluated. BI-RADS category and Fischer score were assigned for each enhancing lesion and compared using a chi-square test. Sensitivity, specificity, and positive predictive values for 27 morphologic and enhancement characteristics were calculated. Pathologic diagnosis was obtained in all patients with enhancing lesions who had ultrasound or mammographic correlation. In those without correlate, 6-, 12-, and 24-month follow-up breast MRIs were obtained. Interobserver kappa correlation was determined for each variable studied. Results: 34 benign and 32 malignant lesions were identified in 26 of 30 patients. BI-RADS category yielded a specificity of 77.1% and a sensitivity of 81.8%. Fischer score had a lower specificity and sensitivity (62.9% and 72.7%, respectively) (P<0.0001). Of the 27 variables studied, >100% enhancement was more sensitive than BI-RADS for malignant lesions. Specificity was highest for rim enhancement (97.1%), but sensitivity was low (24.2%). Interobserver kappa correlation was good for all 27 characteristics ( = 0.84), and highest for BI-RADS assessment ( 0.91). Conclusion: BI-RADS category in breast MRI had the highest combination of specificity and sensitivity, and the highest interobserver correlation. Fischer score and other morphologic and enhancement features lack sensitivity or specificity and do not have high positive predictive values when analyzed as single

  20. Identifying key radiogenomic associations between DCE-MRI and micro-RNA expressions for breast cancer

    Science.gov (United States)

    Samala, Ravi K.; Chan, Heang-Ping; Hadjiiski, Lubomir; Helvie, Mark A.; Kim, Renaid

    2017-03-01

    Understanding the key radiogenomic associations for breast cancer between DCE-MRI and micro-RNA expressions is the foundation for the discovery of radiomic features as biomarkers for assessing tumor progression and prognosis. We conducted a study to analyze the radiogenomic associations for breast cancer using the TCGA-TCIA data set. The core idea that tumor etiology is a function of the behavior of miRNAs is used to build the regression models. The associations based on regression are analyzed for three study outcomes: diagnosis, prognosis, and treatment. The diagnosis group consists of miRNAs associated with clinicopathologic features of breast cancer and significant aberration of expression in breast cancer patients. The prognosis group consists of miRNAs which are closely associated with tumor suppression and regulation of cell proliferation and differentiation. The treatment group consists of miRNAs that contribute significantly to the regulation of metastasis thereby having the potential to be part of therapeutic mechanisms. As a first step, important miRNA expressions were identified and their ability to classify the clinical phenotypes based on the study outcomes was evaluated using the area under the ROC curve (AUC) as a figure-of-merit. The key mapping between the selected miRNAs and radiomic features were determined using least absolute shrinkage and selection operator (LASSO) regression analysis within a two-loop leave-one-out cross-validation strategy. These key associations indicated a number of radiomic features from DCE-MRI to be potential biomarkers for the three study outcomes.

  1. MRI screening for silicone breast implant rupture: accuracy, inter- and intraobserver variability using explantation results as reference standard

    Energy Technology Data Exchange (ETDEWEB)

    Maijers, M.C.; Ritt, M.J.P.F. [VU University Medical Centre, Department of Plastic, Reconstructive and Hand Surgery, De Boelelaan 1117, PO Box 7057, Amsterdam (Netherlands); Niessen, F.B. [VU University Medical Centre, Department of Plastic, Reconstructive and Hand Surgery, De Boelelaan 1117, PO Box 7057, Amsterdam (Netherlands); Jan van Goyen Clinic, Department of Plastic Surgery, Amsterdam (Netherlands); Veldhuizen, J.F.H. [MRI Centre, Amsterdam (Netherlands); Manoliu, R.A. [MRI Centre, Amsterdam (Netherlands); VU University Medical Centre, Department of Radiology, Amsterdam (Netherlands)

    2014-06-15

    The recall of Poly Implant Prothese (PIP) silicone breast implants in 2010 resulted in large numbers of asymptomatic women with implants who underwent magnetic resonance imaging (MRI) screening. This study's aim was to assess the accuracy and interobserver variability of MRI screening in the detection of rupture and extracapsular silicone leakage. A prospective study included 107 women with 214 PIP implants who underwent explantation preceded by MRI. In 2013, two radiologists blinded for previous MRI findings or outcome at surgery, independently re-evaluated all MRI examinations. A structured protocol described the MRI findings. The ex vivo findings served as reference standard. In 208 of the 214 explanted prostheses, radiologists agreed independently about the condition of the implants. In five of the six cases they disagreed (2.6 %), but subsequently reached consensus. A sensitivity of 93 %, specificity of 93 %, positive predictive value of 77 % and negative predictive value of 98 % was found. The interobserver agreement was excellent (kappa value of 0.92). MRI has a high accuracy in diagnosing rupture in silicone breast implants. Considering the high kappa value of interobserver agreement, MRI appears to be a consistent diagnostic test. A simple, uniform classification, may improve communication between radiologist and plastic surgeon. (orig.)

  2. Design, Development, and Evaluation of a Master-Slave Surgical System for Breast Biopsy under Continuous MRI.

    Science.gov (United States)

    Yang, Bo; Roys, Steven; Tan, U-Xuan; Philip, Mathew; Richard, Howard; Gullapalli, Rao; Desai, Jaydev P

    2014-04-01

    Magnetic Resonance Imaging (MRI) provides superior soft-tissue contrast in cancer diagnosis compared to other imaging modalities. However, the strong magnetic field inside the MRI bore along with limited scanner bore size poses significant challenges. Since current approaches in breast biopsy using MR images is primarily a blind targeting approach, it is necessary to develop a MRI-compatible robot that can avoid multiple needle insertions into the breast tissue. This MRI-compatible robotic system could potentially lead to improvement in the targeting accuracy and reduce sampling errors. A master-slave surgical system has been developed comprising of a MRI-compatible slave robot which consists of one piezo motor and five pneumatic cylinders connected by long pneumatic transmission lines. The slave robot follows the configuration of the master robot, which provides an intuitive manipulation interface for the physician and operates inside the MRI bore to adjust the needle position and orientation and perform needle insertion task. Based on the MRI experiments using the slave robot, there was no significant distortion in the images and hence the slave robot can be safely operated inside the MRI with minimal loss in signal-to-noise ratio (SNR). Ex vivo and in vivo experiments have been conducted to evaluate the performance of the master-slave surgical system.

  3. In vitro assessment of MRI issues at 3-Tesla for a breast tissue expander with a remote port.

    Science.gov (United States)

    Linnemeyer, Hannah; Shellock, Frank G; Ahn, Christina Y

    2014-04-01

    A patient with a breast tissue expander may require a diagnostic assessment using magnetic resonance imaging (MRI). To ensure patient safety, this type of implant must undergo in vitro MRI testing using proper techniques. Therefore, this investigation evaluated MRI issues (i.e., magnetic field interactions, heating, and artifacts) at 3-Tesla for a breast tissue expander with a remote port. A breast tissue expander with a remote port (Integra Breast Tissue Expander, Model 3612-06 with Standard Remote Port, PMT Corporation, Chanhassen, MN) underwent evaluation for magnetic field interactions (translational attraction and torque), MRI-related heating, and artifacts using standardized techniques. Heating was evaluated by placing the implant in a gelled-saline-filled phantom and MRI was performed using a transmit/receive RF body coil at an MR system reported, whole body averaged specific absorption rate of 2.9-W/kg. Artifacts were characterized using T1-weighted and GRE pulse sequences. Magnetic field interactions were not substantial and, thus, will not pose a hazard to a patient in a 3-Tesla or less MRI environment. The highest temperature rise was 1.7°C, which is physiologically inconsequential. Artifacts were large in relation to the remote port and metal connector of the implant but will only present problems if the MR imaging area of interest is where these components are located. A patient with this breast tissue expander with a remote port may safely undergo MRI at 3-Tesla or less under the conditions used for this investigation. These findings are the first reported at 3-Tesla for a tissue expander. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Is the performance of MRI in preoperative staging of breast cancer independent of clinical and histological factors? A subgroup analysis.

    Science.gov (United States)

    Carreira Gómez, C; Zamora Romero, J; Gil de Miguel, A; Chiva de Agustín, M; Plana Farrás, M N; Martínez González, J

    2015-01-01

    To determine whether preoperative breast MRI is more useful in patients according to their breast density, age, menopausal status, and biopsy findings of carcinoma in situ. We retrospectively studied 264 patients treated for breast cancer who had undergone mammography, ultrasonography, and MRI. We compared the size of the tumor on the three techniques and the sensitivity of the techniques for detecting additional lesions both in the overall group and in subgroups of patients classified according to their breast density, age, menopausal status, and histological findings of intraductal carcinoma. The definitive histological diagnosis was used as the gold standard. MRI was the technique that was most concordant with the histological findings for the size of the lesion, and it was also the technique that detected the most additional lesions. With MRI, we observed no differences in lesion size between the overall group and the subgroups in which MRI provided added value. Likewise, we observed no differences in the number of additional lesions detected in the overall group except for multicentric lesions, which was larger in older patients (P=.02). In the subgroup of patients in which MRI provided added value, the sensitivity for bilateral lesions was higher in patients with fatty breasts (P=.04). Multifocal lesions were detected significantly better in premenopausal patients (P=.03). MRI is better than mammography and better than ultrasonography for establishing the size of the tumor and for detecting additional lesions. Our results did not identify any subgroups in which the technique was more useful. Copyright © 2013 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  5. Expanding the indications for MRI in the diagnosis and treatment of breast cancer: what is best practice?

    Science.gov (United States)

    Saunders, Christobel; Taylor, Donna

    2015-03-01

    Breast magnetic resonance imaging (MRI) now has an accepted place in screening younger women at high risk of breast cancer, and is increasingly used in a number of other settings including assessment of response to neo-adjuvant therapy and local staging of cancer. Although the evidence for its general use in these settings is very limited, in highly selected patients, especially where discordance with conventional measurements occurs, MRI can have a place in assessing extent of disease, both whether operable and how operable, and guiding surgery. These scenarios and future indications and alternative technologies are explored in this paper.

  6. Expanding the indications for MRI in the diagnosis and treatment of breast cancer: what is best practice?

    Energy Technology Data Exchange (ETDEWEB)

    Saunders, Christobel, E-mail: christobel.saunders@uwa.edu.au; Taylor, Donna [School of Surgery, University of Western Australia and Royal Perth Hospital Breast Service, Crawley, Western Australia (Australia)

    2015-03-15

    Breast magnetic resonance imaging (MRI) now has an accepted place in screening younger women at high risk of breast cancer, and is increasingly used in a number of other settings including assessment of response to neo-adjuvant therapy and local staging of cancer. Although the evidence for its general use in these settings is very limited, in highly selected patients, especially where discordance with conventional measurements occurs, MRI can have a place in assessing extent of disease, both whether operable and how operable, and guiding surgery. These scenarios and future indications and alternative technologies are explored in this paper.

  7. 三阴性乳腺癌的MRI研究进展%Research progresses of MRI for triple-negative breast cancer

    Institute of Scientific and Technical Information of China (English)

    韩小伟; 李俊峰; 原志娜; 左慧慧

    2013-01-01

    Triple-negative breast cancer (TNBC),which characterized by distinct biological and clinical pathological features,has a worse prognosis because the lack of effective therapeutic targets.Breast MR is the most accurate imaging modality for diagnosis of breast cancer currently.MR imaging recognition could assist in diagnosis,pretreatment planning and prognosis evaluation of TNBC,as well as adding to understanding of the biological behavior of TNBC.MR findings of a large solitary lesion,mass with smooth margin,high signal intensity on T2WI and rim enhancement are typical MRI features associated with TNBC.Further work is necessary about the clinical application of dynamic contrast-enhanced MR imaging (DCE-MRI),DWI and MRS.%目的 三阴性乳腺癌(TNBC)具有特殊的生物学行为及临床病理学特征,临床缺乏有效治疗方法,预后较差.目前MRI是诊断乳腺癌的最准确的影像学方法.MRI有助于诊断TNBC、制订治疗方案与预后评估,并能加深对其生物学行为的理解.TNBC的MRI特征包括较大的单发病灶,边缘光滑,T2WI呈高信号,增强后环形强化;而动态对比增强MRI(DCE-MRI)、DWI及MRS对于TNBC的临床应用价值有待更深入研究.

  8. Assessment of patellar maltracking using combined static and dynamic MRI

    Energy Technology Data Exchange (ETDEWEB)

    McNally, E.G.; Ostlere, S.J.; Pal, C.; Phillips, A.; Reid, H. [Department of Radiology, Nuffield Orthopaedic Centre, Headington, Oxford OX3 9JW (United Kingdom); Dodd, C. [Department of Orthopaedic Surgery, Nuffield Orthopaedic Centre, Headington, Oxford OX3 9JW (United Kingdom)

    2000-07-01

    Between January 1995 and Jul 1997, 474 patients with anterior knee pain resistant to conservative treatment were referred for MR of the knee. The MR examination consisted of routine sequences with an additional patellofemoral dynamic examination using a technique that has been developed at this institution. The dynamic study examines both knees simultaneously, with the patient supine and the quadriceps loaded. No gating or restraint apparatus is needed. Patellar subluxation or tilt was present in 188(40%) of cases, bilateral in 104 and unilateral in 84 cases (right 39, left 45). It was classified as mild in 51%, moderate in 39% and severe in 10%. Subluxation was more prevalent in females than males (42% vs. 37%) and this was most obvious in the severe group where 68% were female. In 90 knees selected at random, four measurements of patellofemoral morphology were obtained using reconstructed images from a volume gradient echo sequence. These measurements were correlated with the degree of subluxation or tilt. A tibial tubercle distance greater than 20 mm, a femoral sulcus angle greater than 150 degrees, sulcus depth less than 4 mm were specific for subluxation but no measurement proved to be sufficiently sensitive to preclude a tracking study. MRI can be used to define more precisely the anatomy of the extensor mechanism and its relationship to the femur and tibia, in both a static and dynamic setting. In this way, patients with anterior knee pain can be classified more accurately and the outcomes of treatment more reliably assessed. (orig.)

  9. Digital optical tomography system for dynamic breast imaging.

    Science.gov (United States)

    Flexman, Molly L; Khalil, Michael A; Al Abdi, Rabah; Kim, Hyun K; Fong, Christopher J; Desperito, Elise; Hershman, Dawn L; Barbour, Randall L; Hielscher, Andreas H

    2011-07-01

    Diffuse optical tomography has shown promising results as a tool for breast cancer screening and monitoring response to chemotherapy. Dynamic imaging of the transient response of the breast to an external stimulus, such as pressure or a respiratory maneuver, can provide additional information that can be used to detect tumors. We present a new digital continuous-wave optical tomography system designed to simultaneously image both breasts at fast frame rates and with a large number of sources and detectors. The system uses a master-slave digital signal processor-based detection architecture to achieve a dynamic range of 160 dB and a frame rate of 1.7 Hz with 32 sources, 64 detectors, and 4 wavelengths per breast. Included is a preliminary study of one healthy patient and two breast cancer patients showing the ability to identify an invasive carcinoma based on the hemodynamic response to a breath hold.

  10. 廓清型乳腺纤维腺瘤的 MRI 诊断%The MRI diagnosis of the breast fibroadenoma with a washout type of the time signal intesity curve

    Institute of Scientific and Technical Information of China (English)

    李勤勍; 杨军; 丁莹莹; 李卓琳; 刘洋

    2016-01-01

    目的:探讨廓清型乳腺纤维腺瘤的 MRI 表现,提高对此类型肿瘤的影像诊断水平。方法回顾性分析经病理证实的各20例MR 时间-信号曲线(TIC)呈廓清型表现的乳腺纤维腺瘤及乳腺癌的 MRI 图像,归纳、比较2组病变的形态学表现、内部信号、表观扩散系数(ADC)值以及动态增强表现,并进行统计学分析。结果动态增强扫描 TIC 为廓清型乳腺纤维腺瘤形态多为卵圆形或圆形(18/20),边界清楚(16/20),T2 WI 多呈高信号,内部可见无强化的低信号分隔(9/20);平均最小 ADC 值为(1.412±0.332)×10-3 mm2/s,高于乳腺癌(0.888±0.160)×10-3 mm2/s,差异有统计学意义(P 0.05)。结论廓清型乳腺纤维腺瘤与乳腺癌在 MRI 动态增强TIC 及早期强化率方面有着相似的表现,但清楚的边缘、更高的 T2 WI 信号、内部无强化的低信号分隔以及更高的 ADC 值有助于廓清型乳腺纤维腺瘤的诊断。%Objective To investigate the MRI findings of the breast fibroadenoma which has a washout type of time signal intensity curve (TIC)for the purpose of improving imaging diagnosis.Methods The MRI findings of 20 cases of the breast fibroadenoma with a washout TIC and 20 cases of breast carcinoma verified by histopathology were analyzed retrospectively.Morphological features,internal signal, ADC value and dynamic enhancement performance of the two groups were compared with each other.Results The shapes of the breast fibroadenomas were more commonly ovoid or round (18/20),and the margins were circumscribed(16/20),Most of the fibroadenomas were high intensity in T2 WI with the non-contrast enhanced separations (9/20).The average minimum ADC value was (1.412±0.332)×10-3 mm2/s,and higher than that of breast cancer (0.888 ±0.1 60)×10 -3 mm2/s with the significant difference (P 0.05 ). Conclusion The breast fibroadenoma with washout TIC has a similar performance with the breast cancer in TIC and the early enhancement rate

  11. MRI-Guided Diffuse Optical Spectroscopy of Malignant and Benign Breast Lesions

    Directory of Open Access Journals (Sweden)

    Vasilis Ntziachristos

    2002-01-01

    Full Text Available We present the clinical implementation of a novel hybrid system that combines magnetic resonance imaging (MRI and near-infrared (NIR optical measurements for the noninvasive study of breast cancer in vivo. Fourteen patients were studied with a MR-NIR prototype imager and spectrometer. A diffuse optical tomographic scheme employed the MR images as a priori information to implement an image-guided NIR localized spectroscopic scheme. All patients who entered the study also underwent gadolinium-enhanced MRI and biopsy so that the optical findings were crossvalidated with MR readings and histopathology. The technique quantified the oxy-and deoxyhemoglobin of five malignant and nine benign breast lesions in vivo. Breast cancers were found with decreased oxygen saturation and higher blood concentration than most benign lesions. The average hemoglobin concentration ([H] of cancers was 0.130±0.100 mM, and the average hemoglobin saturation (Y was 60±9% compared to [H]=0.018±0.005 mM and Y=69±6% of background tissue. Fibroadenomas exhibited high hemoglobin concentration [H]=0.060±0.010 mM and mild decrease in oxygen saturation Y=67±2%. Cysts and other normal lesions were easily differentiated based on intrinsic contrast information. This novel optical technology can be a significant add-on in MR examinations and can be used to characterize functional parameters of cancers with diagnostic and treatment prognosis potential. It is foreseen that the technique can play a major role in functional activation studies of brain and muscle as well.

  12. A simple scoring system for breast MRI interpretation: does it compensate for reader experience?

    Science.gov (United States)

    Marino, Maria Adele; Clauser, Paola; Woitek, Ramona; Wengert, Georg J; Kapetas, Panagiotis; Bernathova, Maria; Pinker-Domenig, Katja; Helbich, Thomas H; Preidler, Klaus; Baltzer, Pascal A T

    2016-08-01

    To investigate the impact of a scoring system (Tree) on inter-reader agreement and diagnostic performance in breast MRI reading. This IRB-approved, single-centre study included 100 patients with 121 consecutive histopathologically verified lesions (52 malignant, 68 benign). Four breast radiologists with different levels of MRI experience and blinded to histopathology retrospectively evaluated all examinations. Readers independently applied two methods to classify breast lesions: BI-RADS and Tree. BI-RADS provides a reporting lexicon that is empirically translated into likelihoods of malignancy; Tree is a scoring system that results in a diagnostic category. Readings were compared by ROC analysis and kappa statistics. Inter-reader agreement was substantial to almost perfect (kappa: 0.643-0.896) for Tree and moderate (kappa: 0.455-0.657) for BI-RADS. Diagnostic performance using Tree (AUC: 0.889-0.943) was similar to BI-RADS (AUC: 0.872-0.953). Less experienced radiologists achieved AUC: improvements up to 4.7 % using Tree (P-values: 0.042-0.698); an expert's performance did not change (P = 0.526). The least experienced reader improved in specificity using Tree (16 %, P = 0.001). No further sensitivity and specificity differences were found (P > 0.1). The Tree scoring system improves inter-reader agreement and achieves a diagnostic performance similar to that of BI-RADS. Less experienced radiologists, in particular, benefit from Tree. • The Tree scoring system shows high diagnostic accuracy in mass and non-mass lesions. • The Tree scoring system reduces inter-reader variability related to reader experience. • The Tree scoring system improves diagnostic accuracy in non-expert readers.

  13. MRI-guided vacuum-assisted breast biopsy: comparison with stereotactically guided and ultrasound-guided techniques

    Energy Technology Data Exchange (ETDEWEB)

    Imschweiler, Thomas; Freiwald, Bianka; Kubik-Huch, Rahel A. [Kantonspital Baden AG, Institute for Radiology, Baden (Switzerland); Haueisen, Harald [Kantonspital Aarau AG, Institute for Radiology, Aarau (Switzerland); Kampmann, Gert [Clinica Sant' Anna, Lugano, Sorengo (Switzerland); Rageth, Luzi [Adjumed Services AG, Zurich (Switzerland); Seifert, Burkhardt [Institute for Social and Preventive Medicine, University of Zurich, Division of Biostatistics, Zuerich (Switzerland); Rageth, Christoph [Breast Centre, Zurich (Switzerland)

    2014-01-15

    To analyse the development of MRI-guided vacuum-assisted biopsy (VAB) in Switzerland and to compare the procedure with stereotactically guided and ultrasound-guided VAB. We performed a retrospective analysis of VABs between 2009 and 2011. A total of 9,113 VABs were performed. Of these, 557 were MRI guided. MRI-guided VAB showed the highest growth rate (97 %) of all three procedures. The technical success rates for MRI-guided, stereotactically guided and ultrasound-guided VAB were 98.4 % (548/557), 99.1 % (5,904/5,960) and 99.6 % (2,585/2,596), respectively. There were no significant differences (P = 0.12) between the MRI-guided and the stereotactically guided procedures. The technical success rate for ultrasound-guided VAB was significantly higher than that for MRI-guided VAB (P < 0.001). There were no complications using MRI-guided VAB requiring open surgery. The malignancy diagnosis rate for MRI-guided VAB was similar to that for stereotactically guided VAB (P = 0.35). MRI-guided VAB is a safe and accurate procedure that provides insight into clinical breast findings. (orig.)

  14. Application of MRI breast imaging reporting and data system in breast lesions%MRI乳腺影像报告及数据系统在乳腺疾病诊断中的应用研究

    Institute of Scientific and Technical Information of China (English)

    赵华丽; 陈克敏

    2011-01-01

    目的:探讨MRI乳腺影像报告及数据系统(BI-RADS)在乳腺病变诊断中的应用价值.方法:对经手术及病理证实的72例乳腺癌患者和52例乳腺良性病变患者,行乳腺MRI检查,在常规定位和校正扫描后,行横断面脂肪抑制的短时反转恢复(STIR)、横断面快速自旋回波(FSE)T1WI、双侧矢状位FSE-T2WI加脂肪抑制、乳腺动态对比增强(DCE)成像这4个序列的扫描.采用受试者工作特征(ROC)曲线对MRI BI-RADS分类的诊断效能进行分析,并获取诊断阈值.结果:乳腺MRI BI-RADS分类对病灶的诊断灵敏度、特异度、准确率分别为91.0%、96.2%、93.2%.结论:MRI BI-RADS分类是诊断及鉴别乳腺良、恶性肿瘤有效的影像学检测方法,可为临床实际应用提供相对客观、规范的标准,减少了诊断主观性,便于医师间的交流、研究.%Objective To study the diagnostic value of MRI breast imaging reporting and data system (BI-RADS) for breast lesions. Methods One hundred and twenty-four subjects were enrolled in this study, including 72 breast cancer cases (73 lesions) and 52 benign cases (59 lesions). All breast lesions were verified by pathology. MRI was performed for every case. MRI sequences included T1WI, T2WI, STIR and dynamic contrast-enhanced MRI scanning (VIBRANT). The sensitivity, specificity and accuracy of MRI BI-RADS were evaluated by ROC analysis. Results The sensitivity, specificity and accuracy of MRI BI-RADS were 91.0%, 96.2% and 93.2%, respectively. Conclusions MRI BI-RADS has high sensitivity, specificity and accuracy, and it is useful in the differential diagnosis of malignant and benign lesions, MRI BI-RADS provides an objective canonical classification, reducing subjectivity and is convenient for communication between physicians.

  15. MRI

    Science.gov (United States)

    MRI does not use ionizing radiation. No side effects from the magnetic fields and radio waves have been reported. The most common type of contrast (dye) used is gadolinium. It is very safe. Allergic reactions rarely ...

  16. Comparison of conventional DCE-MRI and a novel golden-angle radial multicoil compressed sensing method for the evaluation of breast lesion conspicuity.

    Science.gov (United States)

    Heacock, Laura; Gao, Yiming; Heller, Samantha L; Melsaether, Amy N; Babb, James S; Block, Tobias K; Otazo, Ricardo; Kim, Sungheon G; Moy, Linda

    2017-06-01

    To compare a novel multicoil compressed sensing technique with flexible temporal resolution, golden-angle radial sparse parallel (GRASP), to conventional fat-suppressed spoiled three-dimensional (3D) gradient-echo (volumetric interpolated breath-hold examination, VIBE) MRI in evaluating the conspicuity of benign and malignant breast lesions. Between March and August 2015, 121 women (24-84 years; mean, 49.7 years) with 180 biopsy-proven benign and malignant lesions were imaged consecutively at 3.0 Tesla in a dynamic contrast-enhanced (DCE) MRI exam using sagittal T1-weighted fat-suppressed 3D VIBE in this Health Insurance Portability and Accountability Act-compliant, retrospective study. Subjects underwent MRI-guided breast biopsy (mean, 13 days [1-95 days]) using GRASP DCE-MRI, a fat-suppressed radial "stack-of-stars" 3D FLASH sequence with golden-angle ordering. Three readers independently evaluated breast lesions on both sequences. Statistical analysis included mixed models with generalized estimating equations, kappa-weighted coefficients and Fisher's exact test. All lesions demonstrated good conspicuity on VIBE and GRASP sequences (4.28 ± 0.81 versus 3.65 ± 1.22), with no significant difference in lesion detection (P = 0.248). VIBE had slightly higher lesion conspicuity than GRASP for all lesions, with VIBE 12.6% (0.63/5.0) more conspicuous (P < 0.001). Masses and nonmass enhancement (NME) were more conspicuous on VIBE (P < 0.001), with a larger difference for NME (14.2% versus 9.4% more conspicuous). Malignant lesions were more conspicuous than benign lesions (P < 0.001) on both sequences. GRASP DCE-MRI, a multicoil compressed sensing technique with high spatial resolution and flexible temporal resolution, has near-comparable performance to conventional VIBE imaging for breast lesion evaluation. 3 Technical Efficacy: Stage 3 J. MAGN. RESON. IMAGING 2017;45:1746-1752. © 2016 International Society for Magnetic Resonance in Medicine.

  17. Accuracy of MRI for prediction of response to neo-adjuvant chemotherapy in triple negative breast cancer compared to other subtypes of breast cancer

    Directory of Open Access Journals (Sweden)

    Gaurav J Bansal

    2016-01-01

    Full Text Available Purpose: The aim of this study was to compare the accuracy of magnetic resonance imaging (MRI for the prediction of response to neo-adjuvant chemotherapy in triple negative (TN breast cancer, with respect to other subtypes. Materials and Methods: There were a total of 1610 breast cancers diagnosed between March 2009 and August 2014, out of which 82 patients underwent MRI before and after neo-adjuvant chemotherapy but just before surgery. TN cancers were analyzed with respect to others subtypes. Accuracy of MRI for prediction of pathological complete response was compared between different subtypes by obtaining receiver operating characteristic (ROC curves. The Statistical Package for the Social Sciences version 21 was used for all data analysis, with P value of 0.05 as statistically significant. Results: Out of 82 patients, 29 were luminal (HR+/HER2−, 23 were TN (HR−, HER2−, 11 were HER2 positive (HR−, HER2+, and 19 were of hybrid subtype (HR+/HER2+. TN cancers presented as masses on the pre-chemotherapy MRI scan, were grade 3 on histopathology, and showed concentric shrinkage following chemotherapy. TN cancers were more likely to have both imaging and pathological complete response following chemotherapy (P = 0.055 in contrast to luminal cancers, which show residual cancer. ROC curves were constructed for the prediction of pathological complete response with MRI. For the TN subgroup, MR had a sensitivity of 0.745 and specificity of 0.700 (P = 0.035, with an area under curve of 0.745 (95% confidence interval: 0.526–0.965, which was significantly better compared to other subtypes. Conclusion: TN breast cancers present as masses and show concentric shrinkage following chemotherapy. MRI is most accurate in predicting response to chemotherapy in the TN group, compared to others subtypes. MRI underestimates residual disease in luminal cancers.

  18. A modified Seeded Region Growing algorithm for vessel segmentation in breast MRI images for investigating the nature of potential lesions

    Science.gov (United States)

    Glotsos, D.; Vassiou, K.; Kostopoulos, S.; Lavdas, El; Kalatzis, I.; Asvestas, P.; Arvanitis, D. L.; Fezoulidis, I. V.; Cavouras, D.

    2014-03-01

    The role of Magnetic Resonance Imaging (MRI) as an alternative protocol for screening of breast cancer has been intensively investigated during the past decade. Preliminary research results have indicated that gadolinium-agent administrative MRI scans may reveal the nature of breast lesions by analyzing the contrast-agent's uptake time. In this study, we attempt to deduce the same conclusion, however, from a different perspective by investigating, using image processing, the vascular network of the breast at two different time intervals following the administration of gadolinium. Twenty cases obtained from a 3.0-T MRI system (SIGNA HDx; GE Healthcare) were included in the study. A new modification of the Seeded Region Growing (SRG) algorithm was used to segment vessels from surrounding background. Delineated vessels were investigated by means of their topology, morphology and texture. Results have shown that it is possible to estimate the nature of the lesions with approximately 94.4% accuracy, thus, it may be claimed that the breast vascular network does encodes useful, patterned, information, which can be used for characterizing breast lesions.

  19. BI-RADS(R) -MRI4类乳腺癌阳性预测值与亚分类的初探%Positive Predictive Value and Subcategory for Breast Cancer in BI-RADS(R)-MRI Category 4 Lesions

    Institute of Scientific and Technical Information of China (English)

    刘炳光; 曹满瑞; 张方景; 杜牧; 朱志军; 赵弘

    2012-01-01

    目的 分析MRI的乳腺影像报告和数据系统(breast imaging reporting and data system,BI-RADS(R)-MRI)4类病例乳腺癌阳性预测值(positive predictive value,PPV),初步探讨其亚分类. 方法 回顾性总结BI-RADS(R)-MRI 4类286例患者的MRI资料,以病理及随访结果为金标准,统计该类病例活检率及PPV,并用Logistic回归法分析各征象的PPV和优势比(OR).结果 BI-RADS(R)-MRI 4类活检率为75.5%,PPV为30.6%.不规则型肿块呈不均匀强化,平台型或流出型曲线的PPV为0.56;毛刺肿块,强化均匀的PPV为0.45;圆形/椭圆形肿块,边缘光滑,强化均匀的PPV为0.11.病灶呈导管/段样分布、不均匀强化的PPV为0.35;病灶呈局灶/区域/广泛分布、强化均匀的PPV为0.22.结论 PPV能初步对BI-RADS(R)-MRI 4类行亚分类,但仍需进一步研究.%Objective To analyze the positive predictive value (PPV) for breast cancer in lesions categorized as Bill ADS (Breast Imaging reporting and Data System) category 4 by Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), and to investigate the subcategories. Methods Medical records of 286 patients with BIRADS 4 breast lesions diagnosed by DCE-MRI were retrospectively reviewed. Biopsy rate and PPV were calculated for patients who performed biopsy or clinical follow up. PPV and the odds ratios (OR) of the BI RADS 4 lesion characteristics were calculated by logistic regression analysis. Results The biopsy rate of 286 lesions was 75.5% , PPV was 30.6%. The PPV of masses with irregular shape and margin, heterogeneous enhancement and plateau or washout curve was 0. 56. The PPV of masses with speculated margin and homogeneous enhancement was 0.45. The PPV of mass with round/oval shape, smooth margin and homogeneous enhancement was 0.11. The PPV of non mass like enhancements with ductal /segmental distribution, heterogeneous enhancement was 0. 35. The PPV of focal/regional/diffuse distribution, homogeneous enhancement was 0

  20. Quantitative DCE-MRI for prediction of pathological complete response following neoadjuvant treatment for locally advanced breast cancer: the impact of breast cancer subtypes on the diagnostic accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Drisis, Stylianos; Stathopoulos, Konstantinos; Chao, Shih-Li; Lemort, Marc [Institute Jules Bordet, Radiology Department, Brussels (Belgium); Metens, Thierry [Erasme University Hospital, Radiology Department, Brussels (Belgium); Ignatiadis, Michael [Institute Jules Bordet, Oncology Department, Brussels (Belgium)

    2016-05-15

    To assess whether DCE-MRI pharmacokinetic (PK) parameters obtained before and during chemotherapy can predict pathological complete response (pCR) differently for different breast cancer groups. Eighty-four patients who received neoadjuvant chemotherapy for locally advanced breast cancer were retrospectively included. All patients underwent two DCE-MRI examinations, one before (EX1) and one during treatment (EX2). Tumours were classified into different breast cancer groups, namely triple negative (TNBC), HER2+ and ER+/HER2-, and compared with the whole population (WP). PK parameters Ktrans and Ve were extracted using a two-compartment Tofts model. At EX1, Ktrans predicted pCR for WP and TNBC. At EX2, maximum diameter (Dmax) predicted pCR for WP and ER+/HER2-. Both PK parameters predicted pCR in WP and TNBC and only Ktrans for the HER2+. pCR was predicted from relative difference (EX1 - EX2)/EX1 of Dmax and both PK parameters in the WP group and only for Ve in the TNBC group. No PK parameter could predict response for ER+/HER-. ROC comparison between WP and breast cancer groups showed higher but not statistically significant values for TNBC for the prediction of pCR Quantitative DCE-MRI can better predict pCR after neoadjuvant treatment for TNBC but not for the ER+/HER2- group. (orig.)

  1. Does breast MRI background parenchymal enhancement indicate metabolic activity? Qualitative and 3D quantitative computer imaging analysis.

    Science.gov (United States)

    Mema, Eralda; Mango, Victoria L; Guo, Xiaotao; Karcich, Jenika; Yeh, Randy; Wynn, Ralph T; Zhao, Binsheng; Ha, Richard S

    2017-06-24

    To investigate whether the degree of breast magnetic resonance imaging (MRI) background parenchymal enhancement (BPE) is associated with the amount of breast metabolic activity measured by breast parenchymal uptake (BPU) of 18F-FDG on positron emission tomography / computed tomography (PET/CT). An Institutional Review Board (IRB)-approved retrospective study was performed. Of 327 patients who underwent preoperative breast MRI from 1/1/12 to 12/31/15, 73 patients had 18F-FDG PET/CT evaluation performed within 1 week of breast MRI and no suspicious findings in the contralateral breast. MRI was performed on a 1.5T or 3.0T system. The imaging sequence included a triplane localizing sequence followed by sagittal fat-suppressed T2 -weighted sequence, and a bilateral sagittal T1 -weighted fat-suppressed fast spoiled gradient-echo sequence, which was performed before and three times after a rapid bolus injection (gadobenate dimeglumine, Multihance; Bracco Imaging; 0.1 mmol/kg) delivered through an IV catheter. The unaffected contralateral breast in these 73 patients underwent BPE and BPU assessments. For PET/CT BPU calculation, a 3D region of interest (ROI) was drawn around the glandular breast tissue and the maximum standardized uptake value (SUVmax ) was determined. Qualitative MRI BPE assessments were performed on a 4-point scale, in accordance with BI-RADS categories. Additional 3D quantitative MRI BPE analysis was performed using a previously published in-house technique. Spearman's correlation test and linear regression analysis was performed (SPSS, v. 24). The median time interval between breast MRI and 18F-FDG PET/CT evaluation was 3 days (range, 0-6 days). BPU SUVmax mean value was 1.6 (SD, 0.53). Minimum and maximum BPU SUVmax values were 0.71 and 4.0. The BPU SUVmax values significantly correlated with both the qualitative and quantitative measurements of BPE, respectively (r(71) = 0.59, P Qualitatively assessed high BPE group (BI-RADS 3/4) had significantly

  2. Breast segmentation in MRI using Poisson surface reconstruction initialized with random forest edge detection

    Science.gov (United States)

    Martel, Anne L.; Gallego-Ortiz, Cristina; Lu, YingLi

    2016-03-01

    Segmentation of breast tissue in MRI images is an important pre-processing step for many applications. We present a new method that uses a random forest classifier to identify candidate edges in the image and then applies a Poisson reconstruction step to define a 3D surface based on the detected edge points. Using a leave one patient out cross validation we achieve a Dice overlap score of 0.96 +/- 0.02 for T1 weighted non-fat suppressed images in 8 patients. In a second dataset of 332 images acquired using a Dixon sequence, which was not used in training the random classifier, the mean Dice score was 0.90 +/- 0.03. Using this approach we have achieved accurate, robust segmentation results using a very small training set.

  3. SU-E-P-14: Dosimetric Effects of Magnetic Field in MRI-Guided Radiation Therapy Delivery for Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chen, G; Currey, A; Li, X [Medical College of Wisconsin, Milwaukee, WI (United States)

    2015-06-15

    Purpose: MRI-guided radiation therapy (RT) delivery would be beneficial for breast irradiation. The electron return effect due to the presence of a transverse magnetic field (TMF) may cause dosimetric issues on dose on skin and at the lung-tissue interface. The purpose of this study is to investigate these issues. Methods: IMRT plans with tangential beams and VMAT plans with 200 degree arcs to cover ipsilateral breast were generated for 10 randomly selected breast cancer cases using a research planning system (Monaco, Elekta) utilizing Monte Carlo dose calculation with or without a TMF of 1.5 T. Plans were optimized to deliver uniform dose to the whole breast with an exclusion of 5 mm tissue under the skin (PTV-EVAL). All four plans for each patient were re-scaled to have the same PTV-EVAL volume to receive the same prescription dose. The skin is defined as the first 5 mm of ipsilateral-breast tissue, plus extensions in the surrounding region. Results: The presence of 1.5 T TMF resulted in (1)increased skin dose, with the mean and maximum skin dose increase of 5% and 9%, respectively; (2) similar dose homogeneity within the PTV-EVAL; (3) the slightly improved (3%) dose homogeneity in the whole breast; (4) Averages of 9 and 16% increases in V5 and V20, respectively, for ipsilateral lung; and (5) increased the mean heart dose by 34%. VMAT plans don’t improve whole breast dose uniformity as compared that to the tangential plans. Conclusion: The presence of transverse magnetic field in MRI-guided RT delivery for whole breast irradiation can Result in slightly improved dose homogeneity in the whole breast, increased dose to the ipsilateral lung, heart, and skin. Plan optimization with additional specific dose volume constraints may eliminate/reduce these dose increases. This work is partially supported by Elekta Inc.

  4. Intra-observer agreement in single and joint double readings of contrast-enhanced breast MRI screening for women with high genetic breast cancer risks

    Directory of Open Access Journals (Sweden)

    Hugo C

    2013-04-01

    Full Text Available Objectives: To examine intra-observer reliability (IR for lesion detection on contrast-enhanced breast magnetic resonance images (MRI for screening women at high risk of breast cancer in single and joint double readings, without case selection. Methods: Contrast-enhanced breast MRIs were interpreted twice by the same independent reader and twice in joint readings. IR was assessed for lesion detection, normal MRI identification, mass, non-mass like enhancements (NMLE and focus characterisation, and BI-RADS assessment. Results: MRI examinations for 124 breasts, 65 women (mean age 43.4y were retrospectively reviewed with 110 lesions identified. Abnormal BIRADS (3-5 classifications were found for 52.3% in single readings and 58.5% in joint readings. Seven biopsies were performed for 4 histologically confirmed cancers. IR for BI-RADS classifications was good for single (0.63, 95% CI: 0.49-0.77, and joint readings (0.77, 95% CI: 0.61-0.93. IR for background parenchymal enhancement (BPE was moderate across single (0.53, 95% CI: 0.40-0.65 and joint readings (0.44, 95% CI: 0.33-0.56. IR for BI-RADS category according to each enhancement was poor for single (0.27, 95% CI: 0.10-0.44, and higher for joint readings, (0.58, 95% CI: 0.43-0.72. Conclusions: IR in BI-RADS breast assessments or BI-RADS lesion assessments are better with joint reading in screening for women with high genetic risks, in particular for abnormal MRI (BI-RADS 3, 4 and 5.

  5. Cholestrol granuloma of the breast incidentally detected on dynamic abdominal CT: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Sun Hye; Lee, Eun Hye; Hong, Hyun Sook; Kwak, Jeong Ja [Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon (Korea, Republic of)

    2016-01-15

    A breast cholesterol granuloma is an uncommon nodular breast lesion. We incidentally detected a persistently enhancing breast mass on the dynamic abdominal computed tomography (CT) of a 78-year-old woman. The mass decreased in diameter over 50 days following a core needle biopsy. This report is the first to describe the dynamic-enhanced CT features of a breast cholesterol granuloma.

  6. TH-A-BRF-05: MRI of Individual Lymph Nodes to Guide Regional Breast Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Heijst, T van; Asselen, B van; Lagendijk, J; Bongard, D van den; Philippens, M [University Medical Center Utrecht, Utrecht (Netherlands)

    2014-06-15

    Purpose: In regional radiotherapy (RT) for breast-cancer patients, direct visualization of individual lymph nodes (LNs) may reduce target volumes and Result in lower toxicity (i.e. reduced radiation pneumonitis, arm edema, arm morbidity), relative to standard CT-based delineations. To this end, newly designed magnetic resonance imaging (MRI) sequences were optimized and assessed qualitatively and quantitatively. Methods: In ten healthy female volunteers, a scanning protocol was developed and optimized. Coronal images were acquired in supine RT position positioned on a wedge board on a 1.5 T Ingenia (Philips) wide-bore MRI. In four volunteers the optimized MRI protocol was applied, including a 3-dimensional (3D) T1-weighted (T1w) fast-field-echo (FFE). T2w sequences, including 3D FFE, 3D and 2D fast spin echo (FSE), and diffusion-weighted single-shot echo-planar imaging (DWI) were also performed. Several fatsuppression techniques were used. Qualitative evaluation parameters included LN contrast, motion susceptibility, visibility of anatomical structures, and fat suppression. The number of visible axillary and supraclavicular LNs was also determined. Results: T1 FFE, insensitive to motion, lacked contrast of LNs, which often blended in with soft tissue and blood. T2 FFE showed high contrast, but some LNs were obscured due to motion. Both 2D and 3D FSE were motion-insensitive having high contrast, although some blood remained visible. 2D FSE showed more anatomical details, while in 3D FSE, some blurring occurred. DWI showed high LN contrast, but suffered from geometric distortions and low resolution. Fat suppression by mDixon was the most reliable in regions with magnetic-field inhomogeneities. The FSE sequences showed the highest sensitivity for LN detection. Conclusion: MRI of regional LNs was achieved in volunteers. The FSE techniques were robust and the most sensitive. Our optimized MRI sequences can facilitate direct delineation of individual LNs. This can Result

  7. Neural Changes following Behavioral Activation for a Depressed Breast Cancer Patient: A Functional MRI Case Study

    Directory of Open Access Journals (Sweden)

    Michael J. Gawrysiak

    2012-01-01

    Full Text Available Functional neuroimaging is an innovative but at this stage underutilized method to assess the efficacy of psychotherapy for depression. Functional magnetic resonance imaging (fMRI was used in this case study to examine changes in brain activity in a depressed breast cancer patient receiving an 8-session Behavioral Activation Treatment for Depression (BATD, based on the work of Hopko and Lejuez (2007. A music listening paradigm was used during fMRI brain scans to assess reward responsiveness at pre- and posttreatment. Following treatment, the patient exhibited attenuated depression and changes in blood oxygenation level dependence (BOLD response in regions of the prefrontal cortex and the subgenual cingulate cortex. These preliminary findings outline a novel means to assess psychotherapy efficacy and suggest that BATD elicits functional brain changes in areas implicated in the pathophysiology of depression. Further research is necessary to explore neurobiological mechanisms of change in BATD, particularly the potential mediating effects of reward responsiveness and associated brain functioning.

  8. Association between dynamic features of breast DCE-MR imaging and clinical response of neoadjuvant chemotherapy: a preliminary analysis

    Science.gov (United States)

    Huang, Lijuan; Fan, Ming; Li, Lihua; Zhang, Juan; Shao, Guoliang; Zheng, Bin

    2016-03-01

    Neoadjuvant chemotherapy (NACT) is being used increasingly in the management of patients with breast cancer for systemically reducing the size of primary tumor before surgery in order to improve survival. The clinical response of patients to NACT is correlated with reduced or abolished of their primary tumor, which is important for treatment in the next stage. Recently, the dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is used for evaluation of the response of patients to NACT. To measure this correlation, we extracted the dynamic features from the DCE- MRI and performed association analysis between these features and the clinical response to NACT. In this study, 59 patients are screened before NATC, of which 47 are complete or partial response, and 12 are no response. We segmented the breast areas depicted on each MR image by a computer-aided diagnosis (CAD) scheme, registered images acquired from the sequential MR image scan series, and calculated eighteen features extracted from DCE-MRI. We performed SVM with the 18 features for classification between patients of response and no response. Furthermore, 6 of the 18 features are selected to refine the classification by using Genetic Algorithm. The accuracy, sensitivity and specificity are 87%, 95.74% and 50%, respectively. The calculated area under a receiver operating characteristic (ROC) curve is 0.79+/-0.04. This study indicates that the features of DCE-MRI of breast cancer are associated with the response of NACT. Therefore, our method could be helpful for evaluation of NACT in treatment of breast cancer.

  9. Evaluation of Fat Suppression of Diffusion-weighted Imaging Using Section Select Gradient Reversal Technique on 3 T Breast MRI.

    Science.gov (United States)

    Takemori, Daichi; Kimura, Daisuke; Yamada, Eiji; Higashida, Mitsuji

    2016-07-01

    This study evaluates fat suppression of diffusion-weighted imaging (DWI) using section select gradient reversal (SSGR) technique in clinical images on 3 T breast MRI. A total of 20 patients with breast cancer were examined at a Philips Ingenia 3 T MRI. We acquired DWI with SPAIR, SSGR-SPAIR, STIR, and SSGR-STIR. We evaluated contrast between the fat region and lesion, the coefficient of variance (CV) of the fat region and the apparent diffusion coefficient (ADC) of normal breast tissue and lesion. The contrast between the fat region and lesion was improved with SSGR technique. The CV of the fattest region did not have any significant difference in SPAIR technique (p>0.05), but it was significantly decreased in the STIR technique using SSGR technique (p<0.05). Positive correlation was observed in ADC value between SPAIR and other fat suppression techniques (SSGR-SPAIR, STIR, SSGR-STIR). DWI using SSGR technique was suggested to be effective on 3 T breast MRI.

  10. Accelerating PS model-based dynamic cardiac MRI using compressed sensing.

    Science.gov (United States)

    Zhang, Xiaoyong; Xie, Guoxi; Shi, Caiyun; Su, Shi; Zhang, Yongqin; Liu, Xin; Qiu, Bensheng

    2016-02-01

    High spatiotemporal resolution MRI is a challenging topic in dynamic MRI field. Partial separability (PS) model has been successfully applied to dynamic cardiac MRI by exploiting data redundancy. However, the model requires substantial preprocessing data to accurately estimate the model parameters before image reconstruction. Since compressed sensing (CS) is a potential technique to accelerate MRI by reducing the number of acquired data, the combination of PS and CS, named as Stepped-SparsePS, was introduced to accelerate the preprocessing data acquisition of PS in this work. The proposed Stepped-SparsePS method sequentially reconstructs a set of aliased dynamic images in each channel based on PS model and then the final dynamic images from the aliased images using CS. The results from numerical simulations and in vivo experiments demonstrate that Stepped-SparsePS could significantly reduce data acquisition time while preserving high spatiotemporal resolution. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Multi-slice MRI with the dynamic multi-coil technique.

    Science.gov (United States)

    Juchem, Christoph; Nahhass, Omar M; Nixon, Terence W; de Graaf, Robin A

    2015-11-01

    To date, spatial encoding for MRI is based on linear X, Y and Z field gradients generated by dedicated X, Y and Z wire patterns. We recently introduced the dynamic multi-coil technique (DYNAMITE) for the generation of magnetic field shapes for biomedical MR applications from a set of individually driven localized coils. The benefits for B0 magnetic field homogenization have been shown, as well as proof of principle of radial and algebraic MRI. In this study the potential of DYNAMITE MRI is explored further and the first multi-slice MRI implementation in which all gradient fields are purely DYNAMITE based is presented. The obtained image fidelity is shown to be virtually identical to that of a conventional MRI system with dedicated X, Y and Z gradient coils. Comparable image quality is a milestone towards the establishment of fully functional DYNAMITE MRI (and shim) systems.

  12. Accuracy of fully automated, quantitative, volumetric measurement of the amount of fibroglandular breast tissue using MRI: correlation with anthropomorphic breast phantoms.

    Science.gov (United States)

    Wengert, Georg J; Pinker, Katja; Helbich, Thomas H; Vogl, Wolf-Dieter; Spijker, Sylvia M; Bickel, Hubert; Polanec, Stephan H; Baltzer, Pascal A

    2017-06-01

    To demonstrate the accuracy of fully automated, quantitative, volumetric measurement of the amount of fibroglandular breast tissue (FGT), using MRI, and to investigate the impact of different MRI sequences using anthropomorphic breast phantoms as the ground truth. In this study, 10 anthropomorphic breast phantoms that consisted of different known fractions of adipose and protein tissue, which closely resembled normal breast parenchyma, were developed. Anthropomorphic breast phantoms were imaged with a 1.5 T unit (Siemens, Avantofit) using an 18-channel breast coil. The sequence protocol consisted of an isotropic Dixon sequence (Di), an anisotropic Dixon sequence (Da), and T1 3D FLASH sequences with and without fat saturation (T1). Fully automated, quantitative, volumetric measurement of FGT for all anthropomorphic phantoms and sequences was performed and correlated with the amounts of fatty and protein components in the phantoms as the ground truth. Fully automated, quantitative, volumetric measurements of FGT with MRI for all sequences ranged from 5.86 to 61.05% (mean 33.36%). The isotropic Dixon sequence yielded the highest accuracy (median 0.51%-0.78%) and precision (median range 0.19%) compared with anisotropic Dixon (median 1.92%-2.09%; median range 0.55%) and T1 -weighted sequences (median 2.54%-2.46%; median range 0.82%). All sequences yielded good correlation with the FGT content of the anthropomorphic phantoms. The best correlation of FGT measurements was identified for Dixon sequences (Di, R(2)  = 0.999; Da, R(2)  = 0.998) compared with conventional T1 -weighted sequences (R(2)  = 0.971). MRI yields accurate, fully automated, quantitative, volumetric measurements of FGT, an increasingly important and sensitive imaging biomarker for breast cancer risk. Compared with conventional T1 sequences, Dixon-type sequences show the highest correlation and reproducibility for automated, quantitative, volumetric FGT measurements using anthropomorphic breast

  13. Effectiveness of dynamic contrast-enhanced magnetic resonance imaging in evaluating clinical responses to neoadjuvant chemotherapy in breast cancer

    Institute of Scientific and Technical Information of China (English)

    LIU Yin-hua; YE Jing-ming; XU Ling; HUANG Qing-yun; ZHAO Jian-xin; DUAN Xue-ning; QIN Nai-shan; WANG Xiao-ying

    2011-01-01

    Background Use of neoadjuvant chemotherapy necessitates assessment of response to cytotoxic drugs.The aim of this research was to investigate the effectiveness of dynamic contrast-enhanced magnetic resonance imaging (MRI) for evaluating clinical responses to neoadjuvant chemotherapy in breast cancer patients.Methods We examined patients receiving neoadjuvant chemotherapy for primary breast cancer between October 2007and September 2008.Dynamic contrast-enhanced MRI was used to examine breast tumors prior to and after neoadjuvant chemotherapy.The MRI examination assessed tumors using Response Evaluation Criteria in Solid Tumors (RECIST).The Miller-Payne grading system was used as a histopathological examination to assess the effect of the treatment.We examined the relationship between the results of RECIST and histopathological criteria.In addition,we used time-signal intensity curves (MRI T-SI) to further evaluate the effects of neoadjuvant chemotherapy on tumor response.Results MRI examination of patients completing four three-week anthracycline-taxanes chemotherapy treatment revealed that no patients had complete responses (CR),58 patients had partial responses (PR),29 patients had stable disease (SD),and four with progressive disease (PD).The effectiveness of neoadjuvant chemotherapy (CR + PR) was 63.7% (58/91).The postoperative histopathological evaluations revealed the following:seven G5 (pCR) cases (7.7%),39G4 cases (42.9%),16 G3 cases (17.6%),23 G2 cases (25.3%),and six G1 cases (6.6%).The effectiveness (G5 + G4 +G3) was 68.1% (62/91).MRI T-SI standards classified 53 responding cases,29 stable cases,and nine progressing cases.These results indicated that the treatment was 58.2% effective (53/91) overall.Conclusions Dynamic contrast-enhanced MRI and histopathological standards were highly correlated.Importantly,MRI T-SI evaluation was found to be useful in assessing the clinical effectiveness of neoadjuvant chemotherapy.

  14. Design of an MRI-compatible robotic stereotactic device for minimally invasive interventions in the breast.

    Science.gov (United States)

    Larson, Blake T; Erdman, Arthur G; Tsekos, Nikolaos V; Yacoub, Essa; Tsekos, Panagiotis V; Koutlas, Ioannis G

    2004-08-01

    The objective of this work was to develop a robotic device to perform biopsy and therapeutic interventions in the breast with real-time magnetic resonance imaging (MRI) guidance. The device was designed to allow for (i) stabilization of the breast by compression, (ii) definition of the interventional probe trajectory by setting the height and pitch of a probe insertion apparatus, and (iii) positioning of an interventional probe by setting the depth of insertion. The apparatus is fitted with five computer-controlled degrees of freedom for delivering an interventional procedure. The entire device is constructed of MR compatible materials, i.e. nonmagnetic and non-conductive, to eliminate artifacts and distortion of the MR images. The apparatus is remotely controlled by means of ultrasonic motors and a graphical user interface, providing real-time MR-guided planning and monitoring of the operation. Joint motion measurements found probe placement in less than 50 s and sub-millimeter repeatability of the probe tip for same-direction point-to-point movements. However, backlash in the rotation joint may incur probe tip positional errors of up to 5 mm at a distance of 40 mm from the rotation axis, which may occur for women with large breasts. The imprecision caused by this backlash becomes negligible as the probe tip nears the rotation axis. Real-time MR-guidance will allow the physician to correct this error Compatibility of the device within the MR environment was successfully tested on a 4 Tesla MR human scanner

  15. Characterization of ductal carcinoma in situ on diffusion weighted breast MRI

    Energy Technology Data Exchange (ETDEWEB)

    Rahbar, Habib; Partridge, Savannah C.; Eby, Peter R.; DeMartini, Wendy B.; Gutierrez, Robert L.; Peacock, Sue; Lehman, Constance D. [University of Washington, Seattle Cancer Care Alliance, Department of Radiology, Seattle, WA (United States)

    2011-09-15

    To characterize ductal carcinoma in situ (DCIS) and its subtypes on diffusion-weighted imaging (DWI). We retrospectively reviewed 74 pure DCIS lesions in 69 women who underwent DWI at 1.5 T (b = 0 and 600 s/mm{sup 2}). Each lesion was characterized by qualitative DWI intensity, quantitative DWI lesion-to-normal contrast-to-noise ratio (CNR), and quantitative apparent diffusion coefficient (ADC). The detection rate was calculated with predetermined thresholds for each parameter. The effects of lesion size, grade, morphology, and necrosis were assessed. Ninety-six percent (71/74) of DCIS lesions demonstrated greater qualitative DWI intensity than normal breast tissue. Quantitatively, DCIS lesions demonstrated on average 56% greater signal than normal tissue (mean CNR = 1.83 {+-} 2.7) and lower ADC values (1.50 {+-} 0.28 x 10{sup -3} mm{sup 2}/s) than normal tissue (2.01 {+-} 0.37 x 10{sup -3} mm{sup 2}/s, p < 0.0001). A 91% detection rate was achieved utilizing an ADC threshold (<1.81 x 10{sup -3} mm{sup 2}/s). Non-high-grade DCIS exhibited greater qualitative DWI intensity (p = 0.02) and quantitative CNR (p = 0.01) than high-grade DCIS but no difference in ADC (p = 0.40). Lesion size, morphology, and necrosis did not affect qualitative or quantitative DWI parameters of DCIS lesions (p > 0.05). DCIS lesions have higher DWI signal intensity and lower ADC values than normal breast tissue. DWI warrants further investigation as a potential non-contrast MRI tool for early breast cancer detection. (orig.)

  16. MRI-only lesions: application of diffusion-weighted imaging obviates unnecessary MR-guided breast biopsies

    Energy Technology Data Exchange (ETDEWEB)

    Spick, Claudio; Pinker-Domenig, Katja; Helbich, Thomas H.; Baltzer, Pascal A. [Medical University of Vienna (AKH), General Hospital Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Wien (Austria); Rudas, Margaretha [Medical University of Vienna (AKH), Clinical Institute of Pathology, Wien (Austria)

    2014-06-15

    To assess if the application of diffusion-weighted imaging (DWI) obviates unnecessary MR-guided biopsies in suspicious breast lesions visible only on contrast-enhanced MRI (CE-MRI). This institutional review board (IRB)-approved, retrospective, single-centre study included 101 patients (mean age, 49.5; SD 13.9 years) who underwent additional DWI at 1.5 T prior to MRI-guided biopsy of 104 lesions classified as suspicious for malignancy and visible on CE-MRI only. An experienced radiologist, blinded to histopathologic and follow-up results, measured apparent diffusion coefficient (ADC) values obtained from DWI. Diagnostic accuracy was investigated using receiver operating characteristics (ROC) analysis. Histopathology revealed 20 malignant and 84 benign lesions. Lesions were masses in 61 (15 malignant, 24.6 %) and non-masses in 43 cases (five malignant, 11.6 %). Mean ADC values were 1.53 ± 0.38 x 10{sup -3} mm{sup 2}/s in benign lesions and 1.06 ± 0.27 x 10{sup -3} mm{sup 2}/s in malignant lesions. ROC analysis revealed exclusively benign lesions if ADC values were greater than 1.58 x 10{sup -3} mm{sup 2}/s. As a consequence, 29 false-positive biopsies (34.5 %) could have been avoided without any false-negative findings. Both in mass and in non-mass lesions, rule-in and rule-out criteria were identified using flexible ADC thresholds based on ROC analysis. Additional application of DWI in breast lesions visible only on MRI can avoid false-positive, MR-guided biopsies. Thus, DWI should be an integral part of breast MRI protocols. (orig.)

  17. Clinical application of bilateral high temporal and spatial resolution dynamic contrast-enhanced magnetic resonance imaging of the breast at 7 T

    Energy Technology Data Exchange (ETDEWEB)

    Pinker, K.; Baltzer, P.; Bernathova, M.; Weber, M.; Leithner, D.; Helbich, T.H. [Medical University Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Waehringer Guertel 18-20, 1090, Vienna (Austria); Bogner, W.; Trattnig, S.; Gruber, S.; Zaric, O. [Medical University Vienna, Department of Biomedical Imaging and Image-guided Therapy, MR Centre of Excellence, Vienna (Austria); Abeyakoon, O. [King' s College, Department of Radiology, London (United Kingdom); Dubsky, P. [Medical University Vienna, Department of Surgery, Vienna (Austria); Bago-Horvath, Z. [Medical University Vienna, Department of Pathology, Vienna (Austria)

    2014-04-15

    The objective of our study was to evaluate the clinical application of bilateral high spatial and temporal resolution dynamic contrast-enhanced magnetic resonance imaging (HR DCE-MRI) of the breast at 7 T. Following institutional review board approval 23 patients with a breast lesion (BIRADS 0, 4-5) were included in our prospective study. All patients underwent bilateral HR DCE-MRI of the breast at 7 T (spatial resolution of 0.7 mm{sup 3} voxel size, temporal resolution of 14 s). Two experienced readers (r1, r2) and one less experienced reader (r3) independently assessed lesions according to BI-RADS registered. Image quality, lesion conspicuity and artefacts were graded from 1 to 5. Sensitivity, specificity and diagnostic accuracy were assessed using histopathology as the standard of reference. HR DCE-MRI at 7 T revealed 29 lesions in 23 patients (sensitivity 100 % (19/19); specificity of 90 % (9/10)) resulting in a diagnostic accuracy of 96.6 % (28/29) with an AUC of 0.95. Overall image quality was excellent in the majority of cases (27/29) and examinations were not hampered by artefacts. There was excellent inter-reader agreement for diagnosis and image quality parameters (κ = 0.89-1). Bilateral HR DCE-MRI of the breast at 7 T is feasible with excellent image quality in clinical practice and allows accurate breast cancer diagnosis. (orig.)

  18. The value of breast MRI in high-risk patients with newly diagnosed breast cancer to exclude invasive disease in the contralateral prophylactic mastectomy: Is there a role to choose wisely patients for sentinel node biopsy?

    Science.gov (United States)

    Freitas, Vivianne; Crystal, Pavel; Kulkarni, Supriya R; Ghai, Sandeep; Bukhanov, Karina; Escallon, Jaime; Scaranelo, Anabel M

    2016-06-01

    The aim of this study was to evaluate the presence of clinically and mammographically occult disease using breast MRI in a cohort of cancer patients undergoing contralateral prophylactic mastectomy (CPM) and the utmost indication of axillary assessment (sentinel node biopsy (SLNB)) for this side. A retrospective review of patients with unilateral invasive breast cancer or ductal carcinoma in situ (DCIS) from institutional MRI registry data (2004-2010) was conducted. Characteristics of patients undergoing CPM with breast MRI obtained less than 6 month before surgery were evaluated. A total of 2322 consecutive patients diagnosed with DCIS or stage I to III infiltrating breast cancer underwent preoperative breast MRI. Of these, 1376 patients (59.2%) had contralateral clinical breast exam and mammography without abnormalities; and 116 patients (4.9%) underwent CPM (28 excluded patients had breast MRI more than 6 months before CPM). The mean age of the 88 patients was 49 years (range 28-76 years). Two (2.3%) DCIS identified on surgical pathology specimen were not depicted by MRI and the 5 mm T1N0 invasive cancer (1.1%) was identified on MRI. Preoperative MRI showed 95% accuracy to demonstrate absence of occult disease with negative predicted value (NPV) of 98% (95% CI: 91.64-99.64%). Occult disease was present in 3.4% of CPM. MRI accurately identified the case of invasive cancer in this cohort. The high negative predictive value suggests that MRI can be used to select patients without consideration of SLNB for the contralateral side.

  19. Colpocystoproctography in the upright and supine positions correlated with dynamic MRI of the pelvic floor

    Energy Technology Data Exchange (ETDEWEB)

    Gufler, Hubert E-mail: hubert.gufler@radiol.med.uni-giessen.de; Ohde, Angelika; Grau, Gabriele; Grossmann, Anette

    2004-07-01

    Purpose: To test whether there are statistically significant differences between measurement results on colpocystoproctography in the upright and the supine positions, and to correlate these results with dynamic MRI. Patients and Methods: Seven patients with pelvic floor descent had received colpocystoproctography in the upright and supine positions and, additionally, dynamic MRI of the pelvic floor. Bladder neck position, angle of urethral inclination, posterior vesicourethral angle, and vaginal vault position were measured at relaxed pelvic floor and at pelvic strain. Differences between the measurement results of each parameter in the upright and supine position on colpocystoproctography were calculated and correlated with the measurement results from the dynamic MRI. Results: At pelvic strain, bladder neck position, angle of urethral inclination, posterior vesicourethral angle and vaginal vault position measurements showed no statistically significant differences between colpocystoproctography in the upright and supine positions or dynamic MRI. For the bladder neck height at pelvic floor relaxation, significant differences were found between colpocystoproctography in the upright and supine positions, and colpocystoproctography in the upright position versus dynamic MRI. Conclusion: At pelvic strain, measurement data from dynamic MRI are not statistically different from data from colpocystoproctography either in supine and upright positions.

  20. Dynamic 3 T MRI of temporomandibular joint in diagnosing a stuck disk

    Directory of Open Access Journals (Sweden)

    J Sureka

    2012-01-01

    Full Text Available Magnetic resonance imaging (MRI is the imaging modality of choice in the evaluation of internal derangement of the temporomandibular joint (TMJ. Dynamic MRI including the open and close mouth views in sagittal plane determine the exact position of articular disk and thus help to evaluate the joint for internal derangement. We also highlight the role of dynamic MRI of TMJ in diagnosis of stuck disk in a 17-year-old male who presented with symptoms of pain and difficulty in opening the mouth.

  1. Breast MRI BI-RADS assessments and abnormal interpretation rates by clinical indication in US community practices.

    Science.gov (United States)

    Lee, Christoph I; Ichikawa, Laura; Rochelle, Michele C; Kerlikowske, Karla; Miglioretti, Diana L; Sprague, Brian L; DeMartini, Wendy B; Wernli, Karen J; Joe, Bonnie N; Yankaskas, Bonnie C; Lehman, Constance D

    2014-11-01

    As breast magnetic resonance imaging (MRI) use grows, benchmark performance parameters are needed for auditing and quality assurance purposes. We describe the variation in breast MRI abnormal interpretation rates (AIRs) by clinical indication among a large sample of US community practices. We analyzed data from 41 facilities across five Breast Cancer Surveillance Consortium imaging registries. Each registry obtained institutional review board approval for this Health Insurance Portability and Accountability Act compliant analysis. We included 11,654 breast MRI examinations conducted in 2005-2010 among women aged 18-79 years. We categorized clinical indications as 1) screening, 2) extent of disease, 3) diagnostic (eg, breast symptoms), and 4) other (eg, short-interval follow-up). We characterized assessments as positive (ie, Breast Imaging Reporting and Data System [BI-RADS] 0, 4, and 5) or negative (ie, BI-RADS 1, 2, and 6) and provide results with BI-RADS 3 categorized as positive and negative. We tested for differences in AIRs across clinical indications both unadjusted and adjusted for patient characteristics and registry and assessed for changes in AIRs by year within each clinical indication. When categorizing BI-RADS 3 as positive, AIRs were 21.0% (95% confidence interval [CI], 19.8-22.3) for screening, 31.7% (95% CI, 29.6-33.8) for extent of disease, 29.7% (95% CI, 28.3-31.1) for diagnostic, and 27.4% (95% CI, 25.0-29.8) for other indications (P assurance and auditing purposes. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

  2. Breast imaging reporting and data system (BI-RADS) lexicon for breast MRI: Interobserver variability in the description and assignment of BI-RADS category

    Energy Technology Data Exchange (ETDEWEB)

    El Khoury, Mona, E-mail: monelkhoury@gmail.com [Centre Hospitalier Universitaire de Montréal, Breast Centre, Radiology Department, 3840 Rue Saint Urbain, Montréal, QC H2W1T8 (Canada); Lalonde, Lucie; David, Julie; Labelle, Maude [Centre Hospitalier Universitaire de Montréal, Breast Centre, Radiology Department, 3840 Rue Saint Urbain, Montréal, QC H2W1T8 (Canada); Mesurolle, Benoit [Centre Hospitalier Universitaire de McGill, Cedar Breast Centre, Radiology Department, 687 Pine Avenue West, Montreal, QC H3A1A1 (Canada); Trop, Isabelle [Centre Hospitalier Universitaire de Montréal, Breast Centre, Radiology Department, 3840 Rue Saint Urbain, Montréal, QC H2W1T8 (Canada)

    2015-01-15

    Highlights: • The use of BI-RADS lexicon in interpreting breast MRI examinations is beneficial. • Our study shows: (a) moderate to substantial agreement between observers and (b) better agreement in interpreting mass than non-mass enhancement (NME). • Careful analysis of the NME should be done to help detect cancer as early as possible. - Abstract: Purpose: To retrospectively evaluate interobserver variability between breast radiologists when describing abnormal enhancement on breast MR examinations and assigning a BI-RADS category using the Breast Imaging Reporting and Data System (BI-RADS) terminology. Materials and methods: Five breast radiologists blinded to patients’ medical history and pathologic results retrospectively and independently reviewed 257 abnormal areas of enhancement on breast MRI performed in 173 women. Each radiologist described the focal enhancement using BI-RADS terminology and assigned a final BI-RADS category. Krippendorff's α coefficient of agreement was used to asses interobserver variability. Results: All radiologists agreed on the morphology of enhancement in 183/257 (71%) lesions, yielding a substantial agreement (Krippendorff's α = 0.71). Moderate agreement was obtained for mass descriptors – shape, margins and internal enhancement – (α = 0.55, 0.51 and 0.45 respectively) and NME (non-mass enhancement) descriptors – distribution and internal enhancement – (α = 0.54 and 0.43). Overall substantial agreement was obtained for BI-RADS category assignment (α = 0.71). It was however only moderate (α = 0.38) for NME compared to mass (α = 0.80). Conclusion: Our study shows good agreement in describing mass and NME on a breast MR examination but a better agreement in predicting malignancy for mass than NME.

  3. Automated analysis of non-mass-enhancing lesions in breast MRI based on morphological, kinetic, and spatio-temporal moments and joint segmentation-motion compensation technique

    Science.gov (United States)

    Hoffmann, Sebastian; Shutler, Jamie D.; Lobbes, Marc; Burgeth, Bernhard; Meyer-Bäse, Anke

    2013-12-01

    Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) represents an established method for the detection and diagnosis of breast lesions. While mass-like enhancing lesions can be easily categorized according to the Breast Imaging Reporting and Data System (BI-RADS) MRI lexicon, a majority of diagnostically challenging lesions, the so called non-mass-like enhancing lesions, remain both qualitatively as well as quantitatively difficult to analyze. Thus, the evaluation of kinetic and/or morphological characteristics of non-masses represents a challenging task for an automated analysis and is of crucial importance for advancing current computer-aided diagnosis (CAD) systems. Compared to the well-characterized mass-enhancing lesions, non-masses have no well-defined and blurred tumor borders and a kinetic behavior that is not easily generalizable and thus discriminative for malignant and benign non-masses. To overcome these difficulties and pave the way for novel CAD systems for non-masses, we will evaluate several kinetic and morphological descriptors separately and a novel technique, the Zernike velocity moments, to capture the joint spatio-temporal behavior of these lesions, and additionally consider the impact of non-rigid motion compensation on a correct diagnosis.

  4. Real-time MRI navigated US: Role in diagnosis and guided biopsy of incidental breast lesions and axillary lymph nodes detected on breast MRI but not on second look US

    Energy Technology Data Exchange (ETDEWEB)

    Pons, Elena Pastor, E-mail: elenapastorpons@gmail.com; Azcón, Francisco Miras, E-mail: frmiaz00@gmail.com; Casas, María Culiañez, E-mail: mariacc1980@gmail.com; Meca, Salvador Martínez, E-mail: isalvaa@hotmail.com; Espona, José Luis García, E-mail: gespona@hotmail.com

    2014-06-15

    Objectives: To prospectively evaluate the accuracy of real-time ultrasound combined with supine-MRI using volume navigation technique (RtMR-US) in diagnosis and biopsy of incidental breast lesions (ILSM) and axillary lymph nodes (LNSM) suspicious of malignancy on contrast enhanced magnetic resonance imaging (CE-MRI). Materials and methods: Five hundred and seventy-seven women were examined using breast CE-MRI. Those with incidental breast lesions not identified after second-look ultrasound (US) were recruited for RtMR-US. Biopsy was performed in ILSM. Breast lesions were categorized with BI-RADS system and Fisher’ exact test. Axillary lymph nodes morphology was described. To assess efficacy of RtMR-US, diagnostic accuracy, sensitivity, specificity, detection rate and Kappa index of conventional-US and RtMR-US were calculated. Results: Forty-three lesions were detected on CE-MRI before navigation. Eighteen were carcinomas and 25 ILSM. Of these, 21 underwent a RtMR-US. Detection rate on RtMR-US (90.7%) was higher than on conventional-US (43%) (p < 0.001). Agreement between both techniques was low (k = 0.138). Twenty ILSM and 2 LNSM were biopsied. Sixty-five percent were benign (100% of BI-RADS3 and 56% of BI-RADS4-5). Diagnostic performance of RtMR-US identifying malignant nodules for overall lesions and for the subgroup of ILSM was respectively: sensitivity 96.3% and 100%, specificity 18.8% and 30.7%, positive predictive value 66.7% and 43.7%, negative predictive value 75% and 100%. In addition RtMR-US enabled biopsy of 2 metastatic lymph nodes. Conclusions: Real time-US with supine-MRI using a volume navigation technique increases the detection of ILSM. RtMR-US may be used to detect occult breast carcinomas and to assess cancer extension, preventing unnecessary MRI-guided biopsies and sentinel lymph node biopsies. Incidental lesions BI-RADS 3 non-detected on conventional-US are probably benign.

  5. Diffusion-weighted MRI, dynamic susceptibility contrast MRI and ultrasound perfusion quantification of denervated muscle in rabbits

    Energy Technology Data Exchange (ETDEWEB)

    Goyault, G.; Beregi, J.P. [University Hospital, Department of Cardiovascular imaging, Cardiologic Hospital, Lille (France); Bierry, G.; Holl, N.; Dietemann, J.L.; Kremer, S. [University Hospital, Department of Neuroradiology, Strasbourg (France); Lhermitte, B. [University Hospital, Department of Pathology, Strasbourg (France)

    2012-01-15

    The purpose of this study was to assess denervated muscle perfusion using dynamic susceptibility contrast MRI (DSCMRI) and contrast-enhanced ultrasound (CEUS), and to measure denervated muscle apparent diffusion coefficient (ADC) on b1000 diffusion-weighted MRI (DWMRI) at 3 T in order to clarify whether muscle denervation leads to an increase in the extracellular extravascular space, or an increase in blood flow - or both. Axotomy of the right sciatic nerve of six white rabbits was performed at day 0. At day 9, hind limb muscles MRI and CEUS were performed to assess the consequences of denervation and both semimembranosus muscles of each rabbit were explanted for histological studies. Signal intensity on T2- and T1-weighted MRI, ADC on DWMRI, maximum signal drop (MSD) on DSCMRI and the area under the curve (AUC) on CEUS were measured over circular regions of interest (ROI), in both semimembranosus muscles. Non-parametric Wilcoxon matched-pairs tests were used to assess the mean differences between denervated and normal muscles. T2 fat-saturated (FS) MRI studies showed a strong signal in the right semimembranosus muscles compared with the left side, and gadolinium enhancement was observed on T1 FS MRI. Denervated muscles show a significant increase in ADC on DWMRI (p < 0.01) and a significant signal enhancement on DSCMR imaging (p < 0.05) and on first-pass CEUS (p < 0.05). The results of this study - based on perfusion- and diffusion-weighted images - suggest that, after denervation, both increased blood flow through muscle tissue and expansion of the extracellular water volume are present. (orig.)

  6. Assessment of swallowing and its disorders—A dynamic MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Vijay Kumar, K.V., E-mail: vijaykumarkv@yahoo.in [Department of Speech, Language and Hearing Sciences, SRU (India); Shankar, V., E-mail: drshankarv@yahoo.co.in [Department of Neurology, SRU (India); Santosham, Roy, E-mail: santoshamroy@yahoo.com [Department of Radiology and Imaging Sciences, SRU (India)

    2013-02-15

    Magnetic resonance imaging overcomes the limitations of videofluoroscopy in assessing without radiation exposure. The clinical utility of dynamic MRI for swallowing disorders is not well documented. This study demonstrates the feasibility of using dynamic MRI in assessment of swallowing disorders. Ten normal and three brainstem lesion patients participated in this study. GE Signa HDxt 1.5 Tesla MRI scanner with head-and-neck coil as a receiver and fast imaging employing steady state acquisition sequence was used. The swallow was analyzed in terms of symmetry and amplitude of movements of velum, faucial pillars, tongue, epiglottis and cricopharyngeous and images from the sagittal, coronal and axial planes. In sagittal plane posterior movement of tongue and its compression on velum, elevation of hyoid bone, elevation of larynx and lid action of epiglottis, in the coronal view the symmetrical movements of the faucial pillars and pharyngeal constrictor muscles and in axial plane three anatomical landmarks were targeted based on their role in swallowing, viz. velum, epiglottis and cricopharyngeous were studied. In brainstem lesion individuals, posterior movement of tongue, and elevation of larynx were not seen. Asymmetrical movements of faucial pillars and cricopharyngeous muscle were appreciated in the dynamic MRI. This demonstrates that, dynamic MRI is an efficient tool to understand the swallowing physiology and helps the speech language pathologist in modifying the swallowing maneuvers. Dynamic MRI is an effective tool in assessing swallowing and its disorders. This muscle specific information is not appreciated in videofluoroscopy and this information is necessary to modify the therapy maneuvers.

  7. 磁共振成像在乳腺癌中的应用%Application of MRI in Breast Carcinoma

    Institute of Scientific and Technical Information of China (English)

    吴艳梅

    2011-01-01

    Breast cancer is one of the most common carcinoma in women and its mortality is quite high.Magnetic resonance imaging( MRI ) has unique advantages due to its inherently high soft-tissue resolution and no radiation. It plays an important role in diagnosis of breast cancer and establishing of operation solution and differentiation of tumor recurrence. It can detect primary breast cancers and additional foci of cancers that are occult to standard imaging, and can be used for screening high-risk populations. Here is to review the performances of MRI imaging, as well as it applications in the diagnosis and treatment of breast cancer,in order to promote popularization and applications of MRI.%乳腺癌是女性常见的恶性肿瘤之一,病死率较高.磁共振成像(MRI)具有极好的软组织分辨率和无辐射特点,对乳腺检查具有独到的优势.MRI对乳腺癌的诊断、手术方案的制订及鉴别复发有重要作用,能监测到原位癌、多灶性癌,可用于高危人群的普查.现就乳腺癌MRI影像表现及MRI技术在乳腺癌诊断和治疗中的作用予以综述,旨在促进其推广和应用.

  8. The value of breast MRI in high‐risk patients with newly diagnosed breast cancer to exclude invasive disease in the contralateral prophylactic mastectomy: Is there a role to choose wisely patients for sentinel node biopsy?

    OpenAIRE

    Freitas, Vivianne; Crystal, Pavel; Kulkarni, Supriya R.; Ghai, Sandeep; Bukhanov, Karina; Escallon, Jaime; Scaranelo, Anabel M.

    2016-01-01

    Abstract The aim of this study was to evaluate the presence of clinically and mammographically occult disease using breast MRI in a cohort of cancer patients undergoing contralateral prophylactic mastectomy (CPM) and the utmost indication of axillary assessment (sentinel node biopsy (SLNB)) for this side. A retrospective review of patients with unilateral invasive breast cancer or ductal carcinoma in situ (DCIS) from institutional MRI registry data (2004–2010) was conducted. Characteristics o...

  9. Breast MRI in Patients with Unilateral Bloody and Serous-Bloody Nipple Discharge: A Comparison with Galactography

    Directory of Open Access Journals (Sweden)

    Lucia Manganaro

    2015-01-01

    Full Text Available Purpose. Assessing the role of breast MRI compared to galactography in patients with unilateral bloody or serous-bloody nipple discharge. Materials and Methods. Retrospective study including 53 unilateral discharge patients who performed galactography and MRI. We evaluated the capability of both techniques in identifying pathology and distinguishing between nonmalignant and malignant lesions. Lesions BIRADS 1/2 underwent follow-up, while the histological examination after surgery has been the gold standard to assess pathology in lesions BIRADS 3/4/5. The ROC analysis was used to test diagnostic MRI and galactography ability. Results. After surgery and follow-up, 8 patients had no disease (15%, 23 papilloma (43%, 11 papillomatosis (21%, 5 ductal cancer in situ (10%, and 6 papillary carcinoma (11% diagnoses. Both techniques presented 100% specificity; MRI sensitivity was 98% versus 49% of galactography. Considering MRI, we found a statistical association between mass enhancement and papilloma (P<0.001; AUC 0.957; CI 0.888–1.025, ductal enhancement and papillomatosis (P<0.001; AUC 0.790; CI 0.623–0.958, segmental enhancement and ductal cancer in situ (P=0.007; AUC 0.750; CI 0.429–1.071, and linear enhancement and papillary cancer (P=0.011. Conclusions. MRI is a valid tool to detect ductal pathologies in patients with suspicious bloody or serous-bloody discharge showing higher sensitivity and specificity compared to galactography.

  10. Breast MRI in patients with unilateral bloody and serous-bloody nipple discharge: a comparison with galactography.

    Science.gov (United States)

    Manganaro, Lucia; D'Ambrosio, Ilaria; Gigli, Silvia; Di Pastena, Francesca; Giraldi, Guglielmo; Tardioli, Stefano; Framarino, Marialuisa; Porfiri, Lucio Maria; Ballesio, Laura

    2015-01-01

    Assessing the role of breast MRI compared to galactography in patients with unilateral bloody or serous-bloody nipple discharge. Retrospective study including 53 unilateral discharge patients who performed galactography and MRI. We evaluated the capability of both techniques in identifying pathology and distinguishing between nonmalignant and malignant lesions. Lesions BIRADS 1/2 underwent follow-up, while the histological examination after surgery has been the gold standard to assess pathology in lesions BIRADS 3/4/5. The ROC analysis was used to test diagnostic MRI and galactography ability. After surgery and follow-up, 8 patients had no disease (15%), 23 papilloma (43%), 11 papillomatosis (21%), 5 ductal cancer in situ (10%), and 6 papillary carcinoma (11%) diagnoses. Both techniques presented 100% specificity; MRI sensitivity was 98% versus 49% of galactography. Considering MRI, we found a statistical association between mass enhancement and papilloma (P < 0.001; AUC 0.957; CI 0.888-1.025), ductal enhancement and papillomatosis (P < 0.001; AUC 0.790; CI 0.623-0.958), segmental enhancement and ductal cancer in situ (P = 0.007; AUC 0.750; CI 0.429-1.071), and linear enhancement and papillary cancer (P = 0.011). MRI is a valid tool to detect ductal pathologies in patients with suspicious bloody or serous-bloody discharge showing higher sensitivity and specificity compared to galactography.

  11. Quantitative Assessment of Breast Parenchymal Uptake on 18F-FDG PET/CT: Correlation with Age, Background Parenchymal Enhancement, and Amount of Fibroglandular Tissue on MRI.

    Science.gov (United States)

    Leithner, Doris; Baltzer, Pascal A; Magometschnigg, Heinrich F; Wengert, Georg J; Karanikas, Georgios; Helbich, Thomas H; Weber, Michael; Wadsak, Wolfgang; Pinker, Katja

    2016-10-01

    Background parenchymal enhancement (BPE), and the amount of fibroglandular tissue (FGT) assessed with MRI have been implicated as sensitive imaging biomarkers for breast cancer. The purpose of this study was to quantitatively assess breast parenchymal uptake (BPU) on (18)F-FDG PET/CT as another valuable imaging biomarker and examine its correlation with BPE, FGT, and age.

  12. Human cerebral blood volume measurements using dynamic contrast enhancement in comparison to dynamic susceptibility contrast MRI

    Energy Technology Data Exchange (ETDEWEB)

    Artzi, Moran [Tel Aviv Sourasky Medical Center, Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv (Israel); Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Liberman, Gilad; Vitinshtein, Faina; Aizenstein, Orna [Tel Aviv Sourasky Medical Center, Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv (Israel); Nadav, Guy [Tel Aviv Sourasky Medical Center, Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv (Israel); Tel Aviv University, Faculty of Engineering, Tel Aviv (Israel); Blumenthal, Deborah T.; Bokstein, Felix [Tel Aviv Sourasky Medical Center, Neuro-Oncology Service, Tel Aviv (Israel); Bashat, Dafna Ben [Tel Aviv Sourasky Medical Center, Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv (Israel); Tel Aviv University, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv (Israel)

    2015-07-15

    Cerebral blood volume (CBV) is an important parameter for the assessment of brain tumors, usually obtained using dynamic susceptibility contrast (DSC) MRI. However, this method often suffers from low spatial resolution and high sensitivity to susceptibility artifacts and usually does not take into account the effect of tissue permeability. The plasma volume (v{sub p}) can also be extracted from dynamic contrast enhancement (DCE) MRI. The aim of this study was to investigate whether DCE can be used for the measurement of cerebral blood volume in place of DSC for the assessment of patients with brain tumors. Twenty-eight subjects (17 healthy subjects and 11 patients with glioblastoma) were scanned using DCE and DSC. v{sub p} and CBV values were measured and compared in different brain components in healthy subjects and in the tumor area in patients. Significant high correlations were detected between v{sub p} and CBV in healthy subjects in the different brain components; white matter, gray matter, and arteries, correlating with the known increased tissue vascularity, and within the tumor area in patients. This work proposes the use of DCE as an alternative method to DSC for the assessment of blood volume, given the advantages of its higher spatial resolution, its lower sensitivity to susceptibility artifacts, and its ability to provide additional information regarding tissue permeability. (orig.)

  13. The Lumbar Spine as a Dynamic Structure Depicted in Upright MRI.

    Science.gov (United States)

    Kubosch, David; Vicari, Marco; Siller, Alexander; Strohm, Peter C; Kubosch, Eva J; Knöller, Stefan; Hennig, Jürgen; Südkamp, Norbert P; Izadpanah, Kaywan

    2015-08-01

    Spinal canal stenosis is a dynamic phenomenon that becomes apparent during spinal loading. Current diagnostic procedures have considerable short comings in diagnosing the disease to full extend, as they are performed in supine situation. Upright MRI imaging might overcome this diagnostic gap.This study investigated the lumbar neuroforamenal diameter, spinal canal diameter, vertebral body translation, and vertebral body angles in 3 different body positions using upright MRI imaging.Fifteen subjects were enrolled in this study. A dynamic MRI in 3 different body positions (at 0° supine, 80° upright, and 80° upright + hyperlordosis posture) was taken using a 0.25 T open-configuration scanner equipped with a rotatable examination bed allowing a true standing MRI.The mean diameter of the neuroforamen at L5/S1 in 0° position was 8.4 mm on the right and 8.8 mm on the left, in 80° position 7.3 mm on the right and 7.2 mm on the left, and in 80° position with hyperlordosis 6.6 mm (P dynamic process, that can be displayed in upright MRI imaging. The range of anomalies is clinically relevant and dynamic positioning of the patient during MRI can provide essential diagnostic information which are not attainable with other methods.

  14. Differences in perfusion parameters between upper and lower lumbar vertebral segments with dynamic contrast-enhanced MRI (DCE MRI)

    Energy Technology Data Exchange (ETDEWEB)

    Savvopoulou, Vasiliki; Vlahos, Lampros; Moulopoulos, Lia Angela [University of Athens, Areteion Hospital, Department of Radiology, Medical School, Athens (Greece); Maris, Thomas G. [University of Crete, Deparment of Medical Physics, Faculty of Medicine, Heraklion (Greece)

    2008-09-15

    To investigate the influence of age, sex and spinal level on perfusion parameters of normal lumbar bone marrow with dynamic contrast-enhanced MRI (DCE MRI). Sixty-seven subjects referred for evaluation of low back pain or sciatica underwent DCE MRI of the lumbar spine. After subtraction of dynamic images, a region of interest (ROI) was placed on each lumbar vertebral body of all subjects, and time intensity curves were generated. Consequently, perfusion parameters were calculated. Statistical analysis was performed to search for perfusion differences among lumbar vertebrae and in relation to age and sex. Upper (L1, L2) and lower (L3, L4, L5) vertebrae showed significant differences in perfusion parameters (p<0.05). Vertebrae of subjects younger than 50 years showed significantly higher perfusion compared to vertebrae of older ones (p<0.05). Vertebrae of females demonstrated significantly increased perfusion compared to those of males of corresponding age (p<0.05). All perfusion parameters, except for washout (WOUT), showed a mild linear correlation with age. Time to maximum slope (TMSP) and time to peak (TTPK) showed the same correlation with sex (0.22

  15. Imaging anti-angiogenic treatment response with DCE-VCT, DCE-MRI and DWI in an animal model of breast cancer bone metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Baeuerle, Tobias [Department of Medical Physics in Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany)], E-mail: t.baeuerle@dkfz-heidelberg.de; Bartling, Soenke [Department of Medical Physics in Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany)], E-mail: s.bartling@dkfz-heidelberg.de; Berger, Martin [Unit of Chemotherapy and Toxicology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany)], E-mail: m.berger@dkfz-heidelberg.de; Schmitt-Graeff, Annette [Institute of Pathology, University of Freiburg, Postfach 214, 79002 Freiburg (Germany)], E-mail: annette.schmitt-graeff@uniklinik-freiburg.de; Hilbig, Heidegard [Institute of Anatomy, University of Leipzig, Liebigstrasse 13, 04103 Leipzig (Germany)], E-mail: Heidegard.Hilbig@medizin.uni-leipzig.de; Kauczor, Hans-Ulrich [Department of Diagnostic and Interventional Radiology, Radiologische Klinik, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg (Germany)], E-mail: hans-ulrich.kauczor@med.uni-heidelberg.de; Delorme, Stefan [Department of Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany)], E-mail: s.delorme@dkfz-heidelberg.de; Kiessling, Fabian [Department of Medical Physics in Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Department of Experimental Molecular Imaging, RWTH Aachen, Pauwelsstrasse 20, 52074 Aachen (Germany)], E-mail: fkiessling@ukaachen.de

    2010-02-15

    As current classification systems for the assessment of treatment response in bone metastasis do not meet the needs of oncologists, new imaging biomarkers are desirable. Therefore, the diagnostic impact of dynamic contrast enhanced (DCE)-volumetric computed tomography (VCT) (descriptive analysis), DCE-MRI (two-compartment model) and diffusion weighted imaging (DWI) for monitoring anti-angiogenic therapy effects of the VEGF antibody bevacizumab in breast cancer bone metastases in rats was studied. Nude rats (n = 8 animals treated with bevacizumab and n = 9 untreated control rats) with site-specific osteolytic bone metastasis of the hind leg were imaged with a 1.5 T clinical MRI-scanner in an animal coil as well as in a volumetric CT-scanner at days 30, 40, 50 and 60 after inoculation of MDA-MB-231 human breast cancer cells. From these data, osteolytic lesion size (OLS), peak enhancement (PE), area under the curve (AUC), amplitude (A), exchange rate constant (k{sub ep}) and apparent diffusion coefficient (ADC) were determined in bone metastases. Prior to changes in OLS (p {<=} 0.05 at days 50 and 60) there was already a significant decrease in PE, AUC and A (p {<=} 0.05 at days 40-60) in treated animals compared to controls. However, for k{sub ep} and ADC there were no significant differences between the groups at any time point (p > 0.05 at days 40-60). In conclusion, anti-angiogenic treatment response in osteolytic breast cancer bone metastases can be assessed early with surrogate markers of vascularization, while DWI appears to be insensitive.

  16. Breast MRI at very short TE (minTE). Image analysis of minTE sequences on non-fat-saturated, subtracted T1-weighted images

    Energy Technology Data Exchange (ETDEWEB)

    Wenkel, Evelyn; Janka, Rolf; Kaemmerer, Nadine; Uder, Michael; Hammon, Matthias; Brand, Michael [Univ. Hospital Erlangen (Germany). Dept. of Radiology; Geppert, Christian [Siemens Healthcare GmbH, Erlangen (Germany); Hartmann, Arndt [Univ. Hospital Erlangen (Germany). Dept. of Pathology

    2017-02-15

    The aim was to evaluate a minimum echo time (minTE) protocol for breast magnetic resonance imaging (MRI) in patients with breast lesions compared to a standard TE (nTE) time protocol. Breasts of 144 women were examined with a 1.5 Tesla MRI scanner. Additionally to the standard gradient-echo sequence with nTE (4.8 ms), a variant with minimum TE (1.2 ms) was used in an interleaved fashion which leads to a better temporal resolution and should reduce the scan time by approximately 50%. Lesion sizes were measured and the signal-to-noise ratio (SNR) as well as the contrast-to-noise ratio (CNR) were calculated. Subjective confidence was evaluated using a 3-point scale before looking at the nTE sequences (1 = very sure that I can identify a lesion and classify it, 2 = quite sure that I can identify a lesion and classify it, 3 = definitely want to see nTE for final assessment) and the subjective image quality of all examinations was evaluated using a four-grade scale (1 = sharp, 2 = slight blur, 3 = moderate blur and 4 = severe blur/not evaluable) for lesion and skin sharpness. Lesion morphology and contrast enhancement were also evaluated. With minTE sequences, no lesion was rated with ''definitely want to see nTE sequences for final assessment''. The difference of the longitudinal and transverse diameter did not differ significantly (p>0.05). With minTE, lesions and skin were rated to be significantly more blurry (p<0.01 for lesions and p<0.05 for skin). There was no difference between both sequences with respect to SNR, CNR, lesion morphology, contrast enhancement and detection of multifocal disease. Dynamic breast MRI with a minTE protocol is feasible without a major loss of information (SNR, CNR, lesion morphology, contrast enhancement and lesion sizes) and the temporal resolution can be increased by a factor of 2 using minTE sequences.

  17. Towards MRI-guided radiotherapy in early-stage breast cancer patients

    NARCIS (Netherlands)

    Hartogh, M.D. den

    2014-01-01

    At the Department of Radiation Oncology of the UMC Utrecht, an MRI-linear accelerator (MRI-linac) is being developed. This hybrid MRI radiotherapy system features an 8 MV linear accelerator rotating around a 1.5 T cylindrical MRI scanner. This combination enables direct visualization of the radiothe

  18. Towards MRI-guided radiotherapy in early-stage breast cancer patients

    NARCIS (Netherlands)

    Hartogh, M.D. den

    2014-01-01

    At the Department of Radiation Oncology of the UMC Utrecht, an MRI-linear accelerator (MRI-linac) is being developed. This hybrid MRI radiotherapy system features an 8 MV linear accelerator rotating around a 1.5 T cylindrical MRI scanner. This combination enables direct visualization of the

  19. A progressive processing method for breast cancer detection via UWB based on an MRI-derived model

    Science.gov (United States)

    Xiao, Xia; Song, Hang; Wang, Zong-Jie; Wang, Liang

    2014-07-01

    Ultra-wideband (UWB) microwave imaging is a promising method for breast cancer detection based on the large contrast of electric parameters between the malignant tumor and its surrounded normal breast organisms. In the case of multiple tumors being present, the conventional imaging approaches may be ineffective to detect all the tumors clearly. In this paper, a progressive processing method is proposed for detecting more than one tumor. The method is divided into three stages: primary detection, refocusing and image optimization. To test the feasibility of the approach, a numerical breast model is developed based on the realistic magnetic resonance image (MRI). Two tumors are assumed embedded in different positions. Successful detection of a 3.6 mm-diameter tumor at a depth of 42 mm is achieved. The correct information of both tumors is shown in the reconstructed image, suggesting that the progressive processing method is promising for multi-tumor detection.

  20. Clinical Application Value of MRI Diffusion-weighted Image in the Diagnosis of Stage T1 Breast Cancer%MRI扩散加权成像对乳腺癌T1期诊断的应用价值

    Institute of Scientific and Technical Information of China (English)

    朱辉严; 谌力群; 许平; 谢磊

    2016-01-01

    目的:探讨乳腺癌 T1期应用 MRI 扩散加权成像的临床诊断价值研究。方法临床选择2012年1月~2015年12月本院收治的乳腺癌 T1期患者25例为研究对象,同期入选乳腺良性肿瘤25例为研究对照,进行 MRI 扩散加权成像检查法,后进行 MRI 动态增强扫描,比较 MRI 动态增强扫描与 MRI 扩散加权像检查法的诊断准确性;比较乳腺良性肿瘤与乳腺癌 T1期患者的 MRI 加权扩散像 ADC 值;比较乳腺良性肿瘤与乳腺癌 T1期患者的 MRI 动态增强减影扫描的环形强化、毛刺征、形态不规则等特征发生情况。结果MRI 扩散加权成像检查法的诊断准确率为80.0%(20例),MRI 动态增强减影扫描的诊断准确率为52.0%(13例),两组比较差异有统计学意义(P<0.05);乳腺癌 T1期患者的 MRI 加权扩散像 ADC 值显著低于乳腺癌良性肿瘤,差异有统计学意义(P<0.05);乳腺癌 T1期患者的MRI 动态增强减影扫描检测出环形强化、毛刺征、形态不规则等特征的发生情况显著高于乳腺良性肿瘤,差异有统计学意义(P<0.05)。结论乳腺癌 T1期患者进行 MRI 扩散加权成像检查可提高检查的准确性,临床效果确切,可与MRI 动态增强扫描联合应用,有助于早期诊断乳腺癌,值得临床推广。%Objective To study the clinical diagnosis value of MRI diffusion-weighted image in the diagnosis of Stage T1 breast cancer.Methods 25 patients with Stage T1 breast cancer treated from July 2014 to May 2015 in our hospital were selected as observation group.At the same time period,50 cases of benign tumor were selected as control group.The accuracy based on MRI diffusion-weighted image and dynamic MRI enhancement imaging was compared.ADC value of MRI diffusion-weighted image for two groups was compared,the incidence rate of ring enhancement,spiculation,irregular form based on dynamic MRI enhancement imaging for two groups was compared.Results The

  1. Subtraction and dynamic MR images of breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Murakami, Yoshitaka; Aoki, Manabu; Harada, Junta (Jikei Univ., Tokyo (Japan). School of Medicine)

    1993-04-01

    The purpose of this study was to evaluate the diagnostic effectiveness of subtraction and dynamic MR imaging in patients with breast masses. In 23 breast cancers and six fibroadenomas, spin echo T1 images were obtained at 0.2 Tesla before and every minute after intravenous injection of Gd-DTPA (0.1 or 0.2 mmol/kg). Subtraction images were obtained sequentially on the CRT monitor. All breast masses were enhanced after gadolinium and stood out as bright lesions on subtraction images. The tumor margin and its extension were more precisely evaluated on subtraction MR images than on conventional postcontrast MR images. Breast cancer showed a characteristic time-intensity curve with an early peak, in contrast to fibroadenoma, which showed a gradual increase in signal intensity. Subtraction MR imaging is a simple method for the evaluation of breast masses, and further, the time-intensity curve obtained by dynamic study is helpful in the differential diagnosis of lesions. (author).

  2. Upright, weight-bearing, dynamic-kinetic MRI of the spine: initial results.

    Science.gov (United States)

    Jinkins, J Randy; Dworkin, Jay S; Damadian, Raymond V

    2005-09-01

    The potential relative beneficial aspects of upright, weight-bearing (pMRI), dynamic-kinetic (kMRI) spinal imaging over that of recumbent MRI (rMRI) include the revelation of occult spinal disease dependent on true axial loading, the unmasking of kinetic-dependent spinal disease and the ability to scan the patient in the position of clinically relevant signs and symptoms. This imaging unit under study also demonstrated low claustrophobic potential and yielded comparatively high resolution images with little motion/magnetic susceptibility/chemical shift artifact. Overall, it was found that rMRI underestimated the presence and maximum degree of gravity-dependent spinal pathology and missed altogether pathology of a dynamic nature, factors that are optimally revealed with p/kMRI. Furthermore, p/kMRI enabled optimal linkage of the patient's clinical syndrome with the medical imaging abnormality responsible for the clinical presentation, thereby allowing for the first time an improvement at once in both imaging sensitivity and specificity.

  3. Upright, weight-bearing, dynamic-kinetic MRI of the spine: initial results

    Energy Technology Data Exchange (ETDEWEB)

    Jinkins, J. Randy [State University of New York, Department of Radiology, Downstate Medical Center, Brooklyn, NY (United States); Fonar Corporation, Melville, NY (United States); Dworkin, Jay S.; Damadian, Raymond V. [Fonar Corporation, Melville, NY (United States)

    2005-09-01

    The potential relative beneficial aspects of upright, weight-bearing (pMRI), dynamic-kinetic (kMRI) spinal imaging over that of recumbent MRI (rMRI) include the revelation of occult spinal disease dependent on true axial loading, the unmasking of kinetic-dependent spinal disease and the ability to scan the patient in the position of clinically relevant signs and symptoms. This imaging unit under study also demonstrated low claustrophobic potential and yielded comparatively high resolution images with little motion/magnetic susceptibility/chemical shift artifact. Overall, it was found that rMRI underestimated the presence and maximum degree of gravity-dependent spinal pathology and missed altogether pathology of a dynamic nature, factors that are optimally revealed with p/kMRI. Furthermore, p/kMRI enabled optimal linkage of the patient's clinical syndrome with the medical imaging abnormality responsible for the clinical presentation, thereby allowing for the first time an improvement at once in both imaging sensitivity and specificity. (orig.)

  4. Prostatic Cancer: Diagnosis and Differentiation by Dynamic Contrast-Enhanced MRI

    Institute of Scientific and Technical Information of China (English)

    SHIHao; DINGHongyu; ZHANGGuangying; YANGZhenzhen

    2005-01-01

    Objective: To assess the role of dynamic contrast-enhanced MRI (DCE-MRI) in the diagnosis and differentiation of prostatic cancer (PC). Methods: Five volunteers, 36 patients with benign prostatic hyperplasia (BPH) and 13 patients with biopsy-proven prostate cancer underwent conventional MRI, DCE-MR1 and delayed enhancement MRI. The value of the signal intensity in DCE-MRI was measured and calculated to draw the time-signal intensity curve of the normal peripheral zone (PZ), the prostate cancer and the benign prostatic hyperplasia. Results: In DCE-MRI, the normal peripheral zone was enhanced mildly and slowly and the peak value was located in late phase. The enhancement of the lesions in 36 patients with the benign prostatic hyperplasia was obvious in early phase and strengthened gradually, and then turned to decrease in late phase after peak value. The lesions in 9 of 13 cases with prostate cancer were enhanced obviously in early phase and washed out rapidly, and the peak value was located in early phase, but the peak value was in mediate and late phase in the other 4 cases with diffuse lesion in the prostate on T2WI. Conclusion: In DCE-MRI, the enhancement patterns of the normal peripheral zone,the prostate cancer and the benign prostatic hyperplasia were significantly different. DCE-MRI was very useful in the diagnosis and differentiation of prostate cancer.

  5. 乳腺癌的MRI诊断及临床应用进展%Diagnosis and clinical application progress of MRI on breast cancer

    Institute of Scientific and Technical Information of China (English)

    杨秀

    2015-01-01

    Objective:To explore the diagnosis and clinical application of MRI on breast cancer.Methods:Compared the MRI test results and pathological results in 120 patients with breast disease,and also compared their TNM staging and pTNM stage based on the MRI before the surgery,to explore the accuracy of MRI examination,and its accuracy of MRI diagnosed on TNM staging. Results:The diagnostic accuracy of MRI on diagnosis of breast cancer and benign disease was 88.9% and 87.5% respectively. Conclusion:MRI can diagnosis of TNM staging of breast cancer accurately.%目的:探究乳腺癌的MRI诊断及临床应用进展。方法:比较120例乳腺疾病患者MRI检查结果与病理结果以及术前乳腺癌患者以MRI为基础的TNM分期与pTNM分期,探讨MRI检查的准确性以及MRI诊断TNM分期的准确性。结果:MRI诊断乳腺癌以及良性疾病的准确率分别为88.9%、87.5%。结论:MRI能够较准确地诊断乳腺癌的TNM分期情况。

  6. Breast cancer screening

    Science.gov (United States)

    Mammogram - breast cancer screening; Breast exam - breast cancer screening; MRI - breast cancer screening ... performed to screen women to detect early breast cancer when it is more likely to be cured. ...

  7. Technical Note: Multipurpose CT, ultrasound, and MRI breast phantom for use in radiotherapy and minimally invasive interventions

    Energy Technology Data Exchange (ETDEWEB)

    Ruschin, Mark, E-mail: Mark.Ruschin@sunnybrook.ca; Chin, Lee; Ravi, Ananth; McCann, Claire [Department of Medical Physics, Sunnybrook Odette Cancer Centre, Toronto, Ontario M4N 3M5, Canada and Department of Radiation Oncology, University of Toronto, Toronto, Ontario M4N 3M5 (Canada); Davidson, Sean R. H. [Techna Institute, University Health Network, Toronto, Ontario M5G 1P5 (Canada); Phounsy, William [Department of Physics, Ryerson University, Toronto, Ontario M5B 2K3 (Canada); Yoo, Tae Sun [Institute of Health Policy, University of Toronto, Toronto, Ontario M5T 3M6 (Canada); Pignol, Jean-Philippe [Department of Radiation Oncology, Erasmus MC Cancer Institute, 3075 EA Rotterdam (Netherlands)

    2016-05-15

    Purpose: To develop a multipurpose gel-based breast phantom consisting of a simulated tumor with realistic imaging properties in CT, ultrasound and MRI, or a postsurgical cavity on CT. Applications for the phantom include: deformable image registration (DIR) quality assurance (QA), autosegmentation validation, and localization testing and training for minimally invasive image-guided procedures such as those involving catheter or needle insertion. Methods: A thermoplastic mask of a typical breast patient lying supine was generated and then filled to make an array of phantoms. The background simulated breast tissue consisted of 32.4 g each of ballistic gelatin (BG) powder and Metamusil™ (MM) dissolved in 800 ml of water. Simulated tumors were added using the following recipe: 12 g of barium sulfate (1.4% v/v) plus 0.000 14 g copper sulfate plus 0.7 g of MM plus 7.2 g of BG all dissolved in 75 ml of water. The phantom was evaluated quantitatively in CT by comparing Hounsfield units (HUs) with actual breast tissue. For ultrasound and MRI, the phantoms were assessed based on subjective image quality and signal-difference to noise (SDNR) ratio, respectively. The stiffness of the phantom was evaluated based on ultrasound elastography measurements to yield an average Young’s modulus. In addition, subjective tactile assessment of phantom was performed under needle insertion. Results: The simulated breast tissue had a mean background value of 24 HU on CT imaging, which more closely resembles fibroglandular tissue (40 HU) as opposed to adipose (−100 HU). The tumor had a mean CT number of 45 HU, which yielded a qualitatively realistic image contrast relative to the background either as an intact tumor or postsurgical cavity. The tumor appeared qualitatively realistic on ultrasound images, exhibiting hypoechoic characteristics compared to background. On MRI, the tumor exhibited a SDNR of 3.7. The average Young’s modulus was computed to be 15.8 ± 0.7 kPa (1 SD

  8. Multimodal breast cancer imaging using coregistered dynamic diffuse optical tomography and digital breast tomosynthesis

    Science.gov (United States)

    Zimmermann, Bernhard B.; Deng, Bin; Singh, Bhawana; Martino, Mark; Selb, Juliette; Fang, Qianqian; Sajjadi, Amir Y.; Cormier, Jayne; Moore, Richard H.; Kopans, Daniel B.; Boas, David A.; Saksena, Mansi A.; Carp, Stefan A.

    2017-04-01

    Diffuse optical tomography (DOT) is emerging as a noninvasive functional imaging method for breast cancer diagnosis and neoadjuvant chemotherapy monitoring. In particular, the multimodal approach of combining DOT with x-ray digital breast tomosynthesis (DBT) is especially synergistic as DBT prior information can be used to enhance the DOT reconstruction. DOT, in turn, provides a functional information overlay onto the mammographic images, increasing sensitivity and specificity to cancer pathology. We describe a dynamic DOT apparatus designed for tight integration with commercial DBT scanners and providing a fast (up to 1 Hz) image acquisition rate to enable tracking hemodynamic changes induced by the mammographic breast compression. The system integrates 96 continuous-wave and 24 frequency-domain source locations as well as 32 continuous wave and 20 frequency-domain detection locations into low-profile plastic plates that can easily mate to the DBT compression paddle and x-ray detector cover, respectively. We demonstrate system performance using static and dynamic tissue-like phantoms as well as in vivo images acquired from the pool of patients recalled for breast biopsies at the Massachusetts General Hospital Breast Imaging Division.

  9. DCE-MRI and DWI Integration for Breast Lesions Assessment and Heterogeneity Quantification

    Directory of Open Access Journals (Sweden)

    C. Andrés Méndez

    2012-01-01

    Full Text Available In order to better predict and follow treatment responses in cancer patients, there is growing interest in noninvasively characterizing tumor heterogeneity based on MR images possessing different contrast and quantitative information. This requires mechanisms for integrating such data and reducing the data dimensionality to levels amenable to interpretation by human readers. Here we propose a two-step pipeline for integrating diffusion and perfusion MRI that we demonstrate in the quantification of breast lesion heterogeneity. First, the images acquired with the two modalities are aligned using an intermodal registration. Dissimilarity-based clustering is then performed exploiting the information coming from both modalities. To this end an ad hoc distance metric is developed and tested for tuning the weighting for the two modalities. The distributions of the diffusion parameter values in subregions identified by the algorithm are extracted and compared through nonparametric testing for posterior evaluation of the tissue heterogeneity. Results show that the joint exploitation of the information brought by DCE and DWI leads to consistent results accounting for both perfusion and microstructural information yielding a greater refinement of the segmentation than the separate processing of the two modalities, consistent with that drawn manually by a radiologist with access to the same data.

  10. Lesion type and reader experience affect the diagnostic accuracy of breast MRI: a multiple reader ROC study.

    Science.gov (United States)

    Baltzer, Pascal A T; Kaiser, Werner Alois; Dietzel, Matthias

    2015-01-01

    To evaluate the influence of lesion type (mass versus non-mass) and reader experience on the diagnostic performance of breast MRI (BMRI) in a non-screening setting. Consecutive patients (mean age, 55 ± 12 years) with breast lesions that were verified by biopsy or surgery, and who had had BMRI as part of their diagnostic workup, were eligible for this retrospective single-center study. Cancers diagnosed by biopsy before BMRI were excluded to eliminate biological and interpretation bias due to biopsy or chemotherapy effects (n=103). Six blinded readers (experience level, high (HE, n=2); intermediate (IE, n=2); and low (LE, n=2)) evaluated all examinations and assigned independent MRI BI-RADS ratings. Lesion type (mass, non-mass, focal) was noted. Receiver operating characteristics (ROC) and logistic regression analysis was performed to compare diagnostic accuracies. There were 259 histologically verified lesions (123 malignant, 136 benign) investigated. There were 169 mass (103 malignant, 66 benign) and 48 non-mass lesions (19 malignant, 29 benign). Another 42 lesions that met the inclusion criteria were biopsied due to conventional findings (i.e., microcalcifications, architectural distortions), but did not enhance on MRI (41 benign, one DCIS). ROC analysis revealed a total area under the curve (AUC) between 0.834 (LE) and 0.935 (HI). Logistic regression identified a significant effect of non-mass lesions (Preader experience (P=0.005) on diagnostic performance. Non-mass lesion type and low reader experience negatively affect the diagnostic performance of breast MRI in a non-screening setting. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. Algorithm-based method for detection of blood vessels in breast MRI for development of computer-aided diagnosis.

    Science.gov (United States)

    Lin, Muqing; Chen, Jeon-Hor; Nie, Ke; Chang, Daniel; Nalcioglu, Orhan; Su, Min-Ying

    2009-10-01

    To develop a computer-based algorithm for detecting blood vessels that appear in breast dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI), and to evaluate the improvement in reducing the number of vascular pixels that are labeled by computer-aided diagnosis (CAD) systems as being suspicious of malignancy. The analysis was performed in 34 cases. The algorithm applied a filter bank based on wavelet transform and the Hessian matrix to detect linear structures as blood vessels on a two-dimensional maximum intensity projection (MIP). The vessels running perpendicular to the MIP plane were then detected based on the connectivity of enhanced pixels above a threshold. The nonvessel enhancements were determined and excluded based on their morphological properties, including those showing scattered small segment enhancements or nodular or planar clusters. The detected vessels were first converted to a vasculature skeleton by thinning and subsequently compared to the vascular track manually drawn by a radiologist. When evaluating the performance of the algorithm in identifying vascular tissue, the correct-detection rate refers to pixels identified by both the algorithm and radiologist, while the incorrect-detection rate refers to pixels identified by only the algorithm, and the missed-detection rate refers to pixels identified only by the radiologist. From 34 analyzed cases the median correct-detection rate was 85.6% (mean 84.9% +/- 7.8%), the incorrect-detection rate was 13.1% (mean 15.1% +/- 7.8%), and the missed-detection rate was 19.2% (mean 21.3% +/- 12.8%). When detected vessels were excluded in the hot-spot color-coding of the CAD system, they could reduce the labeling of vascular vessels in 2.6%-68.6% of hot-spot pixels (mean 16.6% +/- 15.9%). The computer algorithm-based method can detect most large vessels and provide an effective means in reducing the labeling of vascular pixels as suspicious on a DCE-MRI CAD system. This algorithm may improve the

  12. Dynamic Contrast-Enhanced MRI for the Detection of Prostate Cancer: Meta-Analysis

    Science.gov (United States)

    Tan, Cher Heng; Hobbs, Brian Paul; Wei, Wei; Kundra, Vikas

    2016-01-01

    Objective The purpose of this study was to systematically review and meta-analyze dynamic contrast-enhanced MRI (DCE-MRI) for the detection of prostate cancer in comparison with standard evaluation with T2-weighted imaging. Materials and Methods A PubMed electronic database search for the terms “dynamic contrast-enhanced,” “prostate,” and “MRI” was completed for articles up to September 17, 2013. All included studies had histopathologic correlation. Two by two contingency data were constructed for each study. A binormal bayesian ROC model was used to estimate and compare sensitivity, specificity, and AUC among eligible modalities. Results Both DCE-MRI (0.82–0.86) and diffusion-weighted MRI (DWI) (0.84–0.88) yielded significantly better AUC than T2-weighted imaging (0.68–0.77). Moreover, partial AUC for the combination of DCE-MRI, DWI, and T2-weighted imaging was improved significantly (0.111; 0.103–0.119) when compared with DCE-MRI alone (0.079; 0.072–0.085) and T2-weighted imaging alone (0.079; 0.074–0.084) but not DWI alone (0.099; 0.091–0.108). Sensitivity and specificity were similar among the four modalities. Conclusion DCE-MRI improves AUC of tumor detection overall compared with T2-weighted imaging alone. Methods for DCE-MRI analysis require standardization, but visual analysis performs similar to semiquantitative methods. A two-parameter approach using DCE-MRI and T2-weighted imaging or DWI and T2-weighted imaging may be sufficient, and the latter may be more favorable for most routine prostate cancer imaging. PMID:25794093

  13. 乳腺叶状瘤的X线及MRI表现%Phyllodes Tumors of the Breast:Mammography and MRI Features

    Institute of Scientific and Technical Information of China (English)

    孙宗琼; 陈林; 邵婉仪; 贺锋; 丁勇俊; 岳建国

    2013-01-01

    目的 探讨乳腺叶状瘤(PT)X线和MRI的影像学特征,以提高其影像诊断和鉴别诊断水平.方法 回顾性分析经手术、病理证实的30例PT患者的临床及影像资料,其中22例行X线检查,19例行MRI.结果 30例均为单发,表现为乳腺内直径1.5~21 cm(平均6.2 cm)的肿块;22例行乳腺X线检查者,病灶表现为圆形(5例)或分叶状(17例)、密度高于邻近腺体的肿块,边界清楚(16例)或部分不清(6例),所有病例均未发现钙化及邻近皮肤增厚、乳头回缩、周围乳腺结构扭曲等恶性征象.行MRI的19例患者,病灶表现为圆形(7例)或分叶状(12例),T1WI上呈等信号(8例)或低信号(11例),信号均匀(12例)或不均匀(7例),出现囊变或分隔(5例)、出血(2例);19例肿瘤T2WI上均为高信号,动态增强后时间-信号强度曲线(TIC)呈平台型16例,轻度流出型3例.30例PT病理诊断:Ⅰ级14例,Ⅱ级10例,Ⅲ级6例.结论 PT的影像学表现有一定的特点,尤其MRI动态增强扫描对诊断有重要价值,但其良恶性的判定仍有赖于组织病理学检查.%Objective To evaluate the mammography and MRI features of phyllodes tumors (PT) in breast, and to improve diagnosis accuracy. Methods The clinic and image data of PT(n =30) confirmed by surgery and histopathology were retrospectively analyzed. 22 patients and 19 patients performed mammography and MRI examination respectively. Re-sults 30 tumors showed spheroid mass in breasts ranged from 1.5 cm to 21 cm in diameter(average 6.2 cm) , Mammography revealed round (n = 5 ) or lobulated ( n = 17 ) masses with high density ( compared with surrounding fibroglandular breast tissue) in 22 patients. 16 of 22 tumors had well defined margins. No evidence of calcification and malignant signs,such as skin thickening,nipple retraction or distortion of perifocal structures was detected. On MRI imagings,19 cases showed round ( n = 7) or lobulated ( n = 12 ) masses. Lesions showed middle signal ( n = 8

  14. Background {sup 18}F-FDG uptake in positron emission mammography (PEM): Correlation with mammographic density and background parenchymal enhancement in breast MRI

    Energy Technology Data Exchange (ETDEWEB)

    Koo, Hye Ryoung, E-mail: huilings@hanmail.net [Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Moon, Woo Kyung, E-mail: moonwk@snu.ac.kr [Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Chun, In Kook, E-mail: inkook.chun@gmail.com [Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Eo, Jae Seon, E-mail: jaeseon76@gmail.com [Department of Nuclear Medicine, Korea University Guro Hospital, 148 Gurodongro, Guro-gu, Seoul 152-703 (Korea, Republic of); Jeyanth, Joseph Xavier, E-mail: jeyanth7@snu.ac.kr [Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Chang, Jung Min, E-mail: imchangjm@gmail.com [Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Cho, Nariya, E-mail: river7774@gmail.com [Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Kang, Keon Wook, E-mail: kangkw@snu.ac.kr [Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of)

    2013-10-01

    We aimed to determine whether background {sup 18}F-FDG uptake in positron emission mammography (PEM) was related to mammographic density or background parenchymal enhancement in breast MRI. Methods: We studied a total of 52 patients (mean age, 50.9 years, 26 premenopausal, 26 postmenopausal) with newly diagnosed breast cancer who underwent {sup 18}F-FDG PEM (positron emission mammography), conventional mammography and breast MRI. The background mean {sup 18}F-FDG uptake value on PEM was obtained by drawing a user-defined region of interest (ROI) in a normal area of the contralateral breast. We reviewed the mammography retrospectively for overall breast density of contralateral breast according to the four-point scale (grade 1–4) of the Breast Imaging Reporting and Data System (BI-RADS) classification. The background parenchymal enhancement of breast MRI was classified as minimal, mild, moderate, or marked. All imaging findings were interpreted by two readers in consensus without knowledge of image findings of other modalities. Results: Multiple linear regression analysis revealed a significant correlation between background {sup 18}F-FDG uptake on PEM and mammographic density after adjustment for age and menopausal status (P < 0.01), but not between background {sup 18}F-FDG uptake on PEM and background parenchymal enhancement on MRI. Conclusion: Background {sup 18}F-FDG uptake on PEM significantly increases as mammographic density increases. Background parenchymal enhancement in breast MRI was not an independent predictor of the background {sup 18}F-FDG uptake on PEM unlike mammographic density.

  15. The value of MRI in the differential diagnosis between chronic mastitis and breast cancer%MRI 鉴别诊断慢性乳腺炎与乳腺癌的价值

    Institute of Scientific and Technical Information of China (English)

    刘伟; 嵇鸣; 李若坤; 林光武; 叶春涛

    2016-01-01

    Objective To compare the appearances between chronic mastitis and breast cancer on MRI and investigate the differ-ential diagnostic value.Methods MRI data of 20 patients with chronic mastitis pathologically proved by biopsy or operation were ret-rospectively analyzed.30 cases of breast cancer were contemporaneously chosen as the control group.Morphological feature and dy-namic contrast-enhanced(DCE)manifestation of the lesions were evaluated and statistical difference was compared between mastitis and breast cancer.Morphological feature included configuration,spiculated sign,ring-like enhancement,peri-focal edema,skin thick-ening,nipple involvement and axillary lymph nodes enlargement.DCE manifestation contained calculating early enhancement ratio and drawing time-intensity curve (TIC).Results There were significant statistical differences among configuration,ring-like en-hancement and peri-focal edema between mastitis and breast cancer,respectively.No statistical differences could be found among spiculated sign,skin thickening,nipple involvement and axillary lymph nodes enlargement.Early enhancement ratio in the group of mastitis was 1.1 56±0.635 while 1.253±0.499 in the group of breast cancer and there was no statistical difference between them. There were 1 1 cases with type Ⅰ TIC,6 with type Ⅱ,3 with type Ⅲ in the lesions of mastitis,while 4 with type Ⅰ,1 1 with typeⅡ,1 5 with type Ⅲ in the lesions of breast cancer and significant statistical differences could be found between two groups.Conclu-sion Mastitis usually manifests as non-mass-like lesions on MRI.Ring-like enhancement,peri-focal edema and benign type TIC can be applied to discriminate mastitis from breast cancer.%目的:比较慢性乳腺炎与乳腺癌的 MRI 表现,探讨 MRI 鉴别诊断两者的价值。方法回顾性分析20例经穿刺活检或手术病理证实为慢性乳腺炎的 MRI 检查资料,同时期经病理证实的30例乳腺癌作为对照。评估两者的形态

  16. Imaging of Her2-targeted magnetic nanoparticles for breast cancer detection: comparison of SQUID-detected magnetic relaxometry and MRI.

    Science.gov (United States)

    Adolphi, Natalie L; Butler, Kimberly S; Lovato, Debbie M; Tessier, T E; Trujillo, Jason E; Hathaway, Helen J; Fegan, Danielle L; Monson, Todd C; Stevens, Tyler E; Huber, Dale L; Ramu, Jaivijay; Milne, Michelle L; Altobelli, Stephen A; Bryant, Howard C; Larson, Richard S; Flynn, Edward R

    2012-01-01

    Both magnetic relaxometry and magnetic resonance imaging (MRI) can be used to detect and locate targeted magnetic nanoparticles, noninvasively and without ionizing radiation. Magnetic relaxometry offers advantages in terms of its specificity (only nanoparticles are detected) and the linear dependence of the relaxometry signal on the number of nanoparticles present. In this study, detection of single-core iron oxide nanoparticles by superconducting quantum interference device (SQUID)-detected magnetic relaxometry and standard 4.7 T MRI are compared. The nanoparticles were conjugated to a Her2 monoclonal antibody and targeted to Her2-expressing MCF7/Her2-18 (breast cancer cells); binding of the nanoparticles to the cells was assessed by magnetic relaxometry and iron assay. The same nanoparticle-labeled cells, serially diluted, were used to assess the detection limits and MR relaxivities. The detection limit of magnetic relaxometry was 125 000 nanoparticle-labeled cells at 3 cm from the SQUID sensors. T(2)-weighted MRI yielded a detection limit of 15 600 cells in a 150 µl volume, with r(1) = 1.1 mm(-1) s(-1) and r(2) = 166 mm(-1) s(-1). Her2-targeted nanoparticles were directly injected into xenograft MCF7/Her2-18 tumors in nude mice, and magnetic relaxometry imaging and 4.7 T MRI were performed, enabling direct comparison of the two techniques. Co-registration of relaxometry images and MRI of mice resulted in good agreement. A method for obtaining accurate quantification of microgram quantities of iron in the tumors and liver by relaxometry was also demonstrated. These results demonstrate the potential of SQUID-detected magnetic relaxometry imaging for the specific detection of breast cancer and the monitoring of magnetic nanoparticle-based therapies.

  17. Dynamic nuclear polarization and optimal control spatial-selective 13C MRI and MRS

    DEFF Research Database (Denmark)

    Vinding, Mads Sloth; Laustsen, Christoffer; Maximov, Ivan I.

    2013-01-01

    Aimed at 13C metabolic magnetic resonance imaging (MRI) and spectroscopy (MRS) applications, we demonstrate that dynamic nuclear polarization (DNP) may be combined with optimal control 2D spatial selection to simultaneously obtain high sensitivity and well-defined spatial restriction. This is ach......Aimed at 13C metabolic magnetic resonance imaging (MRI) and spectroscopy (MRS) applications, we demonstrate that dynamic nuclear polarization (DNP) may be combined with optimal control 2D spatial selection to simultaneously obtain high sensitivity and well-defined spatial restriction....... This is achieved through the development of spatial-selective single-shot spiral-readout MRI and MRS experiments combined with dynamic nuclear polarization hyperpolarized [1-13C]pyruvate on a 4.7T pre-clinical MR scanner. The method stands out from related techniques by facilitating anatomic shaped region...

  18. First clinical experience with a dedicated MRI-guided high-intensity focused ultrasound system for breast cancer ablation

    Energy Technology Data Exchange (ETDEWEB)

    Merckel, Laura G.; Knuttel, Floor M.; Peters, Nicky H.G.M.; Mali, Willem P.T.M.; Bosch, Maurice A.A.J. van den [University Medical Center Utrecht, Department of Radiology, HP E 01.132, Utrecht (Netherlands); Deckers, Roel; Moonen, Chrit T.W.; Bartels, Lambertus W. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Dalen, Thijs van [Diakonessenhuis Utrecht, Department of Surgery, Utrecht (Netherlands); Schubert, Gerald [Philips Healthcare, Best (Netherlands); Weits, Teun [Diakonessenhuis Utrecht, Department of Radiology, Utrecht (Netherlands); Diest, Paul J. van [University Medical Center Utrecht, Department of Pathology, Utrecht (Netherlands); Vaessen, Paul H.H.B. [University Medical Center Utrecht, Department of Anesthesiology, Utrecht (Netherlands); Gorp, Joost M.H.H. van [Diakonessenhuis Utrecht, Department of Pathology, Utrecht (Netherlands)

    2016-11-15

    To assess the safety and feasibility of MRI-guided high-intensity focused ultrasound (MR-HIFU) ablation in breast cancer patients using a dedicated breast platform. Patients with early-stage invasive breast cancer underwent partial tumour ablation prior to surgical resection. MR-HIFU ablation was performed using proton resonance frequency shift MR thermometry and an MR-HIFU system specifically designed for breast tumour ablation. The presence and extent of tumour necrosis was assessed by histopathological analysis of the surgical specimen. Pearson correlation coefficients were calculated to assess the relationship between sonication parameters, temperature increase and size of tumour necrosis at histopathology. Ten female patients underwent MR-HIFU treatment. No skin redness or burns were observed in any of the patients. No correlation was found between the applied energy and the temperature increase. In six patients, tumour necrosis was observed with a maximum diameter of 3-11 mm. In these patients, the number of targeted locations was equal to the number of areas with tumour necrosis. A good correlation was found between the applied energy and the size of tumour necrosis at histopathology (Pearson = 0.76, p = 0.002). Our results show that MR-HIFU ablation with the dedicated breast system is safe and results in histopathologically proven tumour necrosis. (orig.)

  19. Application prospective of nanoprobes with MRI and FI dual-modality imaging on breast cancer stem cells in tumor.

    Science.gov (United States)

    Chen, Hetao; Wang, Yu; Wang, Tong; Shi, Dongxing; Sun, Zengrong; Xia, Chunhui; Wang, Baiqi

    2016-06-23

    Breast cancer (BC) is a serious disease to threat lives of women. Numerous studies have proved that BC originates from cancer stem cells (CSCs). But at present, no one approach can quickly and simply identify breast cancer stem cells (BCSCs) in solid tumor. Nanotechnology is probably able to realize this goal. But in study process, scientists find it seems that nanomaterials with one modality, such as magnetic resonance imaging (MRI) or fluorescence imaging (FI), have their own advantages and drawbacks. They cannot meet practical requirements in clinic. The nanoprobe combined MRI with FI modality is a promising tool to accurately detect desired cells with low amount in tissue. In this work, we briefly describe the MRI and FI development history, analyze advantages and disadvantages of nanomaterials with single modality in cancer cell detection. Then the application development of nanomaterials with dual-modality in cancer field is discussed. Finally, the obstacles and prospective of dual-modal nanoparticles in detection field of BCSCs are also pointed out in order to speed up clinical applications of nanoprobes.

  20. Preliminary Experience Using Dynamic MRI at 3.0 Tesla for Evaluation of Soft Tissue Tumors

    OpenAIRE

    2012-01-01

    Objective We aimed to evaluate the use of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) at 3.0 T for differentiating the benign from malignant soft tissue tumors. Also we aimed to assess whether the shorter length of DCE-MRI protocols are adequate, and to evaluate the effect of temporal resolution. Materials and Methods Dynamic contrast-enhanced magnetic resonance imaging, at 3.0 T with a 1 second temporal resolution in 13 patients with pathologically confirmed soft tissue tu...

  1. A novel computer-aided diagnosis system for breast MRI based on feature selection and ensemble learning.

    Science.gov (United States)

    Lu, Wei; Li, Zhe; Chu, Jinghui

    2017-03-06

    Breast cancer is a common cancer among women. With the development of modern medical science and information technology, medical imaging techniques have an increasingly important role in the early detection and diagnosis of breast cancer. In this paper, we propose an automated computer-aided diagnosis (CADx) framework for magnetic resonance imaging (MRI). The scheme consists of an ensemble of several machine learning-based techniques, including ensemble under-sampling (EUS) for imbalanced data processing, the Relief algorithm for feature selection, the subspace method for providing data diversity, and Adaboost for improving the performance of base classifiers. We extracted morphological, various texture, and Gabor features. To clarify the feature subsets' physical meaning, subspaces are built by combining morphological features with each kind of texture or Gabor feature. We tested our proposal using a manually segmented Region of Interest (ROI) data set, which contains 438 images of malignant tumors and 1898 images of normal tissues or benign tumors. Our proposal achieves an area under the ROC curve (AUC) value of 0.9617, which outperforms most other state-of-the-art breast MRI CADx systems. Compared with other methods, our proposal significantly reduces the false-positive classification rate.

  2. Applicability and efficiency of near-optimal spatial encoding for dynamically adaptive MRI.

    Science.gov (United States)

    Zientara, G P; Panych, L P; Jolesz, F A

    1998-02-01

    Adaptive near-optimal MRI spatial encoding entails, for the acquisition of each image update in a dynamic series, the computation of encodes in the form of a linear algebra-derived orthogonal basis set determined from an image estimate. The origins of adaptive encoding relevant to MRI are reviewed. Sources of error of this approach are identified from the linear algebraic perspective where MRI data acquisition is viewed as the projection of information from the field-of-view onto the encoding basis set. The definitions of ideal and non-ideal encoding follow, with nonideal encoding characterized by the principal angles between two vector spaces. An analysis of the distribution of principal angles is introduced and applied in several example cases to quantitatively describe the suitability of a basis set derived from a specific image estimate for the spatial encoding of a given field-of-view. The robustness of adaptive near-optimal spatial encoding for dynamic MRI is favorably shown by results computed using singular value decomposition encoding that simulates specific instances of worst case data acquisition when all objects have changed or new objects have appeared in the field-of-view. The mathematical analysis and simulations presented clarify the applicability and efficiency of adaptively determined near-optimal spatial encoding throughout a range of circumstances as may typically occur during use of dynamic MRI.

  3. Role of Dynamic Magnetic Resonance Imaging in Preoperative Evaluation of Breast Conserving Surgery for Breast Cancer%动态磁共振成像在乳腺癌保乳术中的术前评估作用

    Institute of Scientific and Technical Information of China (English)

    范培芝; 张超杰; 刘鹏; 张志功; 唐梅徕; 顾晓文; 郑维; 李艳春

    2012-01-01

    [Objective] To evaluate the role of dynamic contrast-enhanced magnetic resonance imaging (MRI) in prcopcrativc evaluation of breast-conserving surgery for breast cancer. [Methods! Totally 65 female breast cancer patients with the average age of 35. 8 years old took prcopcrativc mammography and MRI examination. Mammography and MRI examination were used to evaluate the feasibility of breast-conserving surgery. Pathological diagnosis was used to evaluate the accuracy of MRI in the assessment of breast cancer in cutting edge and with multi-center lesions. [Results! Among 65 patients with breast cancer, 64. 6% of the patients could undergo breast-conserving surgery by mammography prcopcrativc evaluation which was lower than that by MRI cvaluation(83. 1 %) , and there was significant difference between thcm( P MRI was 80% , which was significantly higher than that by mammography(53. 8%) ( P Dynamic contrast-enhanced MRI in the prcopcrativc evaluation of young women with stage I~Iib breast cancer undergoing breast conserving surgery can more accurately determine multi-center lesion and incisal margin range than mammography, and is more helpful for deciding whether to adopt breast conserving surgery and more precisely determine surgical margin.%[目的]评价动态增强磁共振成像(MRI)在乳腺癌保乳根治术的术前评估作用.[方法]平均年龄35.8岁的65 例女性乳腺癌患者,术前均行钼靶及MRI检查,对钼靶、MRI评估是否可行保乳手术进行分析,通过病理诊断来评价MRI在评估乳腺癌多中心病灶以及切缘范围上的准确性.[结果]65例患者中,钼靶术前评估认为可保乳术患者64.6%,低于MRI评估的83.1%,且两者相比差异有显著性(P<0.05).对癌块切缘判断准确率MRI为80%,显著高于钼靶的53.8%(P<0.05).[结论]在中青年女性的I~IIb期乳腺癌保乳术的术前评估方法中,动态增强MRI成像较钼靶

  4. MRI对致密型乳腺中乳腺癌的诊断价值%Study on the significance of dense breast in MRI for detecting breast cancer

    Institute of Scientific and Technical Information of China (English)

    黎星; 吕涛; 汪湍

    2012-01-01

    Objective To explore the significance of dense breast in detecting breast cancer by breast MRI. Methods Fifty - three patients with breast cancer showing dense breast in mammography were examined by breast MRI. All these 53 cases had been confirmed by pathological examination. Their morphological features, diffusion - weighted imaging ( DW1) and time - signal intensity curve ( TIC ) were analyzed. Results Among fifty - three cases of breast cancer, 23 cases were detected by mammography, and 30 cases were misdiagnosed. Among these 53 cases, 49 of them were detected by MRI, 4 cases were misdiagnosed, and its sensitivity was 92. 5% . Conclusion The appearance of dense breast in breast MRI has very important significance in diagnosis of breast cancer.%目的 探讨MRI对致密型乳腺中乳腺癌的诊断价值.方法 收集53例同时行钼靶X线检查及MRI检查的致密型乳腺,均经手术后病理证实为乳腺癌患者,通过对病变的检出、形态学、扩散加权成像(DWI)以及时间-信号曲线(TIC)等方面进行分析诊断.结果 53例患者中,钼靶诊断正确为23例,误诊及漏诊为30例;MRI诊断正确为49例,误诊及漏诊为4例,其敏感度为92.5%.结论 乳腺MRI检查对致密型乳腺中乳腺癌的诊断具有重要不可替代的价值.

  5. BOLD-MRI of breast invasive ductal carcinoma: correlation of R2* value and the expression of HIF-1{alpha}

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Min; Guo, Xiaojuan; Wang, Shuangkun [Capital Medical University, Department of Radiology, Beijing Chao Yang Hospital, Beijing (China); Jin, Mulan; Wang, Ying [Capital Medical University Beijing, Department of Pathology, Beijing Chaoyang Hospital, Beijing (China); Li, Jie; Liu, Jun [Capital Medical University Beijing, Department of Breast Surgery, Beijing Chaoyang Hospital, Beijing (China)

    2013-12-15

    To explore the reliability and feasibility of blood oxygenation level-dependent-based functional magnetic resonance imaging (BOLD-fMRI) to depict hypoxia in breast invasive ductal carcinoma. A total of 103 women with 104 invasive ductal carcinomas (IDCs) underwent breast BOLD-fMRI at 3.0 T. Histological specimens were analysed for tumour size, grade, axillary lymph nodes and expression of oestrogen receptors, progesterone receptors, human epidermal growth factor receptor 2, p53, Ki-67 and hypoxia inducible factor 1{alpha} (HIF-1{alpha}). The distribution and reliability of R2* were analysed. Correlations of the R2* value with the prognostic factors and HIF-1{alpha} were respectively analysed. The R2* map of IDC demonstrated a relatively heterogeneous signal. The mean R2* value was (53.4 {+-} 18.2) Hz. The Shapiro-Wilk test (W = 0.971, P = 0.020) suggested that the sample did not follow a normal distribution. The inter-rater and intrarater correlation coefficient was 0.967 and 0.959, respectively. The R2* values of IDCs were significantly lower in patients without axillary lymph nodes metastasis. The R2* value had a weak correlation with Ki67 expression (r = 0.208, P = 0.038). The mean R2* value correlated moderately with the level of HIF-1{alpha} (r = 0.516, P = 0.000). BOLD-fMRI is a simple and non-invasive technique that yields hypoxia information on breast invasive ductal carcinomas. (orig.)

  6. Computational fluid dynamics simulations of blood flow regularized by 3D phase contrast MRI

    DEFF Research Database (Denmark)

    Rispoli, Vinicius C; Nielsen, Jon; Nayak, Krishna S

    2015-01-01

    approach in regularizing 3D flow fields is evaluated. METHODS: The proposed algorithm incorporates both a Newtonian fluid physics model and a linear PC-MRI signal model. The model equations are solved numerically using a modified CFD algorithm. The numerical solution corresponds to the optimal solution......BACKGROUND: Phase contrast magnetic resonance imaging (PC-MRI) is used clinically for quantitative assessment of cardiovascular flow and function, as it is capable of providing directly-measured 3D velocity maps. Alternatively, vascular flow can be estimated from model-based computation fluid...... dynamics (CFD) calculations. CFD provides arbitrarily high resolution, but its accuracy hinges on model assumptions, while velocity fields measured with PC-MRI generally do not satisfy the equations of fluid dynamics, provide limited resolution, and suffer from partial volume effects. The purpose...

  7. A comparison of Gamma and Gaussian dynamic convolution models of the fMRI BOLD response.

    Science.gov (United States)

    Chen, Huafu; Yao, Dezhong; Liu, Zuxiang

    2005-01-01

    Blood oxygenation level-dependent (BOLD) contrast-based functional magnetic resonance imaging (fMRI) has been widely utilized to detect brain neural activities and great efforts are now stressed on the hemodynamic processes of different brain regions activated by a stimulus. The focus of this paper is the comparison of Gamma and Gaussian dynamic convolution models of the fMRI BOLD response. The convolutions are between the perfusion function of the neural response to a stimulus and a Gaussian or Gamma function. The parameters of the two models are estimated by a nonlinear least-squares optimal algorithm for the fMRI data of eight subjects collected in a visual stimulus experiment. The results show that the Gaussian model is better than the Gamma model in fitting the data. The model parameters are different in the left and right occipital regions, which indicate that the dynamic processes seem different in various cerebral functional regions.

  8. Performance comparison of deep learning and segmentation-based radiomic methods in the task of distinguishing benign and malignant breast lesions on DCE-MRI

    Science.gov (United States)

    Antropova, Natasha; Huynh, Benjamin; Giger, Maryellen

    2017-03-01

    Intuitive segmentation-based CADx/radiomic features, calculated from the lesion segmentations of dynamic contrast-enhanced magnetic resonance images (DCE-MRIs) have been utilized in the task of distinguishing between malignant and benign lesions. Additionally, transfer learning with pre-trained deep convolutional neural networks (CNNs) allows for an alternative method of radiomics extraction, where the features are derived directly from the image data. However, the comparison of computer-extracted segmentation-based and CNN features in MRI breast lesion characterization has not yet been conducted. In our study, we used a DCE-MRI database of 640 breast cases - 191 benign and 449 malignant. Thirty-eight segmentation-based features were extracted automatically using our quantitative radiomics workstation. Also, 2D ROIs were selected around each lesion on the DCE-MRIs and directly input into a pre-trained CNN AlexNet, yielding CNN features. Each method was investigated separately and in combination in terms of performance in the task of distinguishing between benign and malignant lesions. Area under the ROC curve (AUC) served as the figure of merit. Both methods yielded promising classification performance with round-robin cross-validated AUC values of 0.88 (se =0.01) and 0.76 (se=0.02) for segmentationbased and deep learning methods, respectively. Combination of the two methods enhanced the performance in malignancy assessment resulting in an AUC value of 0.91 (se=0.01), a statistically significant improvement over the performance of the CNN method alone.

  9. MRI-aided tissues interface characterization: An accurate signal propagation time calculation method for UWB breast tumor imaging

    Science.gov (United States)

    Wang, Liang; Xiao, Xia; Kikkawa, Takamaro

    2016-12-01

    Radar-based ultrawideband (UWB) microwave imaging is expected to be a safe, low-cost tool for breast cancer detection. However, since radar wave travels at different speeds in different tissues, propagation time is hard to be estimated in heterogeneous breast. Wrongly estimated propagation time leads to error of tumor location in resulting image, aka imaging error. In this paper, we develop a magnetic resonance imaging-aided (MRI-aided) propagation time calculation technique which is independent from radar imaging system but can help decrease the imaging error. The technique can eliminate the influence of the rough interface between fat layer and gland layer in breast and get relative accurate thicknesses of two layers. The propagation time in each layer is calculated and summed. The summed propagation time is used in Confocal imaging algorithm to increase the accuracy of resulting image. 25 patients' breast models with glands of varying size are classified into four categories for imaging simulation tests. Imaging accuracy in terms of tumor location along x-direction has been improved for 21 among 25 cases, as a result, overall around 50% improvement compared to conventional UWB imaging.

  10. Effortful Pitch Glide: A Potential New Exercise Evaluated by Dynamic MRI

    Science.gov (United States)

    Miloro, Keri Vasquez; Pearson, William G., Jr.; Langmore, Susan E.

    2014-01-01

    Purpose: The purpose of this study was to compare the biomechanics of the effortful pitch glide (EPG) with swallowing using dynamic MRI. The EPG is a combination of a pitch glide and a pharyngeal squeeze maneuver for targeting laryngeal and pharyngeal muscles. The authors hypothesized that the EPG would elicit significantly greater structural…

  11. Evaluation of tissue sampling methods used for MRI-detected contralateral breast lesions in the American College of Radiology Imaging Network 6667 trial.

    Science.gov (United States)

    DeMartini, Wendy B; Hanna, Lucy; Gatsonis, Constantine; Mahoney, Mary C; Lehman, Constance D

    2012-09-01

    The purpose of our study was to evaluate tissue sampling methods used for MRI-detected suspicious contralateral breast lesions in the American College of Radiology Imaging Network (ACRIN) 6667 trial. Breast MRI was performed at 25 institutions in 969 women who had a recent diagnosis of unilateral breast cancer and negative contralateral mammography and clinical breast examinations. Biopsy was recommended for MRI findings in 135 women, and 121 underwent sampling. Frequencies and positive biopsy rates of sampling methods used for initial diagnosis and imaging guidance techniques were calculated and compared. Sampling yielded 30 malignant and 91 benign results. Initial sampling used needle biopsy in 88 of 121 (72.7%) and surgical biopsy in 30 of 121 (24.8%) women. Surgical biopsy was excisional biopsy in 28 of 30 (93.3%) and mastectomy in two of 30 (6.7%). The remaining three of 121 (2.5%) women underwent mastectomy, but it was not documented whether this represented initial tissue sampling. Of imaging-guided procedures, 56 of 106 (52.8%) used MRI; 49 of 106 (46.2%), ultrasound; and one of 106 (1.0%), stereotaxis. MRI-guided sampling was with needle biopsy rather than wire-localized surgical biopsy in 33 of 56 (58.9%) women, whereas ultrasound used needle biopsy in 47 of 49 (95.9%). Positive biopsy rates of sampling methods were 20.5% for needle biopsy, 46.2% for excisional biopsy, and 0% for mastectomy. The majority of initial biopsies for MRI-detected contralateral breast lesions used needle biopsy rather than surgical biopsy. Contralateral surgery could have been avoided in most cases had needle biopsy been performed because most excisional biopsy and all mastectomy results were benign. MRI-guided biopsy was significantly more likely than ultrasound-guided sampling to use wire-localized surgical biopsy rather than needle biopsy.

  12. Technical Note: Quantitative dynamic contrast-enhanced MRI of a 3-dimensional artificial capillary network.

    Science.gov (United States)

    Gaass, Thomas; Schneider, Moritz Jörg; Dietrich, Olaf; Ingrisch, Michael; Dinkel, Julien

    2017-04-01

    Variability across devices, patients, and time still hinders widespread recognition of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) as quantitative biomarker. The purpose of this work was to introduce and characterize a dedicated microchannel phantom as a model for quantitative DCE-MRI measurements. A perfusable, MR-compatible microchannel network was constructed on the basis of sacrificial melt-spun sugar fibers embedded in a block of epoxy resin. Structural analysis was performed on the basis of light microscopy images before DCE-MRI experiments. During dynamic acquisition the capillary network was perfused with a standard contrast agent injection system. Flow-dependency, as well as inter- and intrascanner reproducibility of the computed DCE parameters were evaluated using a 3.0 T whole-body MRI. Semi-quantitative and quantitative flow-related parameters exhibited the expected proportionality to the set flow rate (mean Pearson correlation coefficient: 0.991, P quantitative parameters. All evaluated parameters were well in the range of known in vivo results for the applied flow rates. The constructed phantom enables reproducible, flow-dependent, contrast-enhanced MR measurements with the potential to facilitate standardization and comparability of DCE-MRI examinations. © 2017 American Association of Physicists in Medicine.

  13. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging of bone marrow in healthy individuals

    Energy Technology Data Exchange (ETDEWEB)

    Hillengass, Jens (Dept. of Radiology, German Cancer Research Center, Heidelberg (Germany); Dept. of Hematology, Oncology and Rheumatology, Univ. of Heidelberg (Germany)), e-mail: j.hillengass@dkfz.de; Stieltjes, Bram (Dept. of Radiology, German Cancer Research Center, Heidelberg (Germany)); Baeuerle, Tobias (Dept. of Medical Physics in Radiology, German Cancer Research Center, Heidelberg (Germany)) (and others)

    2011-04-15

    Background: Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) displays microcirculation and permeability by application of contrast-media and diffusion-weighted imaging (DWI) is a tool for quantification of cellularity in the investigated area. Recently published examples cover breast cancer, CNS tumors, head and neck cancer, gastrointestinal cancer, prostate cancer as well as hematologic malignancies. Purpose: To investigated the influence of age, sex, and localization of the investigated region on findings of DCE-MRI and DWI. Material and Methods: DCE-MRI-parameters amplitude A and exchange rate constant kep as well as the DWI-parameter ADC of the bone marrow of the lumbar vertebral column of 30 healthy individuals covering the typical range of age of tumor patients were evaluated. ADC was calculated using b=0 and a maximal b value of either 400 or 750 s/mm2. Results: Amplitude A of DCE-MRI decreased with age (P = 0.01) and amplitude A, exchange rate constant kep as well as ADC based on b = 400 s/mm2 and b = 750 s/mm2, respectively, decreased significantly from the first to the fifth lumbar vertebra with P = 0.02, P = 0.05, P = 0.003, and P = 0.002, respectively. Conclusion: Quantitative parameters of functional imaging techniques in bone marrow are influenced by the age of the examined individual and the anatomical location of the investigated region

  14. MRI动态增强时间强度曲线与乳腺癌微血管密度的相关性研究%Relationship between TIC of DCE-MRI and angiogenesis in breast cancer

    Institute of Scientific and Technical Information of China (English)

    刘长高

    2012-01-01

    目的 探讨MRI动态增强在乳腺癌检测中的应用.方法 对80例乳腺癌疑似患者进行MRI平扫及动态增强扫描和病理标本组织学检测,绘制出ROI的DCE-MRI时间信号强度曲线( TIC),测量、计算病灶动态强化参数和肿瘤微血管密度(MVD).结果 (1)80例乳腺癌疑似患者经MRI扫描,发现80例患者(81处病灶)TIC曲线呈廓清型.(2)80例患者的DCE-MRI扫描结果与组织病理学诊断结果一致性较高,呈正相关(r=0.935,P<0.05);(3)乳腺癌癌组织部分微血管密度(MVD)计数为34.74±12.05,明显高于正常组织18.36±3.16(t=6.47,P<0.05);(4)80例乳腺癌DCE-MRI扫描最大增强线形斜率SS值为2.38 ±0.40,增强峰值PH为(619.22±123.53) HU,与MVD呈正相关(r=0.72,P<0.05;r=0.66,P<0.05);信号强度峰值时间Tpeak为(56.10±10.13)t/s,与MVD呈负相关(r=-0.53,P<0.05).结论 DCE-MRI参数能间接反映乳腺癌血管生成状况,有望成为非创伤性早期发现和诊断乳腺癌的重要手段.%Objective To study the clinical application of magnetic resonance imaging (MRI) and dynamic contrast enhancement in the old breast cancer patients.Methods Eighty cases of elderly patients with suspected breast cancer were detected by dynamic enhanced MRI,dynamic contrast enhanced MRI,and pathological examination.Results (1) Among 80 cases of suspected breast cancer patients,MRI scan found that the TIC curve of 80 patients (81 lesions) was entered a type curve.(2)DCE-MRI scan findings were highly consistent with histopathological diagnosis with a significant correlation ( r =0.935,P <0.05).(3)The micro-vessel density( MVD; 34.74 ± 12.05) in breast carcinoma - bearing tissues was significantly higher than the normal tissues adjacent to carcinoma ( 18.36 -± 3.16) ( t =6.47,P < 0.05 ).(4)The value of DCE-MRI scan maximum enhancement linear slope (SS) and enhanced peak PH were 2.38 ±0.40 and (619.22 ± 123.53 ) HU,respectively.A significantly positive correlation was found

  15. The ''EVA'' trial: evaluation of the efficacy of diagnostic methods (mammography, ultrasound, MRI) in the secondary and tertiary prevention of familial breast cancer. Preliminary results after the first half of the study period; Die ''EVA''-Studie: Evaluierung der Leistungsfaehigkeit diagnostischer Verfahren (Mammographie, Sonographie, MRT) zur sekundaeren und tertiaeren Praevention des familiaeren Mammakarzinoms - Zwischenergebnisse nach der ersten Haelfte der Foerderungsperiode

    Energy Technology Data Exchange (ETDEWEB)

    Kuhl, C.K.; Schrading, S.; Morakkabati, N.; Leutner, C.; Schild, H. [Radiologische Universitaetsklinik, Bonn (Germany); Weigel, S.; Tombach, B.; Nordhoff, D.; Heindel, W. [Inst. fuer Klinische Radiologie der Univ. Muenster, Muenster (Germany); Nuessle-Kuegele, K.; Arand, B.; Rieber, A.; Brambs, H.J. [Abt. fuer Roentgendiagnostik der Univ. Ulm, Ulm (Germany); Sittek, H.; Reiser, M. [Inst. fuer Klinische Radiologie des Klinikums der Univ. Muenchen-Grosshadern, Muenchen (Germany)

    2005-06-01

    Purpose: to investigate the respective diagnostic accuracies of the different breast imaging modalities, i. e., mammography (Mx), high-frequency breast ultrasound (US), and dynamic contrast-enhanced breast (MRI) regarding the early diagnosis of familial (hereditary) breast cancer. Materials and methods: a prospective, non-randomized controlled clinical multi-center trial is performed at 4 academic tertiary care centers in Germany (Ulm, Muenchen/Grosshadern, Muenster and Bonn) for a total period of 4 years, sponsored by the German Cancer Aid. The protocol consists of semiannual clinical visits and breast ultrasound, and annual bilateral two-view Mx, US and MRI. Imaging studies were first analyzed independently, then Mx was read in conjunction with US, followed by Mx combined with MRI, and finally, all three imaging modalities were read in synopsis. We present the concept and first results of this trial. Results: so far, 748 screening rounds are available for analysis in 613 women. A total of 12 breast cancers have been identified, with 11/12 cases in the pTis or pT1/N0 stage. The mean size of detected invasive cancers was 7 mm. A total of 19 benign lesions were biopsied due to false-positive imaging diagnoses. The breast cancer detection rates were: Mx: 5/12 (42%), US 3/12 (25%), MRI 10/12 (83%), and the positive predictive values: Mx 5/17 (29%), US 3/15 (30%), and MRI 10/23 (43%). Conclusion: the preliminary data suggest that early diagnosis of familial breast cancer is feasible by intensified surveillance, in particular with the addition of MRI. (orig.)

  16. Dynamic Three-Dimensional Shoulder Mri during Active Motion for Investigation of Rotator Cuff Diseases.

    Directory of Open Access Journals (Sweden)

    Christine Tempelaere

    Full Text Available MRI is the standard methodology in diagnosis of rotator cuff diseases. However, many patients continue to have pain despite treatment, and MRI of a static unloaded shoulder seems insufficient for best diagnosis and treatment. This study evaluated if Dynamic MRI provides novel kinematic data that can be used to improve the understanding, diagnosis and best treatment of rotator cuff diseases.Dynamic MRI provided real-time 3D image series and was used to measure changes in the width of subacromial space, superior-inferior translation and anterior-posterior translation of the humeral head relative to the glenoid during active abduction. These measures were investigated for consistency with the rotator cuff diseases classifications from standard MRI.The study included: 4 shoulders with massive rotator cuff tears, 5 shoulders with an isolated full-thickness supraspinatus tear, 5 shoulders with tendinopathy and 6 normal shoulders. A change in the width of subacromial space greater than 4mm differentiated between rotator cuff diseases with tendon tears (massive cuff tears and supraspinatus tear and without tears (tendinopathy (p = 0.012. The range of the superior-inferior translation was higher in the massive cuff tears group (6.4mm than in normals (3.4mm (p = 0.02. The range of the anterior-posterior translation was higher in the massive cuff tears (9.2 mm and supraspinatus tear (9.3 mm shoulders compared to normals (3.5mm and tendinopathy (4.8mm shoulders (p = 0.05.The Dynamic MRI enabled a novel measure; 'Looseness', i.e. the translation of the humeral head on the glenoid during an abduction cycle. Looseness was better able at differentiating different forms of rotator cuff disease than a simple static measure of relative glenohumeral position.

  17. Dynamic Three-Dimensional Shoulder Mri during Active Motion for Investigation of Rotator Cuff Diseases

    Science.gov (United States)

    Tempelaere, Christine; Pierrart, Jérome; Lefèvre-Colau, Marie-Martine; Vuillemin, Valérie; Cuénod, Charles-André; Hansen, Ulrich; Mir, Olivier; Skalli, Wafa; Gregory, Thomas

    2016-01-01

    Background MRI is the standard methodology in diagnosis of rotator cuff diseases. However, many patients continue to have pain despite treatment, and MRI of a static unloaded shoulder seems insufficient for best diagnosis and treatment. This study evaluated if Dynamic MRI provides novel kinematic data that can be used to improve the understanding, diagnosis and best treatment of rotator cuff diseases. Methods Dynamic MRI provided real-time 3D image series and was used to measure changes in the width of subacromial space, superior-inferior translation and anterior-posterior translation of the humeral head relative to the glenoid during active abduction. These measures were investigated for consistency with the rotator cuff diseases classifications from standard MRI. Results The study included: 4 shoulders with massive rotator cuff tears, 5 shoulders with an isolated full-thickness supraspinatus tear, 5 shoulders with tendinopathy and 6 normal shoulders. A change in the width of subacromial space greater than 4mm differentiated between rotator cuff diseases with tendon tears (massive cuff tears and supraspinatus tear) and without tears (tendinopathy) (p = 0.012). The range of the superior-inferior translation was higher in the massive cuff tears group (6.4mm) than in normals (3.4mm) (p = 0.02). The range of the anterior-posterior translation was higher in the massive cuff tears (9.2 mm) and supraspinatus tear (9.3 mm) shoulders compared to normals (3.5mm) and tendinopathy (4.8mm) shoulders (p = 0.05). Conclusion The Dynamic MRI enabled a novel measure; ‘Looseness’, i.e. the translation of the humeral head on the glenoid during an abduction cycle. Looseness was better able at differentiating different forms of rotator cuff disease than a simple static measure of relative glenohumeral position. PMID:27434235

  18. Effect of breast cancer phenotype on diagnostic performance of MRI in the prediction to response to neoadjuvant treatment

    Energy Technology Data Exchange (ETDEWEB)

    Bufi, Enida, E-mail: reagandus@alice.it [Department of Bioimaging and Radiological Sciences, Catholic University, Rome (Italy); Belli, Paolo; Di Matteo, Marialuisa [Department of Bioimaging and Radiological Sciences, Catholic University, Rome (Italy); Terribile, Daniela; Franceschini, Gianluca [Department of Surgery, Breast Unit, Catholic University, Rome (Italy); Nardone, Luigia [Department of Radiotherapy, Catholic University, Rome (Italy); Petrone, Gianluigi [Department of Pathology, Catholic University, Rome (Italy); Bonomo, Lorenzo [Department of Bioimaging and Radiological Sciences, Catholic University, Rome (Italy)

    2014-09-15

    Aim: The estimation of response to neoadjuvant chemotherapy (NAC) is useful in the surgical decision in breast cancer. We addressed the diagnostic reliability of conventional MRI, of diffusion weighted imaging (DWI) and of a merged criterion coupling morphological MRI and DWI. Diagnostic performance was analysed separately in different tumor subtypes, including HER2+ (human epidermal growth factor receptor 2)/HR+ (hormone receptor) (hybrid phenotype). Materials and methods: Two-hundred and twenty-five patients underwent MRI before and after NAC. The response to treatment was defined according to the RECIST classification and the evaluation of DWI with apparent diffusion coefficient (ADC). The complete pathological response – pCR was assessed (Mandard classification). Results: Tumor phenotypes were Luminal (63.6%), Triple Negative (16.4%), HER2+ (7.6%) or Hybrid (12.4%). After NAC, pCR was observed in 17.3% of cases. Average ADC was statistically higher after NAC (p < 0.001) among patients showing pCR vs. those who had not pCR. The RECIST classification showed adequate performance in predicting the pCR in Triple Negative (area under the receiver operating characteristic curve, ROC AUC = 0.9) and in the HER2+ subgroup (AUC = 0.826). Lower performance was found in the Luminal and Hybrid subgroups (AUC 0.693 and 0.611, respectively), where the ADC criterion yielded an improved performance (AUC = 0.787 and 0.722). The coupling of morphological and DWI criteria yielded maximally improved performance in the Luminal and Hybrid subgroups (AUC = 0.797 and 0.761). Conclusion: The diagnostic reliability of MRI in predicting the pCR to NAC depends on the tumor phenotype, particularly in the Luminal and Hybrid subgroups. In these cases, the coupling of morphological MRI evaluation and DWI assessment may facilitate the diagnosis.

  19. Interplay between functional connectivity and scale-free dynamics in intrinsic fMRI networks.

    Science.gov (United States)

    Ciuciu, Philippe; Abry, Patrice; He, Biyu J

    2014-07-15

    Studies employing functional connectivity-type analyses have established that spontaneous fluctuations in functional magnetic resonance imaging (fMRI) signals are organized within large-scale brain networks. Meanwhile, fMRI signals have been shown to exhibit 1/f-type power spectra - a hallmark of scale-free dynamics. We studied the interplay between functional connectivity and scale-free dynamics in fMRI signals, utilizing the fractal connectivity framework - a multivariate extension of the univariate fractional Gaussian noise model, which relies on a wavelet formulation for robust parameter estimation. We applied this framework to fMRI data acquired from healthy young adults at rest and while performing a visual detection task. First, we found that scale-invariance existed beyond univariate dynamics, being present also in bivariate cross-temporal dynamics. Second, we observed that frequencies within the scale-free range do not contribute evenly to inter-regional connectivity, with a systematically stronger contribution of the lowest frequencies, both at rest and during task. Third, in addition to a decrease of the Hurst exponent and inter-regional correlations, task performance modified cross-temporal dynamics, inducing a larger contribution of the highest frequencies within the scale-free range to global correlation. Lastly, we found that across individuals, a weaker task modulation of the frequency contribution to inter-regional connectivity was associated with better task performance manifesting as shorter and less variable reaction times. These findings bring together two related fields that have hitherto been studied separately - resting-state networks and scale-free dynamics, and show that scale-free dynamics of human brain activity manifest in cross-regional interactions as well.

  20. A Total Variation-Based Reconstruction Method for Dynamic MRI

    Directory of Open Access Journals (Sweden)

    Germana Landi

    2008-01-01

    Full Text Available In recent years, total variation (TV regularization has become a popular and powerful tool for image restoration and enhancement. In this work, we apply TV minimization to improve the quality of dynamic magnetic resonance images. Dynamic magnetic resonance imaging is an increasingly popular clinical technique used to monitor spatio-temporal changes in tissue structure. Fast data acquisition is necessary in order to capture the dynamic process. Most commonly, the requirement of high temporal resolution is fulfilled by sacrificing spatial resolution. Therefore, the numerical methods have to address the issue of images reconstruction from limited Fourier data. One of the most successful techniques for dynamic imaging applications is the reduced-encoded imaging by generalized-series reconstruction method of Liang and Lauterbur. However, even if this method utilizes a priori data for optimal image reconstruction, the produced dynamic images are degraded by truncation artifacts, most notably Gibbs ringing, due to the spatial low resolution of the data. We use a TV regularization strategy in order to reduce these truncation artifacts in the dynamic images. The resulting TV minimization problem is solved by the fixed point iteration method of Vogel and Oman. The results of test problems with simulated and real data are presented to illustrate the effectiveness of the proposed approach in reducing the truncation artifacts of the reconstructed images.

  1. Linking Ventilation Heterogeneity Quantified via Hyperpolarized 3He MRI to Dynamic Lung Mechanics and Airway Hyperresponsiveness.

    Science.gov (United States)

    Lui, Justin K; Parameswaran, Harikrishnan; Albert, Mitchell S; Lutchen, Kenneth R

    2015-01-01

    Advancements in hyperpolarized helium-3 MRI (HP 3He-MRI) have introduced the ability to render and quantify ventilation patterns throughout the anatomic regions of the lung. The goal of this study was to establish how ventilation heterogeneity relates to the dynamic changes in mechanical lung function and airway hyperresponsiveness in asthmatic subjects. In four healthy and nine mild-to-moderate asthmatic subjects, we measured dynamic lung resistance and lung elastance from 0.1 to 8 Hz via a broadband ventilation waveform technique. We quantified ventilation heterogeneity using a recently developed coefficient of variation method from HP 3He-MRI imaging. Dynamic lung mechanics and imaging were performed at baseline, post-challenge, and after a series of five deep inspirations. AHR was measured via the concentration of agonist that elicits a 20% decrease in the subject's forced expiratory volume in one second compared to baseline (PC20) dose. The ventilation coefficient of variation was correlated to low-frequency lung resistance (R = 0.647, P ventilation heterogeneity. Also, the degree of AHR appears to be dependent on the degree to which baseline airway constriction creates baseline ventilation heterogeneity. HP 3He-MRI imaging may be a powerful predictor of the degree of AHR and in tracking the efficacy of therapy.

  2. Simultaneous whole-body {sup 18}F-FDG PET-MRI in primary staging of breast cancer: A pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Taneja, Sangeeta, E-mail: s_taneja1974@yahoo.com [Department of Molecular Imaging and Nuclear Medicine, Indraprastha Apollo Hospitals, Sarita Vihar, Delhi–Mathura Road, New Delhi 110076 (India); Jena, Amarnath, E-mail: drjena2002@yahoo.com [Department of Molecular Imaging and Nuclear Medicine, Indraprastha Apollo Hospitals, Sarita Vihar, Delhi–Mathura Road, New Delhi 110076 (India); Goel, Reema, E-mail: reemagoell@gmail.com [Department of Molecular Imaging and Nuclear Medicine, Indraprastha Apollo Hospitals, Sarita Vihar, Delhi–Mathura Road, New Delhi 110076 (India); Sarin, Ramesh, E-mail: sarinramesh@hotmail.com [Department of Surgical Oncology, Indraprastha Apollo Hospitals, Sarita Vihar, Delhi––Mathura Road, New Delhi 110076 (India); Kaul, Sumaid, E-mail: sumaidkaul53@hotmail.com [Department of Pathology, Indraprastha Apollo Hospitals, Sarita Vihar, Delhi–Mathura Road, New Delhi 110076 (India)

    2014-12-15

    Highlights: • Initial staging of breast cancer important in treatment planning and prognostication. • We assessed role of simultaneous {sup 18}F-FDG PET-MRI in initial staging of breast cancer. • Primary, nodes and metastases on PET, MRI and PET-MRI for count and diagnostic confidence. • High diagnostic accuracy and confidence in detecting index and satellite lesions. • Comprehensive nodal and distant metastases staging with altered management (12 cases). - Abstract: Purpose: Accurate initial staging in breast carcinoma is important for treatment planning and for establishing the likely prognosis. The purpose of this study was to assess the utility of whole body simultaneous {sup 18}F-FDG PET-MRI in initial staging of breast carcinoma. Methods: 36 patients with histologically confirmed invasive ductal carcinoma underwent simultaneous whole body {sup 18}F-FDG PET-MRI on integrated 3 T PET-MR scanner (Siemens Biograph mMR) for primary staging. Primary lesion, nodes and metastases were evaluated on PET, MRI and PET-MRI for lesion count and diagnostic confidence (DC). Kappa co relation analysis was done to assess agreement between the satellite, nodal and metastatic lesions detected by PET and MRI. Histopathology, clinical/imaging follow-up served as the reference standard. Results: 36 patients with 37 histopathologically proven index breast cancer were retrospectively studied. Of 36 patients, 25 patients underwent surgery and 11 patients received systemic therapy. All index cancers were seen on PET and MR. Fused PET-MRI showed highest diagnostic confidence score of 5 as compared to PET (median 4; range 3–5) and MRI (median 4; range 4–5) alone. 2/36 (5.5%) patients were detected to have unsuspected contralateral synchronous cancer. 47 satellite lesions were detected on DCE MRI of which 23 were FDG avid with multifocality and multicentricity in 21 (58%) patients. Kappa co relation analysis revealed fair agreement for satellite lesion detection by the two

  3. 乳腺癌性病变诊断中DW-MRI联合3.0TDCE-MRI的临床研究%Clinical study on the diagnostic significance of breast lesions with DW-MRI combined 3. 0T DCE-MRI

    Institute of Scientific and Technical Information of China (English)

    党勇

    2016-01-01

    Objective To analyze the clinical significance of 3. 0T dynamic contrast enhanced MRI(DCE - MRI)combined with mag-netic resonance diffusion weighted imaging(DW - MRI)in diagnosis of breast lesions. Methods Thirty - nine patients with suspected breast tumors were examined by preoperative DCE - MRI combined DW - MRI inspection and pathological diagnosis of desected tissues. The records of joint diagnosis of benign and malignant tumors by DCE - MRI and DW - MRI were compared with phathologic diagnosis;and the coincidence rate of 2 kinds of diagnostic methods with pathologic diagnosis for benign or malignant tumor had been calculated;and the sensitivity,specificity and accuracy of DCE - MRI,DW - MRI and joint inspection had been analyzed. Results The results confirmed that the coicidence rates of benign and malignant tumors by joint examination with DCE - MRI and DW - MRI were 85. 00% and 95. 00% respectively,and it was significantly high-er than single application of either DCE - MRI or DW - MRI( P < 0. 05);and the sensitivity,specificity and accuracy of joint diagnosis were 95. 30% ,84. 56% and 90. 06% respectively,they were higher than those of DCE - MRI,and their specificity and accuracy were higher than those of DW - MRI;and the manifestations of malignant lesions in joint diagnosis were enhancement of lesions,burred edge and time - signal curve as platform - type or outflow type,with high signal lesions under DWI,and ADC was significantly abnormal. Conclusion The diagnosis of breast cancer with 3. 0T dynamic contrast enhanced MRI(DCE - MRI)combined magnetic resonance diffusion weighted imaging(DW - MRI)has high degree of sensitivity,specificity and accuracy,and it can be applied for preoperative noninvasive examination,and it has a guiding role for treat-ment with broad prospects for application.%目的:分析3.0T 磁共振动态增强扫描(DCE - MRI)联合磁共振扩散加权成像(DW - MRI)诊断乳腺癌性病变临床价值。方法

  4. Prospective comparison of T2w-MRI and dynamic-contrast-enhanced MRI, 3D-MR spectroscopic imaging or diffusion-weighted MRI in repeat TRUS-guided biopsies

    Energy Technology Data Exchange (ETDEWEB)

    Portalez, Daniel [Clinique Pasteur, 45, Department of Radiology, Toulouse (France); Rollin, Gautier; Mouly, Patrick; Jonca, Frederic; Malavaud, Bernard [Hopital de Rangueil, Department of Urology, Toulouse Cedex 9 (France); Leandri, Pierre [Clinique Saint Jean, 20, Department of Urology, Toulouse (France); Elman, Benjamin [Clinique Pasteur, 45, Department of Urology, Toulouse (France)

    2010-12-15

    To compare T2-weighted MRI and functional MRI techniques in guiding repeat prostate biopsies. Sixty-eight patients with a history of negative biopsies, negative digital rectal examination and elevated PSA were imaged before repeat biopsies. Dichotomous criteria were used with visual validation of T2-weighted MRI, dynamic contrast-enhanced MRI and literature-derived cut-offs for 3D-spectroscopy MRI (choline-creatine-to-citrate ratio >0.86) and diffusion-weighted imaging (ADC x 10{sup 3} mm{sup 2}/s < 1.24). For each segment and MRI technique, results were rendered as being suspicious/non-suspicious for malignancy. Sextant biopsies, transition zone biopsies and at least two additional biopsies of suspicious areas were taken. In the peripheral zones, 105/408 segments and in the transition zones 19/136 segments were suspicious according to at least one MRI technique. A total of 28/68 (41.2%) patients were found to have cancer. Diffusion-weighted imaging exhibited the highest positive predictive value (0.52) compared with T2-weighted MRI (0.29), dynamic contrast-enhanced MRI (0.33) and 3D-spectroscopy MRI (0.25). Logistic regression showed the probability of cancer in a segment increasing 12-fold when T2-weighted and diffusion-weighted imaging MRI were both suspicious (63.4%) compared with both being non-suspicious (5.2%). The proposed system of analysis and reporting could prove clinically relevant in the decision whether to repeat targeted biopsies. (orig.)

  5. Dynamic gadolinium-enhanced MRI evaluation of porcine femoral head ischemia and reperfusion

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, T. [Clinic for Orthopaedics and Sports Traumatology, Dreifaltigkeits-Krankenhaus GmbH, Aachener Str. 445-449, 50933 Koeln (Germany); Drescher, W. [Department of Orthopaedics, Christian Albrechts University, Kiel (Germany); Becker, C. [Department of Orthopaedics, Heinrich Heine University, Duesseldorf (Germany); Sangill, R.; Stoedkilde-Joergensen, H. [Institute for Magnetic Resonance Imaging Tomography, University of Aarhus, Skejby Hospital, Aarhus (Denmark); Heydthausen, M. [Computing Center, Heinrich Heine University, Duesseldorf (Germany); Hansen, E.S.; Buenger, C. [Spine Section, Department of Orthopaedics, University of Aarhus (Denmark)

    2003-02-01

    To examine the potential of gadolinium (Gd)-enhanced dynamic MRI in the detection of early femoral head ischemia. Furthermore, to apply a three-compartment model to achieve a clinically applicable MR index for femoral head perfusion during the steady state and arterial hip joint tamponade.Design and materials In a porcine model femoral head perfusion was measured by radioactive tracer microspheres and by using a dynamic Gd-enhanced MRI protocol. Femoral head perfusion measurements and MRI tests were performed unilaterally before, during and after the experimentally induced ischemia of one of the hip joints. Ischemia was induced by increasing intra-articular pressure to 250 mmHg. All pigs showed ischemia of the femoral head epiphysis under hip joint tamponade followed by reperfusion to the same level as before joint tamponade. In two cases perfusion after removal of tamponade continued to be low. In dynamic MRI measurements increases in signal intensity were seen after intravenous infusion of Gd-DTPA, followed by a slow decrease in signal intensity. The signal-intensity curve during femoral head ischemia had a minor increase. Also the coefficient determined was a helpful indicator of femoral head ischemia. Femoral head blood flow as measured by microspheres fell significantly under joint tamponade. Early detection of this disturbed regional blood flow was possible using a dynamic MRI procedure. A biomathematical model resulted from the evaluation of the intervals of signal intensity over time which allows detection of bone blood flow changes at a very early stage. Using this new method earlier detection of femoral head necrosis may be possible. (orig.)

  6. Non-contrast enhanced MRI for evaluation of breast lesions: comparison of non-contrast enhanced high spectral and spatial resolution (HiSS) images vs. contrast enhanced fat-suppressed images

    Science.gov (United States)

    Medved, Milica; Fan, Xiaobing; Abe, Hiroyuki; Newstead, Gillian M.; Wood, Abbie M.; Shimauchi, Akiko; Kulkarni, Kirti; Ivancevic, Marko K.; Pesce, Lorenzo L.; Olopade, Olufunmilayo I.; Karczmar, Gregory S.

    2011-01-01

    RATIONALE AND OBJECTIVES To evaluate high spectral and spatial resolution (HiSS) MRI for diagnosis of breast cancer without injection of contrast media: to compare the performance of pre-contrast HiSS images to conventional contrast-enhanced fat-suppressed T1-weighted images, based on image quality and in the task of classifying benign and malignant breast lesions. MATERIALS AND METHODS Ten benign and 44 malignant lesions were imaged at 1.5T with HiSS (pre-contrast administration) and conventional fat-suppressed imaging (3–10 min post-contrast). This set of 108 images, after randomization, was evaluated by three experienced radiologists blinded to the imaging technique. BIRADS morphologic criteria (lesion shape; lesion margin; internal signal intensity pattern) and final assessment were used to measure reader performance. Image quality was evaluated based on boundary delineation and quality of fat suppression. An overall probability of malignancy was assigned to each lesion for HiSS and conventional images separately. RESULTS On boundary delineation and quality of fat-suppression, pre-contrast HiSS scored similarly to conventional post-contrast MRI. On benign vs. malignant lesion separation, there was no statistically significant difference in ROC performance between HiSS and conventional MRI, and HiSS met a reasonable non-inferiority condition. CONCLUSION Pre-contrast HiSS imaging is a promising approach for showing lesion morphology without blooming and other artifacts caused by contrast agents. HiSS images could be used to guide subsequent dynamic contrast-enhanced MRI scans, to maximize spatial and temporal resolution in suspicious regions. HiSS MRI without contrast agent injection may be particularly important for patients at risk for contrast-induced nephrogenic systemic fibrosis, or allergic reactions. PMID:21962476

  7. The dynamics of deductive reasoning: an fMRI investigation.

    Science.gov (United States)

    Rodriguez-Moreno, Diana; Hirsch, Joy

    2009-03-01

    Although the basis for deductive reasoning has been a traditional focus of philosophical discussion, the neural correlates and mechanisms that underlie deductive reasoning have only recently become the focus of scientific investigation. In syllogistic deductive reasoning information presented in two related sequential premises leads to a subsequent conclusion. While previous imaging studies have identified frontal, parietal, temporal, and occipital complexes that are activated during these reasoning events, there are substantive differences among the findings with respect to the specific regions engaged in reasoning and the contribution of language areas. Further, little is known about the various stages of information processing during reasoning. Using event-related fMRI and an auditory and visual conjunction technique, we identified a long-range supramodal network active during reasoning processes including areas in the left frontal and parietal regions as well as the bilateral caudate nucleus. Time courses of activation for each of these regions suggest that reasoning processes emerge during the presentation of the second premise, and remain active until the validation of the conclusion. Thus, areas within the frontal and parietal regions are differentially engaged at different time points in the reasoning process consistent with coordinated intra-network interactions.

  8. Diagnostic accuracy of {sup 18}F-FDG PET/CT compared with that of contrast-enhanced MRI of the breast at 3 T

    Energy Technology Data Exchange (ETDEWEB)

    Magometschnigg, Heinrich F.; Baltzer, Pascal A.; Fueger, Barbara; Helbich, Thomas H.; Weber, Michael [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Vienna (Austria); Karanikas, Georgios [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Vienna (Austria); Dubsky, Peter [Medical University of Vienna, Department of Surgery, Vienna (Austria); Rudas, Margaretha [Medical University of Vienna, Department of Pathology, Vienna (Austria); Pinker, Katja [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Vienna (Austria); Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York (United States)

    2015-10-15

    To compare the diagnostic accuracy of prone {sup 18}F-FDG PET/CT with that of contrast-enhanced MRI (CE-MRI) at 3 T in suspicious breast lesions. To evaluate the influence of tumour size on diagnostic accuracy and the use of maximum standardized uptake value (SUV{sub MAX}) thresholds to differentiate malignant from benign breast lesions. A total of 172 consecutive patients with an imaging abnormality were included in this IRB-approved prospective study. All patients underwent {sup 18}F-FDG PET/CT and CE-MRI of the breast at 3 T in the prone position. Two reader teams independently evaluated the likelihood of malignancy as determined by {sup 18}F-FDG PET/CT and CE-MRI independently. {sup 18}F-FDG PET/CT data were qualitatively evaluated by visual interpretation. Quantitative assessment was performed by calculation of SUV{sub MAX}. Sensitivity, specificity, diagnostic accuracy, area under the curve and interreader agreement were calculated for all lesions and for lesions <10 mm. Histopathology was used as the standard of reference. There were 132 malignant and 40 benign lesions; 23 lesions (13.4 %) were <10 mm. Both {sup 18}F-FDG PET/CT and CE-MRI achieved an overall diagnostic accuracy of 93 %. There were no significant differences in sensitivity (p = 0.125), specificity (p = 0.344) or diagnostic accuracy (p = 1). For lesions <10 mm, diagnostic accuracy deteriorated to 91 % with both {sup 18}F-FDG PET/CT and CE-MRI. Although no significant difference was found for lesions <10 mm, CE-MRI at 3 T seemed to be more sensitive but less specific than {sup 18}F-FDG PET/CT. Interreader agreement was excellent (κ = 0.85 and κ = 0.92). SUV{sub MAX} threshold was not helpful in differentiating benign from malignant lesions. {sup 18}F-FDG PET/CT and CE-MRI at 3 T showed equal diagnostic accuracies in breast cancer diagnosis. For lesions <10 mm, diagnostic accuracy deteriorated, but was equal for {sup 18}F-FDG PET/CT and CE-MRI at 3 T. For lesions <10 mm, CE-MRI at 3 T seemed

  9. Semiautomatic assessment of respiratory motion in dynamic MRI. Comparison with simultaneously acquired spirometry

    Energy Technology Data Exchange (ETDEWEB)

    Tetzlaff, R.; Eichinger, M.; Puderbach, M. [Radiologie, Deutsches Krebsforschungszentrum, Heidelberg (Germany); Schoebinger, M.; Meinzer, H.P. [Medizinische und Biologische Informatik, Deutsches Krebsforschungszentrum, Heidelberg (Germany); Kauczor, H.U. [Diagnostische Radiologie, Radiologische Universitaetsklinik, Heidelberg (Germany)

    2008-11-15

    Purpose: supplementing global spirometry with regional information could allow for earlier and more specific diagnosis of lung disease. Dynamic magnetic resonance imaging (dMRI) makes it possible to derive functional parameters from the visualization of the pulmonary motion of single lungs. The aim of this study was to compare high temporal resolution measurements of left and right thoracic diameters to simultaneously acquired spirometry. Materials and methods: 10 healthy volunteers underwent 2-dimensional dMRI of both lungs at 1.5 T. Spirometry was performed simultaneously with an MRI-compatible spirometer. Thoracic diameters were measured semiautomatically and compared to simultaneously measured spirometric volumes. A dMRI surrogate for the Tiffeneau Index was compared to the spirometric Tiffeneau. Results: The volume-time and flow-volume curves from dMRI were very similar to the spirometric curves. The semiautomatically measured diameters correlated well with the spirometric volumes (r > = 0.8, p < 10-15). Agreement between the methods at full temporal resolution was not as convincing (width of 95% limits of agreement interval up to 56%). Good agreement was found between the Tiffenau surrogate and spirometry (width of 95% limits of agreement interval of 14.5%). (orig.)

  10. Diagnostic Efficacy of All Series of Dynamic Contrast Enhanced Breast MR Images Using Gradient Vector Flow (GVF Segmentation and Novel Border Feature Extraction for Differentiation Between Malignant

    Directory of Open Access Journals (Sweden)

    L. Bahreini

    2010-12-01

    Full Text Available Background/Objective: To discriminate between malignant and benign breast lesions;"nconventionally, the first series of Breast Subtraction Dynamic Contrast-Enhanced Magnetic"nResonance Imaging (BS DCE-MRI images are used for quantitative analysis. In this study, we"ninvestigated whether using all series of these images could provide us with more diagnostic"ninformation."nPatients and Methods: This study included 60 histopathologically proven lesions. The steps of"nthis study were as follows: selecting the regions of interest (ROI, segmentation using Gradient"nVector Flow (GVF snake for the first time, defining new feature sets, using artificial neural network"n(ANN for optimal feature set selection, evaluation using receiver operating characteristic (ROC"nanalysis."nResults: The results showed GVF snake method correctly segmented 95.3% of breast lesion"nborders at the overlap threshold of 0.4. The first classifier which used the optimal feature set"nextracted only from the first series of BS DCE-MRI images achieved an area under the curve"n(AUC of 0.82, specificity of 60% at sensitivity of 81%. The second classifier which used the same"noptimal feature set but was extracted from all five series of these images achieved an AUC of"n0.90, specificity of 79% at sensitivity of 81%."nConclusion: The result of GVF snake segmentation showed that it could make an accurate"nsegmentation in the borders of breast lesions. According to this study, using all five series of BS"nDCE-MRI images could provide us with more diagnostic information about the breast lesion and"ncould improve the performance of breast lesion classifiers in comparison with using the first"nseries alone.

  11. Triple negative breast cancer: MRI features in comparison to other breast cancer subtypes with correlation to prognostic pathologic factors

    Directory of Open Access Journals (Sweden)

    Noha Mohamed Osman

    2014-12-01

    Conclusion: In our study, TNBC patients were of younger age with higher grade malignancy. TNBC MRI predictors were unifocal rim enhancing mass with round shape, smooth margin, higher signal intensity on T2-WI, in addition to relatively larger sizes of tumors associated with high incidence of intratumoral necrosis and higher ADC values.

  12. Preliminary experience using dynamic MRI at 3.0 tesla for evaluation of soft tissue tumors

    Energy Technology Data Exchange (ETDEWEB)

    Park, Micheal; Jee, Won Hee; Jung, Joon Yong [Dept. of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Kim, Sun Ki [Dept. of Radiology, Incheon St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Incheon (Korea, Republic of); Lee, So Yeon [Dept. of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2013-01-15

    We aimed to evaluate the use of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) at 3.0 T for differentiating the benign from malignant soft tissue tumors. Also we aimed to assess whether the shorter length of DCE-MRI protocols are adequate, and to evaluate the effect of temporal resolution. Dynamic contrast-enhanced magnetic resonance imaging, at 3.0 T with a 1 second temporal resolution in 13 patients with pathologically confirmed soft tissue tumors, was analyzed. Visual assessment of time-signal curves, subtraction images, maximal relative enhancement at the first (maximal peak enhancement [Emax]/1) and second (Emax/2) minutes, Emax, steepest slope calculated by using various time intervals (5, 30, 60 seconds), and the start of dynamic enhancement were analyzed. The 13 tumors were comprised of seven benign and six malignant soft tissue neoplasms. Washout on time-signal curves was seen on three (50%) malignant tumors and one (14%) benign one. The most discriminating DCE-MRI parameter was the steepest slope calculated, by using at 5-second intervals, followed by Emax/1 and Emax/2. All of the steepest slope values occurred within 2 minutes of the dynamic study. Start of dynamic enhancement did not show a significant difference, but no malignant tumor rendered a value greater than 14 seconds. The steepest slope and early relative enhancement have the potential for differentiating benign from malignant soft tissue tumors. Short-length rather than long-length DCE-MRI protocol may be adequate for our purpose. The steepest slope parameters require a short temporal resolution, while maximal peak enhancement parameter may be more optimal for a longer temporal resolution.

  13. Three-dimensional contrast enhanced ultrasound score and dynamic contrast-enhanced magnetic resonance imaging score in evaluating breast tumor angiogenesis: Correlation with biological factors

    Energy Technology Data Exchange (ETDEWEB)

    Jia, Wan-Ru, E-mail: jiawanru@126.com [Department of Diagnostic Ultrasound, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, No. 197 Rui Jin 2nd Road, Shanghai 200025 (China); Chai, Wei-Min, E-mail: chai_weimin@yahoo.com.cn [Department of Radiology, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, No. 197 Rui Jin 2nd Road, Shanghai 200025 (China); Tang, Lei, E-mail: jessietang1003@163.com [Department of Diagnostic Ultrasound, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, No. 197 Rui Jin 2nd Road, Shanghai 200025 (China); Wang, Yi, E-mail: xiatian.0602@163.com [Department of Diagnostic Ultrasound, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, No. 197 Rui Jin 2nd Road, Shanghai 200025 (China); Fei, Xiao-Chun, E-mail: xcf0222@163.com [Department of Pathology, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, No. 197 Rui Jin 2nd Road, Shanghai 200025 (China); Han, Bao-San, E-mail: hanbaosan@126.com [Department of Comprehensive Breast Health Center, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, No. 197 Rui Jin 2nd Road, Shanghai 200025 (China); Chen, Man, E-mail: lucyjia1370@126.com [Department of Diagnostic Ultrasound, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, No. 197 Rui Jin 2nd Road, Shanghai 200025 (China)

    2014-07-15

    Objective: To explore the clinical value of three-dimensional contrast enhanced ultrasound (3D-CEUS) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) score systems in evaluating breast tumor angiogenesis by comparing their diagnostic efficacy and correlation with biological factors. Methods: 3D-CEUS was performed in 183 patients with breast tumors by Esaote Mylab90 with SonoVue (Bracco, Italy), DCE-MRI was performed on a dedicated breast magnetic resonance imaging (DBMRI) system (Aurora Dedicated Breast MRI Systems, USA) with a dedicated breast coil. 3D-CEUS and DCE-MRI score systems were created based on tumor perfusion and vascular characteristics. Microvessel density (MVD), vascular endothelial growth factor (VEGF) and matrix metalloproteinases (MMP-2, MMP-9) expression were measured by immunohistochemistry. Results: Pathological results showed 35 benign and 148 malignant breast tumors. MVD (P = 0.000, r = 0.76), VEGF (P = 0.000, r = 0.55), MMP-2 (P = 0.000, r = 0.39) and MMP-9 (P = 0.000, r = 0.41) expression were all significantly different between benignity and malignancy. Regarding 3D-CEUS 4 points as cutoff value, the sensitivity, specificity and accuracy were 85.1%, 94.3% and 86.9%, respectively, and correlated well with MVD (P = 0.000, r = 0.50), VEGF (P = 0.000, r = 0.50), MMP-2 (P = 0.000, r = 0.50) and MMP-9 (P = 0.000, r = 0.66). Taking DCE-MRI 5 points as cutoff value, the sensitivity, specificity and accuracy were 86.5%, 94.3% and 88.0%, respectively and also correlated well with MVD (P = 0.000, r = 0.52), VEGF (P = 0.000, r = 0.44), MMP-2 (P = 0.000, r = 0.42) and MMP-9 (P = 0.000, r = 0.35). Conclusions: 3D-CEUS score system displays inspiring diagnostic performance and good agreement with DCE-MRI scoring. Moreover, both score systems correlate well with MVD, VEGF, MMP-2 and MMP-9 expression, and thus have great potentials in tumor angiogenesis evaluation.

  14. Dynamic contrast-enhanced MRI for treatment response assessment in patients with oesophageal cancer receiving neoadjuvant chemoradiotherapy

    NARCIS (Netherlands)

    Heethuis, Sophie E.; van Rossum, Peter S N; Lips, IM; Goense, Lucas; Voncken, Francine E.; Reerink, Onne; van Hillegersberg, Richard; Ruurda, Jelle P.; Philippens, Marielle E.; van Vulpen, Marco; Meijer, Gert J.; Lagendijk, JJW; van Lier, A.L.H.M.W.

    2016-01-01

    Purpose To explore and evaluate the potential value of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) for the prediction of pathologic response to neoadjuvant chemoradiotherapy (nCRT) in oesophageal cancer. Material and methods Twenty-six patients underwent DCE-MRI before, during (

  15. Comparative study on X- ray mammography and MRI in diagnosing breast cancer%乳腺癌X线与MRI诊断价值比较分析

    Institute of Scientific and Technical Information of China (English)

    渠红; 鲍春生; 邢丽

    2011-01-01

    目的:比较X线及MRI两种影像学检查方法对于乳腺癌的诊断价值.方法:回顾分析48例经手术病理证实的乳腺癌患者的MRI及X线检查资料,进行对比分析.结果:MRI对于乳腺癌病灶的检出高于X线摄影,但存在假阳性,对于判断病变范围及淋巴结转移等方面MRI具有较大价值.结论:X线摄影与MRI联合应用有助于提高乳腺癌的诊断准确率.%Objective:To compare the capabilities of MRI and X - ray mammography in diagnosing breast cancer. Methods ; A retrospective study of 48 breast cancer proved by pathology was performed, the diagnosing results of MRI and X - ray mammography were compared with that of histopathology.Results : MRI imaging was superior to mammography , but it exist false - positive ; MRI imaging was much valuable for lymph nodes metastases and assesament of lesion extent.Conclusion : X - ray mammography in combination with MRI is helpful in the diagnasis of breast cancer ,the sensitivity and specificity was enhanced when compared to that of single.

  16. Probability of malignancy for lesions detected on breast MRI: a predictive model incorporating BI-RADS imaging features and patient characteristics

    Energy Technology Data Exchange (ETDEWEB)

    DeMartini, Wendy B.; Gutierrez, Robert L.; Peacock, Sue; Lehman, Constance D. [University of Washington Medical Center, Department of Radiology, Seattle, WA (United States); Seattle Cancer Care Alliance, Breast Imaging, Seattle, WA (United States); Kurland, Brenda F. [Fred Hutchinson Cancer Research Center, Clinical Statics, 1100 Fairview Avenue North, PO Box 19024, Seattle, WA (United States); Seattle Cancer Care Alliance, Seattle, WA (United States); Blackmore, C.C. [Virginia Mason Medical Center, Department of Radiology, 1100 9th Avenue, PO Box 900, Seattle, WA (United States)

    2011-08-15

    To predict the probability of malignancy for MRI-detected breast lesions with a multivariate model incorporating patient and lesion characteristics. Retrospective review of 2565 breast MR examinations from 1/03-11/06. BI-RADS 3, 4 and 5 lesions initially detected on MRI for new cancer or high-risk screening were included and outcomes determined by imaging, biopsy or tumor registry linkage. Variables were indication for MRI, age, lesion size, BI-RADS lesion type and kinetics. Associations with malignancy were assessed using generalized estimating equations and lesion probabilities of malignancy were calculated. 855 lesions (155 malignant, 700 benign) were included. Strongest associations with malignancy were for kinetics (washout versus persistent; OR 4.2, 95% CI 2.5-7.1) and clinical indication (new cancer versus high-risk screening; OR 3.0, 95% CI 1.7-5.1). Also significant were age > = 50 years, size > = 10 mm and lesion-type mass. The most predictive model (AUC 0.70) incorporated indication, size and kinetics. The highest probability of malignancy (41.1%) was for lesions on MRI for new cancer, > = 10 mm with washout. The lowest (1.2%) was for lesions on high-risk screening, <10 mm with persistent kinetics. A multivariate model shows promise as a decision support tool in predicting malignancy for MRI-detected breast lesions. (orig.)

  17. 乳腺浸润性导管癌25例的临床及MRI表现分析%Analysis of clinical and MRI manifestation of 25 cases of infiltrating ductal carcinoma of the breast

    Institute of Scientific and Technical Information of China (English)

    李智晞

    2014-01-01

    目的:讨论乳腺浸润性导管癌的临床及MRI表现。方法:回顾性分析25例乳腺浸润性导管癌的临床及MRI表现。结果:乳腺浸润性导管癌好发于右乳外上象限,病理分级为Ⅱ级最多,MRI 上病灶多呈形态不规则的团块状,部分也可呈结节状及分叶状,T1WI呈等信号,T2WI呈稍高信号,DWI多呈高信号影,ADC值降低,20例可见病灶周围多发增生的肿瘤血管影。动态增强扫描,按TIC分型,Ⅰ型(渐增型)5例,Ⅱ型(平台型)11例,Ⅲ型(流出型)9例。结论:乳腺浸润性导管癌在临床及MRI表现上具有较明显的特征。%Objective:To explore the clinical and MRI manifestation.Methods:We retrospectively analyzed the clinical and MRI manifestation in 25 cases of invasive ductal carcinoma of the breast.Results:The primary site of infiltrating ductal carcinoma of the breast was right breast upper outer quadrant.The Ⅱ grade of pathologic grade was most.In MRI,lesion morphology most were irregular.Part were nodular or lobulated.T1WI was equisignal.T2WI was slightly high signal.The DWI was high signal.ADC values were reduced.There were multiple hyperplasia tumor vessels shadow in 20 cases around the focus.On dynamic enhanced scan, according to TIC classification,5 cases were type Ⅰ type(incremental type),11 cases were Ⅱ type(platform type),and 9 cases wereⅢ type(outflow type).Conclusion:There are obvious character of infiltrating ductal carcinoma of the breast in clinical and MRI manifestation.

  18. Multicenter prospective study of magnetic resonance imaging prior to breast-conserving surgery for breast cancer

    Institute of Scientific and Technical Information of China (English)

    Liu Qian; Liu Yinhua; Xu Ling; Duan Xuening; Li Ting; Qin Naishan; Kang Hua

    2014-01-01

    Background This multicenter prospective study aimed to assess the utility of dynamic enhanced magnetic resonance imaging (MRI) prior to breast-conserving surgery for breast cancer.Methods The research subjects were drawn from patients with primary early resectable breast cancer treated in the breast disease centers of six three-level hospitals in Beijing from 1 January 2010 to 31 December 2012.The participants were allocated to a breast-conserving surgery group (breast-conserving group) or a total mastectomy group (total mastectomy group).Enhanced MRI was used to measure breast volume,longest diameter of tumor and tumor volume.The correlations between these measurements and those derived from histopathologic findings were assessed.The relationships between the success rate of breast-conserving surgery and MRI-and pathology-based measurement results were statistically analyzed in the breast-conserving group.Results The study included 461 cases in the total mastectomy group and 195 in the breast-conserving group.Allocation to these groups was based on clinical indications and patient preferences.The cut-off for concurrence between MRI-and pathology-based measurements of the longest diameter of tumor was set at 0.3 cm.In the total mastectomy group,the confidence interval for 95% concurrence of these measurements was 35.41%-44.63%.Correlation coefficients for MRI and histopathology-based measurements of breast volume,tumor volume and tumor volume/breast volume ratio were r=0.861,0.569,and 0.600,respectively (all P <0.001).In the breast-conserving group,with 0.30 cm taken as the cut-off for concurrence,the 95% confidence interval for MRI and pathology-based measurements of the longest diameter of tumor was 29.98%-44.01%.The subjective and objective success rates for breast-conserving surgery were 100% and 88.54%,respectively.Conclusions There were significant correlations between dynamic enhanced MRI-and histopathology-based measurements of the longest

  19. Experimental and numerical analysis of B1+ field and SAR with a new transmit array design for 7 T breast MRI

    Science.gov (United States)

    Kim, Junghwan; Krishnamurthy, Narayan; Santini, Tales; Zhao, Yujuan; Zhao, Tiejun; Bae, Kyongtae Ty; Ibrahim, Tamer S.

    2016-08-01

    Developing a radiofrequency (RF) coil system that produces a uniform B1+ field (circularly polarized component of the transverse magnetic field responsible for excitation) and low specific absorption rate (SAR) is critical for high performance ultrahigh field human imaging. In this study, we provide the design of a new eight channel radiofrequency (RF) transmit (Tx) array for breast MRI at 7 T. A numerical analysis utilizing an in-house finite difference time domain (FDTD) package was carried out in (1) four breast models, (2) homogeneous spherical model and (3) full body model to calculate the B1+ intensity (μT) and homogeneity represented by coefficient of variation (CoV = standard deviation/mean) in the proposed RF array design. The numerical results were compared with that measured in breast phantom (Bphantom) and homogeneous spherical phantom at 7 T MRI and showed very good agreement. Average and peak SARs were also calculated in the four breast models and the temperature rises due to the operation of the RF array were also measured in the Bphantom. The proposed RF array; which can operate in a single or multi transmit modes, demonstrates homogeneous RF field excitation with acceptable local/average SAR levels for breast MRI at 7 T.

  20. Dynamic enhanced MRI of the subacromial bursa: correlation with arthroscopic and histological findings

    Energy Technology Data Exchange (ETDEWEB)

    Matsuzaki, S. [Dept. of Radiology, Osaka Kosei-nenkin Hospital (Japan); Yoneda, M. [Shoulder and Sports Medicine Service, Osaka Kosei-nenkin Hospital, Osaka City, Osaka (Japan); Kobayashi, Y. [Dept. of Pathology, Osaka Kosei-nenkin Hospital (Japan); Fukushima, S. [Dept. of Orthopaedic Surgery, Sapporo Tokeidai Hospital, Osaka (Japan); Wakitani, S. [Dept. of Orthopaedic Surgery, Shinsyu Univ., Matsumato (Japan)

    2003-09-01

    Objective: To assess dynamic MRI with Gd-DTPA enhancement for evaluating inflammatory changes in the subacromial bursa. Design and patients: We detected the signal intensity changes in dynamic MRI of the subacromial bursa, and confirmed these macroscopically by arthroscopy and histologically. The signal intensity was measured using built-in software, and the enhancement ratio (E ratio) was calculated from dynamic MR images. In addition, as a parameter of the rate of the increase in the signal intensity from 0 to 80 s, the mean increase per second in the E ratio was obtained as the coefficient of enhancement (CE). The correlation was studied of the E ratio and CE with the arthroscopic findings (redness, villous formation, thickening and adhesion), and of the E ratio and CE with the histological findings (capillary proliferation, papillary hyperplasia, fibrosis and inflammatory cell infiltration) of the subacromial bursa. Of patients with shoulder pain, this study included those with rotator cuff injury; patients with rheumatoid arthritis or pitching shoulder disorders were excluded. There were 27 patients (15 men, 12 women) ranging in age from 25 to 73 years (mean 49.1 years). Dynamic MRI of the shoulder was also performed on the healthy side of 10 patients and in five normal young volunteers. Results and conclusions: Changes in signal intensity on dynamic MRI were measured in the subacromial bursa. The E ratio (80 s) and CE (0-80 s) were significantly correlated with redness and villous formation as arthroscopic findings, positively correlated with capillary proliferation and papillary hyperplasia as histological findings (p < 0.05), and negatively correlated with fibrosis as a histological finding (p < 0.05) in the subacromial bursa. The patterns of dynamic curves were well correlated with the bursoscopic and histological findings of the synovium of the subacromial bursa. Dynamic MRI appears to correlate with inflammatory activity of synovium of the subacromial

  1. Breast cancer screening with imaging: recommendations from the Society of Breast Imaging and the ACR on the use of mammography, breast MRI, breast ultrasound, and other technologies for the detection of clinically occult breast cancer.

    Science.gov (United States)

    Lee, Carol H; Dershaw, D David; Kopans, Daniel; Evans, Phil; Monsees, Barbara; Monticciolo, Debra; Brenner, R James; Bassett, Lawrence; Berg, Wendie; Feig, Stephen; Hendrick, Edward; Mendelson, Ellen; D'Orsi, Carl; Sickles, Edward; Burhenne, Linda Warren

    2010-01-01

    Screening for breast cancer with mammography has been shown to decrease mortality from breast cancer, and mammography is the mainstay of screening for clinically occult disease. Mammography, however, has well-recognized limitations, and recently, other imaging including ultrasound and magnetic resonance imaging have been used as adjunctive screening tools, mainly for women who may be at increased risk for the development of breast cancer. The Society of Breast Imaging and the Breast Imaging Commission of the ACR are issuing these recommendations to provide guidance to patients and clinicians on the use of imaging to screen for breast cancer. Wherever possible, the recommendations are based on available evidence. Where evidence is lacking, the recommendations are based on consensus opinions of the fellows and executive committee of the Society of Breast Imaging and the members of the Breast Imaging Commission of the ACR.

  2. The usefulness of dynamic MRI for diagnosing and assessing sleep breathing disorder

    Energy Technology Data Exchange (ETDEWEB)

    Moriwaki, Hiroto; Uchida, Akira; Chiba, Sachiko; Moriyama, Hiroshi [Jikei Univ., Tokyo (Japan). School of Medicine; Chiba, Shintarou; Yagi, Asako; Ohta, Masaji [Ohta General Hospital, Kawasaki, Kanagawa (Japan); Tokunaga, Masakazu [Kanagawa Prefecture Midwives and Nurses Training School (Japan). Hospital

    2003-04-01

    Polysomnography is useful for assessing the severity of sleep breathing disorder, including obstructive sleep apnea hypopnea syndrome. The clinical condition is difficult to understand completely, however, based on the apnea hypopnea index (AHI) alone, however, and longitudinal change of shape in the upper airway must be clarified. Most diagnoses of obstructive sites in the upper airway were diagnosed statically, so we attempted to assess changes in upper airway shape using dynamic magnetic resonance imaging (MRI), emphasizing the movement of tongue and lower chin, to analyze the relationship between AHI. Subjects were 62 patients with sleep breathing disorder examined by nocturnal polysomnography and dynamic MRI, assessing the change of shape in the upper airway. We concluded that: the group whose rotation angle of the tongue exceeded 6 deg and that the group whose distance of lower chin movement was longer during sleep than while awake were severe cases. (author)

  3. Automated fibroglandular tissue segmentation and volumetric density estimation in breast MRI using an atlas-aided fuzzy C-means method

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Shandong; Weinstein, Susan P.; Conant, Emily F.; Kontos, Despina, E-mail: despina.kontos@uphs.upenn.edu [Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104 (United States)

    2013-12-15

    Purpose: Breast magnetic resonance imaging (MRI) plays an important role in the clinical management of breast cancer. Studies suggest that the relative amount of fibroglandular (i.e., dense) tissue in the breast as quantified in MR images can be predictive of the risk for developing breast cancer, especially for high-risk women. Automated segmentation of the fibroglandular tissue and volumetric density estimation in breast MRI could therefore be useful for breast cancer risk assessment. Methods: In this work the authors develop and validate a fully automated segmentation algorithm, namely, an atlas-aided fuzzy C-means (FCM-Atlas) method, to estimate the volumetric amount of fibroglandular tissue in breast MRI. The FCM-Atlas is a 2D segmentation method working on a slice-by-slice basis. FCM clustering is first applied to the intensity space of each 2D MR slice to produce an initial voxelwise likelihood map of fibroglandular tissue. Then a prior learned fibroglandular tissue likelihood atlas is incorporated to refine the initial FCM likelihood map to achieve enhanced segmentation, from which the absolute volume of the fibroglandular tissue (|FGT|) and the relative amount (i.e., percentage) of the |FGT| relative to the whole breast volume (FGT%) are computed. The authors' method is evaluated by a representative dataset of 60 3D bilateral breast MRI scans (120 breasts) that span the full breast density range of the American College of Radiology Breast Imaging Reporting and Data System. The automated segmentation is compared to manual segmentation obtained by two experienced breast imaging radiologists. Segmentation performance is assessed by linear regression, Pearson's correlation coefficients, Student's pairedt-test, and Dice's similarity coefficients (DSC). Results: The inter-reader correlation is 0.97 for FGT% and 0.95 for |FGT|. When compared to the average of the two readers’ manual segmentation, the proposed FCM-Atlas method achieves a

  4. Radiolabeled cyclic arginine-glycine-aspartic (RGD)-conjugated iron oxide nanoparticles as single-photon emission computed tomography (SPECT) and magnetic resonance imaging (MRI) dual-modality agents for imaging of breast cancer

    Science.gov (United States)

    Deng, Shengming; Zhang, Wei; Zhang, Bin; Hong, Ruoyu; Chen, Qing; Dong, Jiajia; Chen, Yinyiin; Chen, Zhiqiang; Wu, Yiwei

    2015-01-01

    Ultrasmall superparamagnetic iron oxide nanoparticles (USPIOs) modified with a novel cyclic arginine-glycine-aspartate (RGD) peptide were made and radiolabeled as single-photon emission computed tomography (SPECT) and magnetic resonance imaging (MRI) dual-modality agents for imaging of breast cancer. The probe was tested both in vitro and in vivo to determine its receptor targeting efficacy and feasibility for SPECT and MRI. The radiochemical syntheses of 125I-cRGD-USPIO were accomplished with a radiochemical purity of 96.05 ± 0.33 %. High radiochemical stability was found in fresh human serum and in phosphate-buffered saline. The average hydrodynamic size of 125I-cRGD-USPIO determined by dynamic light scattering was 51.3 nm. Results of in vitro experiments verified the specificity of the radiolabeled nanoparticles to tumor cells. Preliminary biodistribution studies of 125I-radiolabeled cRGD-USPIO in Bcap37-bearing nude mice showed that it had long circulation half-life, high tumor uptake, and high initial blood retention with moderate liver uptake. In vivo tumor targeting and uptake of the radiolabeled nanoparticles in mice model were visualized by SPECT and MRI collected at different time points. Our results strongly indicated that the 125I-cRGD-USPIO could be used as a promising bifunctional radiotracer for early clinical tumor detection with high sensitivity and high spatial resolution by SPECT and MRI.

  5. Tumor metabolism and perfusion ratio assessed by 18F-FDG PET/CT and DCE-MRI in breast cancer patients: Correlation with tumor subtype and histologic prognostic factors

    Energy Technology Data Exchange (ETDEWEB)

    An, Young-Sil [Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine (Korea, Republic of); Kang, Doo Kyoung [Department of Radiology, Ajou University School of Medicine (Korea, Republic of); Jung, Yong Sik; Han, Sehwan [Department of Surgery, Ajou University School of Medicine (Korea, Republic of); Kim, Tae Hee, E-mail: medhand@ajou.ac.kr [Department of Radiology, Ajou University School of Medicine (Korea, Republic of)

    2015-07-15

    Highlights: • In non-triple negative breast cancer, metabolic parameter (SUVmax) was significantly correlated with perfusion parameters (Kep and Ve). • In triple negative cancers, any perfusion parameters did not correlated with metabolic parameters. • Higher SUVmax, higher SUVmax/Ktrans, higher MTV50/Ktrans, higher TLG50/Ktrans, higher TLG50/Ve ratios were significantly correlated with TNBC. • In triple negative breast cancer, perfusion and metabolic parameters are not significantly correlated. • Triple negative breast cancer showed higher metabolic–perfusion ratios compared to non-triple negative breast cancer. - Abstract: Objective: Our purpose was to evaluate whether breast cancer with high metabolic–perfusion ratio would be associated with poor histopathologic prognostic factors and whether triple negative breast cancer (TNBC) would show high metabolic–perfusion ratio compared to non-triple negative breast cancer (non-TNBC). Methods: From March 2011 to November 2011, 67 females with invasive ductal carcinoma of breast who underwent both MRI and 18F-FDG PET/CT were included. Perfusion parameters including Ktrans, Kep and Ve were acquired from Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Metabolic parameters including the standardized uptake value (SUV) and volumetric metabolic parameters including metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were obtained from F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). Results: In non-TNBC, SUVmax was significantly correlated with Kep (ρ = 0.298, p = 0.036) and Ve (ρ = −0.286, p = 0.044). In TNBC, there was no significant correlation between all perfusion and metabolic parameters. Compared to non-TNBC, higher SUVmax (10.2 vs 5.3, p < 0.001), higher SUVmax/Ktrans (56.02 vs 20.3, p < 0.001), higher MTV50/Ktrans (7.8 vs 16.54, p < 0.001), higher TLG50/Ktrans (36.49 vs 12.3, p < 0.001), higher TLG50/Ve (91.34 vs 27.1 p = 0.022) were

  6. Multisensory integration of dynamic emotional faces and voices: method for simultaneous EEG-fMRI measurements

    Directory of Open Access Journals (Sweden)

    Patrick David Schelenz

    2013-11-01

    Full Text Available Combined EEG-fMRI analysis correlates time courses from single electrodes or independent EEG components with the hemodynamic response. Implementing information from only one electrode, however, may miss relevant information from complex electrophysiological networks. Component based analysis, in turn, depends on a priori knowledge of the signal topography. Complex designs such as studies on multisensory integration of emotions investigate subtle differences in distributed networks based on only a few trials per condition. Thus, they require a sensitive and comprehensive approach which does not rely on a-priori knowledge about the underlying neural processes. In this pilot study, feasibility and sensitivity of source localization-driven analysis for EEG-fMRI was tested using a multisensory integration paradigm. Dynamic audiovisual stimuli consisting of emotional talking faces and pseudowords with emotional prosody were rated in a delayed response task. The trials comprised affectively congruent and incongruent displays.In addition to event-locked EEG and fMRI analyses, induced oscillatory EEG responses at estimated cortical sources and in specific temporo-spectral windows were correlated with the corresponding BOLD responses. EEG analysis showed high data quality with less than 10% trial rejection. In an early time window, alpha oscillations were suppressed in bilateral occipital cortices and fMRI analysis confirmed high data quality with reliable activation in auditory, visual and frontal areas to the presentation of multisensory stimuli. In line with previous studies, we obtained reliable correlation patterns for event locked occipital alpha suppression and BOLD signal time course.Our results suggest a valid methodological approach to investigate complex stimuli using the present source localization driven method for EEG-fMRI. This novel procedure may help to investigate combined EEG-fMRI data from novel complex paradigms with high spatial and

  7. Assessment of blood–brain barrier disruption using dynamic contrast-enhanced MRI. A systematic review

    Directory of Open Access Journals (Sweden)

    Anna K. Heye

    2014-01-01

    Full Text Available There is increasing recognition of the importance of blood–brain barrier (BBB disruption in aging, dementia, stroke and multiple sclerosis in addition to more commonly-studied pathologies such as tumors. Dynamic contrast-enhanced MRI (DCE-MRI is a method for studying BBB disruption in vivo. We review pathologies studied, scanning protocols and data analysis procedures to determine the range of available methods and their suitability to different pathologies. We systematically review the existing literature up to February 2014, seeking studies that assessed BBB integrity using T1-weighted DCE-MRI techniques in animals and humans in normal or abnormal brain tissues. The literature search provided 70 studies that were eligible for inclusion, involving 417 animals and 1564 human subjects in total. The pathologies most studied are intracranial neoplasms and acute ischemic strokes. There are large variations in the type of DCE-MRI sequence, the imaging protocols and the contrast agents used. Moreover, studies use a variety of different methods for data analysis, mainly based on model-free measurements and on the Patlak and Tofts models. Consequently, estimated KTrans values varied widely. In conclusion, DCE-MRI is shown to provide valuable information in a large variety of applications, ranging from common applications, such as grading of primary brain tumors, to more recent applications, such as assessment of subtle BBB dysfunction in Alzheimer's disease. Further research is required in order to establish consensus-based recommendations for data acquisition and analysis and, hence, improve inter-study comparability and promote wider use of DCE-MRI.

  8. Multisensory integration of dynamic emotional faces and voices: method for simultaneous EEG-fMRI measurements.

    Science.gov (United States)

    Schelenz, Patrick D; Klasen, Martin; Reese, Barbara; Regenbogen, Christina; Wolf, Dhana; Kato, Yutaka; Mathiak, Klaus

    2013-01-01

    Combined EEG-fMRI analysis correlates time courses from single electrodes or independent EEG components with the hemodynamic response. Implementing information from only one electrode, however, may miss relevant information from complex electrophysiological networks. Component based analysis, in turn, depends on a priori knowledge of the signal topography. Complex designs such as studies on multisensory integration of emotions investigate subtle differences in distributed networks based on only a few trials per condition. Thus, they require a sensitive and comprehensive approach which does not rely on a-priori knowledge about the underlying neural processes. In this pilot study, feasibility and sensitivity of source localization-driven analysis for EEG-fMRI was tested using a multisensory integration paradigm. Dynamic audiovisual stimuli consisting of emotional talking faces and pseudowords with emotional prosody were rated in a delayed response task. The trials comprised affectively congruent and incongruent displays. In addition to event-locked EEG and fMRI analyses, induced oscillatory EEG responses at estimated cortical sources and in specific temporo-spectral windows were correlated with the corresponding BOLD responses. EEG analysis showed high data quality with less than 10% trial rejection. In an early time window, alpha oscillations were suppressed in bilateral occipital cortices and fMRI analysis confirmed high data quality with reliable activation in auditory, visual and frontal areas to the presentation of multisensory stimuli. In line with previous studies, we obtained reliable correlation patterns for event locked occipital alpha suppression and BOLD signal time course. Our results suggest a valid methodological approach to investigate complex stimuli using the present source localization driven method for EEG-fMRI. This novel procedure may help to investigate combined EEG-fMRI data from novel complex paradigms with high spatial and temporal

  9. Assessment of blood–brain barrier disruption using dynamic contrast-enhanced MRI. A systematic review

    Science.gov (United States)

    Heye, Anna K.; Culling, Ross D.; Valdés Hernández, Maria del C.; Thrippleton, Michael J.; Wardlaw, Joanna M.

    2014-01-01

    There is increasing recognition of the importance of blood–brain barrier (BBB) disruption in aging, dementia, stroke and multiple sclerosis in addition to more commonly-studied pathologies such as tumors. Dynamic contrast-enhanced MRI (DCE-MRI) is a method for studying BBB disruption in vivo. We review pathologies studied, scanning protocols and data analysis procedures to determine the range of available methods and their suitability to different pathologies. We systematically review the existing literature up to February 2014, seeking studies that assessed BBB integrity using T1-weighted DCE-MRI techniques in animals and humans in normal or abnormal brain tissues. The literature search provided 70 studies that were eligible for inclusion, involving 417 animals and 1564 human subjects in total. The pathologies most studied are intracranial neoplasms and acute ischemic strokes. There are large variations in the type of DCE-MRI sequence, the imaging protocols and the contrast agents used. Moreover, studies use a variety of different methods for data analysis, mainly based on model-free measurements and on the Patlak and Tofts models. Consequently, estimated KTrans values varied widely. In conclusion, DCE-MRI is shown to provide valuable information in a large variety of applications, ranging from common applications, such as grading of primary brain tumors, to more recent applications, such as assessment of subtle BBB dysfunction in Alzheimer's disease. Further research is required in order to establish consensus-based recommendations for data acquisition and analysis and, hence, improve inter-study comparability and promote wider use of DCE-MRI. PMID:25379439

  10. 乳腺叶状肿瘤 MRI表现特征分析%MRI features of phyllodes tumors of the breast

    Institute of Scientific and Technical Information of China (English)

    曾小伟; 徐绽蕾; 舒月红; 杨小军

    2014-01-01

    Objective To study the MRI performance of phyllodes tumors and to improve the diagnostic level .Methods The MRI data of 13 patients with phyllodes tumors of the breast verified by histopathology were analyzed .The MRI fea‐tures analyzed included morphological features , signal intensity , appearance of dynamic contrast enhancement (DCE‐MRI) ,the type of time‐signal intensity curve(TIC) ,and the features on DWI ,and compared with the results of patholo‐gy .Results 13 cases of PTB were single .Tumor size is 6 .2 cm × 4 .2 cm~1 .2 cm × 1 .1 cm .4 tumors are lobular and seems like the fusion of multiple nodules ,9 tumors are mild lobular .Strip between leaf separated extends to the tumor in‐terna in 8 cases .Lesions showed middle signal or low signal on T1WI ,9 cases showed mixed high signal and 4 cases showed homogeneous high signal On T2WI .8 cases showed high signal and 5 cases showed slightly high signal on DWI(b=800 s/mm2 ) .6 cases were simultaneously detected ADC ,all tumors showed high signal .11 cases showed homogeneous enhancement and 2 cases showed heterogeneous with cystic unreinforced area on DCE‐MRI .Type Ⅱ of TIC were shown in 10 cases ,type in 2 cases and type Ⅲ in 1 case .Among the 13 cases of PTB ,9 lesions were benign and 4 were borderline tumors ,there is no malignant PTB .Conclusion The findings of PTB on MRI have some characteristics .MRI helps diag‐nosis of the PTB .%目的:分析乳腺叶状肿瘤(PTB)的MRI表现,提高对该病的认识和诊断水平。方法回顾性分析经手术病理证实的13例PTB的M RI表现,包括肿瘤的形态特征、平扫信号强度、动态增强表现及时间信号强度曲线,类型、DWI信号特征,并与病理结果对照。结果13例PTB均单发。病灶大小为6.2cm ×4.2cm~1.2cm ×1.1cm。4例分叶状呈多发结节融合样改变,9例边缘轻度分叶,8例在分叶间见条状分隔延伸至肿瘤内部。M RI平扫T1 WI呈等或稍低信号, T2

  11. [A study on the predictive and evaluational value of molecular subtypes and dynamic contrast-enhanced magnetic resonance imaging of neoadjuvant chemotherapy for breast cancer].

    Science.gov (United States)

    Liu, Wen-qing; Ye, Jing-ming; Xu, Ling; Liu, Qian; Zhao, Jian-xin; Duan, Xue-ning; Liu, Yin-hua

    2013-08-01

    To investigate the predictive value of molecular subtypes and the evaluational value of dynamic contrast-enhanced MRI of neoadjuvant chemotherapy for breast cancer. From January 2010 to December 2011, the 79 patients diagnosed as primary invasive breast cancer, having received 6 cycles of neoadjuvant chemotherapy and finished the mastectomy or the breast conserving surgery entered this study. A total of 79 patients participated in this prospective study. There were 6 (7.6%) luminal A cases, 42 (53.2%) luminal B cases, 14 HER-2 (17.7%) positive cases and 17 (21.5%) triple negative cases. The associations between molecular subtypes and clinical response as well as the pathological response were analyzed. The predictive value of molecular subtypes for the neoadjuvant chemotherapy was studied. Clinical effective rate was 85.3% (66/79). There was no statistical correlation between molecular subtypes and clinical effective rate. Pathologic effective rate was 79.7% (63/79). There was no statistical correlation between molecular subtypes and pathologic effective rate. Twenty-seven case achieved pathologic complete remission (pCR) in all the patients. No case achieved pCR in the patients classified as Luminal A. Twelve cases (28.6%, 12/42) achieved pCR in the luminal B patients.Five cases (5/14) achieved pCR in the HER-2 overexpression patients. Ten cases (10/17) achieved pCR in the triple-negative patients. There was a statistical correlation between the molecular subtypes and the pCR rate (P = 0.039), and between clinical evaluation by dynamic contrast-enhanced MRI and evaluation of pathological response (r = 0.432, P = 0.000). Molecular subtypes and dynamic contrast-enhanced MRI have a good value of predicting and evaluating the response of neoadjuvant chemotherapy on breast cancer.

  12. The Tofts model in frequency domain: fast and robust determination of pharmacokinetic maps for dynamic contrast enhancement MRI

    Science.gov (United States)

    Vajuvalli, Nithin N.; Chikkemenahally, Dharmendra Kumar K.; Nayak, Krupa N.; Bhosale, Manoj G.; Geethanath, Sairam

    2016-12-01

    Dynamic contrast enhancement magnetic resonance imaging (DCE-MRI) is a well-established method for non-invasive detection and therapeutic monitoring of pathologies through administration of intravenous contrast agent. Quantification of pharmacokinetic (PK) maps can be achieved through application of compartmental models relevant to the pathophysiology of the tissue under interrogation. The determination of PK parameters involves fitting of time-concentration data to these models. In this work, the Tofts model in frequency domain (TM-FD) is applied to a weakly vascularized tissue such as the breast. It is derived as a convolution-free model from the conventional Tofts model in the time domain (TM-TD). This reduces the dimensionality of the curve-fitting problem from two to one. The approaches of TM-FD and TM-TD were applied to two kinds of in silico phantoms and six in vivo breast DCE data sets with and without the addition of noise. The results showed that computational time taken to estimate PK maps using TM-FD was 16-25% less than with TM-TD. Normalized root mean square error (NRMSE) calculation and Pearson correlation analyses were performed to validate robustness and accuracy of the TM-FD and TM-TD approaches. These compared with ground truth values in the case of phantom studies for four different temporal resolutions. Results showed that NRMSE values for TM-FD were significantly lower than those of TM-TD as validated by a paired t-test along with reduced computational time. This approach therefore enables online evaluation of PK maps by radiologists in a clinical setting, aiding in the evaluation of 3D and/or increased coverage of the tissue of interest.

  13. DCE-MRI of the breast in a stand-alone setting outside a complementary strategy - results of the TK-study

    Energy Technology Data Exchange (ETDEWEB)

    Kaiser, Clemens G.; Krammer, J.; Wasser, K.; Schoenberg, S.O. [University Medical Centre Mannheim, Medical Faculty Mannheim-University of Heidelberg, Institute of Clinical Radiology and Nuclear Medicine, Mannheim (Germany); Reich, C.; Kaiser, W.A. [Friedrich-Schiller-University Hospital Jena, Institute of Diagnostic and Interventional Radiology I, Jena (Germany); Dietzel, M. [Friedrich-Alexander-University Hospital Erlangen-Nuernberg, Department of Neuroradiology, Erlangen (Germany); Baltzer, P.A.T. [Medical University Vienna, Institute of Radiology and Nuclear Medicine, Vienna (Austria)

    2015-06-01

    To evaluate the accuracy of MRI of the breast (DCE-MRI) in a stand-alone setting with extended indications. According to the inclusion criteria, breast specialists were invited to refer patients to our institution for DCE-MRI. Depending on the MR findings, patients received either a follow-up or biopsy. Between 04/2006 and 12/2011 a consecutive total of 1,488 women were prospectively examined. Of 1,488 included patients, 393 patients were lost to follow-up, 1,095 patients were evaluated. 124 patients were diagnosed with malignancy by DCE-MRI (76 TP, 48 FP, 971 TN, 0 FN cases). Positive cases were confirmed by histology, negative cases by MR follow-ups or patient questionnaires over the next 5 years in 1,737 cases (sensitivity 100 %; specificity 95.2 %; PPV 61.3 %; NPV 100 %; accuracy 95.5 %). For invasive cancers only (DCIS excluded), the results were 63 TP; 27 FP; 971 TP and 0 FN (sensitivity 100 %; specificity 97.2 %; PPV 70 %; NPV 100 %; accuracy 97.5 %). The DCE-MRI indications tested imply that negative results in DCE-MRI reliably exclude cancer. The results were achieved in a stand-alone setting (single modality diagnosis). However, these results are strongly dependent on reader experience and adequate technical standards as prerequisites for optimal diagnoses. (orig.)

  14. Combination of low and high resolution T{sub 1}-weighted sequences for improved evaluation of morphologic criteria in dynamic contrast enhanced MRI of the breast; Eine Kombination niedrig und hochaufloesender dynamischer T{sub 1}-gewichteter Sequenzen zur besseren Beurteilung der Morphologie Kontrastmittel aufnehmender Laesionen in der MRT der weiblichen Brust

    Energy Technology Data Exchange (ETDEWEB)

    Vomweg, T.W.; Teifke, A.; Schreiber, W.G.; Thelen, M. [Klinik und Poliklinik fuer Radiologie, Klinikum der Universitaet Mainz (Germany); Schmidt, M. [Klinik und Poliklinik fuer Geburtshilfe und Frauenkrankheiten, Klinikum der Universitaet Mainz (Germany)

    2002-11-01

    Purpose: Presentation of a new protocol for simultaneous acquisition of both low and high resolution T{sub 1}-weighted images of breast lesions for dynamic contrast-enhanced MR mammography. Demonstration of possible diagnostic improvement with representative measurements in patients with suspected breast cancer by adding morphologic parameters from high resolution sequences to the analysis of the signal-time curve. Materials and Methods: Dynamic MR imaging was performed with a 1.5 T system (Magnetom SONATA, Siemens Medical Systems, Germany) and the manufacturer's double-breast coil. Coronal T{sub 1}-weighted 3D FLASH sequences (spatial resolution 1.25 x 1.25mm{sup 2}; slice thickness 1.7 mm) were acquired once before and five times after administration of contrast medium (Gd-DTPA, 0.15 mmol/kg) injection. In addition, a high resolution T{sub 1}-weighted 3D-FLASH sequence (spatial resolution, 0.63 x 0.63 mm{sup 2}) was obtained before administration of contrast medium and after the third post-contrast low-resolution sequence. Except for the acquisition matrix, all imaging parameters were identical for both 3D pulse sequences. To assure comparison of the measured signal intensities for both T{sub 1}-weighted sequences, calibrating phantom measurements were performed using a dilution series of Gd-DTPA. Results: Phantom measurements demonstrated similar signal intensities and enhancement pattern for both sequences. A combined protocol consisting of both pulse sequences can be employed and does not interfere with the signal-time curve analysis. By measuring one high resolution sequence 3:18 minutes after administration of contrast medium, morphologic features can be evaluated without interference from barely enhancing surrounding tissue. The overall study time is not increased. The improved spatial resolution slightly increases the severity of motion artifacts. (orig.) [German] Ziel: Vorstellung eines neuen Protokolls zur gleichzeitigen Messung von niedrig und

  15. MRI Diagnosis of Breast Ductal Carcinoma in Situ%乳腺MRI对导管原位癌及其微浸润的诊断

    Institute of Scientific and Technical Information of China (English)

    梅昂; 华佳

    2011-01-01

    Objective To assess diagnostic value of MRI for breast ductal carcinoma in situ( DCIS). Methods MRI and mammography data in 13 women with breast DCIS and DCIS with microinvasion (DCIS-Mi) confirmed by pathology were retrospectively and comparativcly analyzed with pathologic examination. Results In 13 cases underwent contrast-enhanced dynamic MR imaging,11 lesions showed non-mass-like enhancement. In 10 patients underwent mammography, one case showed negative result. Regarding the BI-RADS Ⅳ or Ⅴ as the positive standard , there was not significant difference in accurate diagnostic rate between MRI and mammography(P=O. 353). Regarding the extent of the lesions measured on pathologic examination as gold standard, 10 cases in MRI and 6 cases in mammography were corresponded,2 lesions overestimated extent by MRI and mammography , respectively, and one lesion underestimated by mammography. The difference was not significant ( P = 0. 277). Conclusion MR imaging features of DCIS and DCIS-Mi were characteristic certainly. MR imaging combined with mammography can improve the detecting rate and diagnostic accuracy of DCIS.%目的 探讨乳腺MRI对导管原位癌及其微浸润的诊断价值.方法 回顾性分析经手术病理证实的乳腺导管原位癌及导管原位癌伴微浸润病例 13例,所有病例均于术前行动态增强MRI检查,其中 10例同时行钼靶X线检查.结果 MR检查13例病灶中11例表现为非肿块样强化,10例行钼靶X线检查,1例阴性,以BIRADS分级中的4、5级为MR和X线检查的阳性指标,其正确诊断率差异无统计学意义(P=0.353).以病理结果为金标准,MRI界定病灶范围符合10例,高估2例,钼靶X线符合6例,高估2例,低估1例,差异无统计学意义(P=0.277).结论 乳腺MRI对导管原位癌及导管原位癌伴微浸润有其特征性表现,钼靶X线和MR检查相结合能提高早期导管原位癌的检出率及正确诊断率.

  16. Dynamic contrast-enhanced MRI in patients with luminal Crohn's disease

    Energy Technology Data Exchange (ETDEWEB)

    Ziech, M.L.W., E-mail: m.l.ziech@amc.uva.nl [Academic Medical Center, Department of Radiology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Lavini, C., E-mail: c.lavini@amc.uva.nl [Academic Medical Center, Department of Radiology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Caan, M.W.A., E-mail: m.w.a.caan@amc.uva.nl [Academic Medical Center, Department of Radiology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Nio, C.Y., E-mail: C.Y.Nio@amc.uva.nl [Academic Medical Center, Department of Radiology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Stokkers, P.C.F., E-mail: p.stokkers@slaz.nl [Academic Medical Center, Department of Gastroenterology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Sint Lucas Andreas Ziekenhuis, Department of Gastroenterology, Jan Tooropstraat 164, 1061 AE, Amsterdam (Netherlands); Bipat, S., E-mail: S.Bipat@amc.uva.nl [Academic Medical Center, Department of Radiology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Ponsioen, C.Y., E-mail: c.y.ponsioen@amc.uva.nl [Academic Medical Center, Department of Gastroenterology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Nederveen, A.J., E-mail: a.j.nederveen@amc.uva.nl [Academic Medical Center, Department of Radiology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands); Stoker, J., E-mail: j.stoker@amc.uva.nl [Academic Medical Center, Department of Radiology, Meibergdreef 9, 1105 AZ, Amsterdam (Netherlands)

    2012-11-15

    Objectives: To prospectively assess dynamic contrast-enhanced (DCE-)MRI as compared to conventional sequences in patients with luminal Crohn's disease. Methods: Patients with Crohn's disease undergoing MRI and ileocolonoscopy within 1 month had DCE-MRI (3T) during intravenous contrast injection of gadobutrol, single shot fast spin echo sequence and 3D T1-weighted spoiled gradient echo sequence, a dynamic coronal 3D T1-weighted fast spoiled gradient were performed before and after gadobutrol. Maximum enhancement (ME) and initial slope of increase (ISI) were calculated for four colon segments (ascending colon + coecum, transverse colon, descending colon + sigmoid, rectum) and (neo)terminal ileum. C-reactive protein (CRP), Crohn's disease activity index (CDAI), per patient and per segment Crohn's disease endoscopic index of severity (CDEIS) and disease duration were determined. Mean values of the (DCE-)MRI parameters in each segment from each patient were compared between four disease activity groups (normal mucosa, non-ulcerative lesions, mild ulcerative and severe ulcerative disease) with Mann-Whitney test with Bonferroni adjustment. Spearman correlation coefficients were calculated for continuous variables. Results: Thirty-three patients were included (mean age 37 years; 23 females, median CDEIS 4.4). ME and ISI correlated weakly with segmental CDEIS (r = 0.485 and r = 0.206) and ME per patient correlated moderately with CDEIS (r = 0.551). ME was significantly higher in segments with mild (0.378) or severe (0.388) ulcerative disease compared to normal mucosa (0.304) (p < 0.001). No ulcerations were identified at conventional sequences. ME correlated with disease duration in diseased segments (r = 0.492), not with CDAI and CRP. Conclusions: DCE-MRI can be used as a method for detecting Crohn's disease ulcerative lesions.

  17. Ensuring safety and functionality of electroglottography measurements during dynamic pulmonary MRI.

    Science.gov (United States)

    Özen, Ali Caglar; Traser, Louisa; Echternach, Matthias; Dadakova, Tetiana; Burdumy, Michael; Richter, Bernhard; Bock, Michael

    2016-11-01

    To combine vocal tract measurements with dynamic MRI of the lungs to provide fundamental insights into the lung physiology during singing. To analyze vocal fold oscillatory patterns during dynamic lung MRI, an electroglottography (EGG) system was modified to allow for simultaneous EGG measurements during MR image acquisitions. A low-pass filter was introduced to suppress residual radiofrequency (RF) coupling into the EGG signal. RF heating was tested in a gel phantom to ensure MR safety, and functionality of the EGG device was assessed in a volunteer experiment at singing frequencies from A5 to A3. In the recorded EGG signals, remaining RF interferences were removed by independent component analysis post processing, and standard EGG parameters such as fundamental frequency, contact quotient and jitter were calculated. In a second volunteer experiment, EGG recordings were compared with lung diameter measurements from 2D time-resolved trueFISP acquisitions. RF heating measurements resulted in less than 1.2°C temperature increase in the gel phantom. EGG parameters measured during MR imaging are within the range of ideal values. In the lung measurement, both the lung diameter and the EGG recordings could be successfully performed with only minimal interference. EGG recording is pos sible during dynamic lung MRI, and glottal activity can be studied safely at 1.5T. Magn Reson Med 76:1629-1635, 2016. © 2015 International Society for Magnetic Resonance in Medicine. © 2015 International Society for Magnetic Resonance in Medicine.

  18. Static and dynamic MRI of a urinary control intra-vaginal device

    Energy Technology Data Exchange (ETDEWEB)

    Maubon, A.J. [Department of Medical Imaging, C. M. C. Beausoleil, Montpellier (France); Department of Radiology, CHU Dupuytren, Limoges (France); Boncoeur-Martel, M.P. [Department of Radiology, CHU Dupuytren, Limoges (France); Juhan, V.; Rouanet, J.P. [Department of Medical Imaging, C. M. C. Beausoleil, Montpellier (France); Courtieu, C.R. [Department of Gynecology, C. M. C. Beausoleil, Montpellier (France); Department of Obstetrics and Gynecology, C. H. U., F-30029 Nimes (France); Thurmond, A.S. [Women' s Imaging, Meridian Park Hospital, Portland, OR (United States); Aubas, P. [Department of Medical Information, Hopital Arnaud de Villeneuve, F-34295 Montpellier (France); Mares, P. [Department of Obstetrics and Gynecology, C. H. U., F-30029 Nimes (France)

    2000-06-01

    The aim of this study was to describe by MRI, in dynamic conditions at rest and straining, the anatomical modifications induced by a commercially available intravaginal device (IVD) aimed at relieving female stress urinary incontinence. Ten female patients complaining of stress urinary incontinence (SUI) had pelvic MRI with static and dynamic sequences, without and with a self-inserted IVD. We studied positions and angulations of the IVD in the pelvis. Paired t-test allowed comparisons of: position of the bladder neck; urethral angulation with the pubis axis; position of the urethra; and posterior urethro-vesical angle (PUVA) without and with IVD. At rest, in ten of ten cases IVD laid cranial to the pubo-rectal muscle; with an average angulation of 95 {+-} 10 with the pubis axis, laterally tilted in three of ten cases. In maximum straining with IVD bladder neck descent was lower by an average of 5.2 {+-} 3.1 mm (p = 0.001), pubo-urethral angle opening was smaller by an average of 22 {+-} 20 (p = 0.015), and bladder neck to pubis distance was shorter by an average of 5.7 {+-} 4 mm. Posterior urethro-vesical angle was not significantly modified. Dynamic MRI allowed a non-invasive assessment of the mode of action of an IVD. The main modifications were a support of the bladder base and bladder neck, with a superior displacement of the urethra toward the pubis. (orig.)

  19. Dynamic contrast-enhanced MRI improves accuracy for detecting focal splenic involvement in children and adolescents with Hodgkin disease

    Energy Technology Data Exchange (ETDEWEB)

    Punwani, Shonit; Taylor, Stuart A.; Halligan, Steve [University College London, Centre for Medical Imaging, London (United Kingdom); University College London Hospital, Department of Radiology, London (United Kingdom); Cheung, King Kenneth; Skipper, Nicholas [University College London, Centre for Medical Imaging, London (United Kingdom); Bell, Nichola; Humphries, Paul D. [University College London Hospital, Department of Radiology, London (United Kingdom); Bainbridge, Alan [University College London, Department of Medical Physics and Bioengineering, London (United Kingdom); Groves, Ashley M.; Hain, Sharon F.; Ben-Haim, Simona [University College Hospital, Institute of Nuclear Medicine, London (United Kingdom); Shankar, Ananth; Daw, Stephen [University College London Hospital, Department of Paediatrics, London (United Kingdom)

    2013-08-15

    Accurate assessment of splenic disease is important for staging Hodgkin lymphoma. The purpose of this study was to assess T2-weighted imaging with and without dynamic contrast-enhanced (DCE) MRI for evaluation of splenic Hodgkin disease. Thirty-one children with Hodgkin lymphoma underwent whole-body T2-weighted MRI with supplementary DCE splenic imaging, and whole-body PET-CT before and following chemotherapy. Two experienced nuclear medicine physicians derived a PET-CT reference standard for splenic disease, augmented by follow-up imaging. Unaware of the PET-CT, two experienced radiologists independently evaluated MRI exercising a locked sequential read paradigm (T2-weighted then DCE review) and recorded the presence/absence of splenic disease at each stage. Performance of each radiologist was determined prior to and following review of DCE-MRI. Incorrect MRI findings were ascribed to reader (lesion present on MRI but missed by reader) or technical (lesion not present on MRI) error. Seven children had splenic disease. Sensitivity/specificity of both radiologists for the detection of splenic involvement using T2-weighted images alone was 57%/100% and increased to 100%/100% with DCE-MRI. There were three instances of technical error on T2-weighted imaging; all lesions were visible on DCE-MRI. T2-weighted imaging when complemented by DCE-MRI imaging may improve evaluation of Hodgkin disease splenic involvement. (orig.)

  20. MRI and pathological features of phyllodes tumor of the breast%乳腺叶状肿瘤的MRI表现与病理特征分析

    Institute of Scientific and Technical Information of China (English)

    张嫣; 余浩杰; 王颀; 郭庆禄; 王霞; 沈敏; 张江宇

    2013-01-01

    目的:分析11例乳腺叶状肿瘤(phyllodes tumors,PTs)MRI平扫、动态增强表现特征并与病理结果对照,提高对该病MRI表现认识和诊断水平.方法:回顾性分析2011年12月至2012年11月期间于我院行乳腺MRI检查并经手术病理证实的11例乳腺叶状肿瘤,分析包括肿瘤形态学特征、平扫T1WI与T2WI信号、Spiral Axial平扫及动态增强表现及时间信号曲线类型,并与病理结果对照.结果:MRI上9例呈分叶形,1例类圆形,1例不规则形;T1WI平扫6例呈稍高混杂信号,4例低信号,1例混杂低信号;T2WI抑脂8例混杂高信号,3例呈均匀高信号;Spiral Axial动态增强扫描8例不均匀强化,3例均匀强化,其中5例见囊变未强化区;11例均早期明显强化,后期呈持续上升型强化3例,平台型强化6例,流出型强化2例.病理诊断良性PTs6例,交界性PTs4例,恶性PTs1例.结论:乳腺PTs的MRI表现具有一定特点,MR检查有助于该病的诊断,确诊仍需依靠病理组织学检查.%Objective To analyze the MRI features and pathological findings of phyllodes tumors of the breast in order to improve the diagnosis of it.Methods MR images of 11 patients with phyllodes tumors confirmed by histopathology during December 2011 to November 2012 were analyzed retrospectively.MRI findings including tumor shape,margin,size,signal intensity on T1-weighted and T2-weighted images before contrast,appearance of dynamic contrast enhancement (DCE-MR Ⅰ),the type of time-signal intensity curve (TIC) feature were analyzed.Results 9 tumors were lobular,1 was oval in shape and 1 was irregular shape.The signal intensity of tumor on T1weighted images was slightly higher mixed signals in 6 cases,was low signal in 4 cases,and was mixed low signal in another 1 case.On T2-weighted fat suppression images,8 cases showed mixed high signal,3 cases showed homogeneous high signal.11 patients underwent DCE-MRI,8 cases showed heterogeneous enhancement,5 cases with cystic

  1. Contribution of the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI to Dynamic MRI in the detection of hypovascular small ({<=}2 cm) HCC in cirrhosis

    Energy Technology Data Exchange (ETDEWEB)

    Golfieri, Rita; Renzulli, Matteo; Lucidi, Vincenzo; Corcioni, Beniamino [University of Bologna, Radiology Unit, Department of Digestive Diseases and Internal Medicine, Sant' Orsola-Malpighi Hospital, Bologna (Italy); Trevisani, Franco [University of Bologna, Unit of Semeiotica, Department of Digestive Diseases and Internal Medicine, Sant' Orsola-Malpighi Hospital, Bologna (Italy); Bolondi, Luigi [University of Bologna, Unit of Internal Medicine, Department of Digestive Diseases and Internal Medicine, Sant' Orsola-Malpighi Hospital, Bologna (Italy)

    2011-06-15

    To prospectively assess the additional value of the hepatobiliary (HB) phase of Gd-EOB-DTPA-MRI in identifying and characterising small ({<=}2 cm) hepatocellular carcinomas (HCCs) undetermined in dynamic phases alone because of their atypical features, according to the AASLD criteria. 127 cirrhotic patients were evaluated with Gd-EOB-DTPA-MRI in two sets: unenhanced and dynamic phases; unenhanced, dynamic and HB phases. Sixty-two out of 215 nodules (29%) were atypical in 42 patients (33%). 62 atypical nodules were reported at histology: high-grade dysplastic nodules (HGDN)/early HCC (n = 20), low-grade DN (LGDN) (n = 21), regenerative nodules (n = 17) and nodular regenerative hyperplasia (n = 4). The sensitivity, specificity, accuracy, positive and negative predictive value (PPV, NPV) were increased by the addition of the HB phase: 88.4-99.4%, 88-95%, 88-98.5%, 97-99%, and 65-97.5%, respectively. Twenty atypical nodules were malignant (32%), 19 of which were characterised only during the HB phase. The HB phase is 11% more sensitive in the classification of HGDN/early HCC than dynamic MRI, with an added value of 32.5% in the NPV. The high incidence (33%) of atypical nodules and their frequent malignancy (32%) suggest the widespread employment of Gd-EOB-DTPA-MRI in the follow-up of small nodules ({<=}2 cm) in cirrhosis. (orig.)

  2. Missing data estimation in fMRI dynamic causal modeling.

    Science.gov (United States)

    Zaghlool, Shaza B; Wyatt, Christopher L

    2014-01-01

    Dynamic Causal Modeling (DCM) can be used to quantify cognitive function in individuals as effective connectivity. However, ambiguity among subjects in the number and location of discernible active regions prevents all candidate models from being compared in all subjects, precluding the use of DCM as an individual cognitive phenotyping tool. This paper proposes a solution to this problem by treating missing regions in the first-level analysis as missing data, and performing estimation of the time course associated with any missing region using one of four candidate methods: zero-filling, average-filling, noise-filling using a fixed stochastic process, or one estimated using expectation-maximization. The effect of this estimation scheme was analyzed by treating it as a preprocessing step to DCM and observing the resulting effects on model evidence. Simulation studies show that estimation using expectation-maximization yields the highest classification accuracy using a simple loss function and highest model evidence, relative to other methods. This result held for various dataset sizes and varying numbers of model choice. In real data, application to Go/No-Go and Simon tasks allowed computation of signals from the missing nodes and the consequent computation of model evidence in all subjects compared to 62 and 48 percent respectively if no preprocessing was performed. These results demonstrate the face validity of the preprocessing scheme and open the possibility of using single-subject DCM as an individual cognitive phenotyping tool.

  3. Placental Perfusion In Uterine Ischemia Model as Evaluated by Dynamic Contrast Enhanced MRI

    Science.gov (United States)

    Drobyshevsky, Alexander

    2017-01-01

    Background To validate DCE MRI method of placental perfusion estimation and to demonstrate application of the method in a rabbit model of fetal antenatal hypoxia-ischemia. Methods Placental perfusion was estimated by dynamic contrast imaging with bolus injection of Gd-DTPA in 3 Tesla GE magnet in a rabbit model of placental ischemia–reperfusion in rabbit dams at embryonic day 25 gestation age. Placental perfusion was measured using steepest slope method on DCE MRI before and after intermittent 40 min uterine ischemia. Antioxidants (n = 2 dams, 9 placentas imaged) or vehicle (n = 5 dams, 23 placenta imaged) were given systemically in a separate group of dams during reperfusion–reoxygenation. Placental perfusion was also measured in two dams from the antioxidant group (10 placentas) and two dams from the control group (12 placentas) by fluorescent microspheres method. Results While placental perfusion estimates between fluorescent microspheres and DCE MRI were significantly correlated (R2 = 0.85; P perfusion in reperfusion–reoxygenation phase in the saline, 0.44 ± 0.06 mL/min/g (P = 0.012, t-test), but not in the antioxidant group, 0.62 ± 0.06 mL/min/g, relative to preocclusion values (0.77 ± 0.07 and 0.84 ± 0.12 mL/min/g, correspondingly). Conclusion Underestimation of true perfusion in placenta by steepest slope DCE MRI is significant and the error appears to be systematic. PMID:25854322

  4. Bayesian Inference for Functional Dynamics Exploring in fMRI Data.

    Science.gov (United States)

    Guo, Xuan; Liu, Bing; Chen, Le; Chen, Guantao; Pan, Yi; Zhang, Jing

    2016-01-01

    This paper aims to review state-of-the-art Bayesian-inference-based methods applied to functional magnetic resonance imaging (fMRI) data. Particularly, we focus on one specific long-standing challenge in the computational modeling of fMRI datasets: how to effectively explore typical functional interactions from fMRI time series and the corresponding boundaries of temporal segments. Bayesian inference is a method of statistical inference which has been shown to be a powerful tool to encode dependence relationships among the variables with uncertainty. Here we provide an introduction to a group of Bayesian-inference-based methods for fMRI data analysis, which were designed to detect magnitude or functional connectivity change points and to infer their functional interaction patterns based on corresponding temporal boundaries. We also provide a comparison of three popular Bayesian models, that is, Bayesian Magnitude Change Point Model (BMCPM), Bayesian Connectivity Change Point Model (BCCPM), and Dynamic Bayesian Variable Partition Model (DBVPM), and give a summary of their applications. We envision that more delicate Bayesian inference models will be emerging and play increasingly important roles in modeling brain functions in the years to come.

  5. Bayesian Inference for Functional Dynamics Exploring in fMRI Data

    Directory of Open Access Journals (Sweden)

    Xuan Guo

    2016-01-01

    Full Text Available This paper aims to review state-of-the-art Bayesian-inference-based methods applied to functional magnetic resonance imaging (fMRI data. Particularly, we focus on one specific long-standing challenge in the computational modeling of fMRI datasets: how to effectively explore typical functional interactions from fMRI time series and the corresponding boundaries of temporal segments. Bayesian inference is a method of statistical inference which has been shown to be a powerful tool to encode dependence relationships among the variables with uncertainty. Here we provide an introduction to a group of Bayesian-inference-based methods for fMRI data analysis, which were designed to detect magnitude or functional connectivity change points and to infer their functional interaction patterns based on corresponding temporal boundaries. We also provide a comparison of three popular Bayesian models, that is, Bayesian Magnitude Change Point Model (BMCPM, Bayesian Connectivity Change Point Model (BCCPM, and Dynamic Bayesian Variable Partition Model (DBVPM, and give a summary of their applications. We envision that more delicate Bayesian inference models will be emerging and play increasingly important roles in modeling brain functions in the years to come.

  6. 磁共振成像在乳腺癌保乳术前评价中的应用%Application of preoperative MRI on breast cancer patients undergoing breast-conserving surgery

    Institute of Scientific and Technical Information of China (English)

    王文静; 洪庆山; 张嫣; 郭庆禄

    2014-01-01

    Objective To evaluate the influence of preoperative MRI on tumor-positive rate of resection margins in breast cancer patients eligible for breast-conserving surgery.Methods Study group consisted of 64 consecutive patients with breast cancer eligible for breast-conserving surgery,while 73 cases as history control group.For the two groups,a first plan for breast-conserving surgery was made on the basis of conventional imaging and clinical evaluation.Study group underwent preoperative breast MRI and re-evalu-ated before final surgical plan was made.Rates of tumor-positive resection margins were compared between the 2 groups.Surgical plan alteration was recorded in the study group.Results Study group had lower rate of tumor-positive resection margin compared with control group (9.6% vs 24.7%,P =0.04).Furthermore,18.8% of study group altered the finial surgical plan to mastectomy after breast MRI.Conclusion Preoperative breast MRI can more acurately evaluate the extent of breast cancer,therefore decrease rate of tumor-positive resection margin in breast cancer patients eligible for breast-conserving surgery.%目的:评价术前磁共振成像(MRI)对乳腺癌保乳术切缘阳性率的影响。方法收集乳腺癌患者64例为研究组,历史对照组73例乳腺癌患者,所有患者经常规检查及评估后均适合行保乳术。研究组患者术前行乳腺 MRI 检查,经评估后确定最终的手术计划。历史对照组未行 MRI 检查。比较2组患者的切缘阳性率差异,记录研究组的手术变更率。结果与对照组相比,研究组保乳术中的切缘阳性率降低(9.6% vs 24.7%;P =0.04)。术前 MRI 使18.8%的患者改变手术计划而行乳房全切术。结论术前乳腺 MRI 检查能更准确评估乳腺癌病灶的范围,从而有助于降低保乳术患者的术中切缘阳性率。

  7. Sparse representation of multi parametric DCE-MRI features using K-SVD for classifying gene expression based breast cancer recurrence risk

    Science.gov (United States)

    Mahrooghy, Majid; Ashraf, Ahmed B.; Daye, Dania; Mies, Carolyn; Rosen, Mark; Feldman, Michael; Kontos, Despina

    2014-03-01

    We evaluate the prognostic value of sparse representation-based features by applying the K-SVD algorithm on multiparametric kinetic, textural, and morphologic features in breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). K-SVD is an iterative dimensionality reduction method that optimally reduces the initial feature space by updating the dictionary columns jointly with the sparse representation coefficients. Therefore, by using K-SVD, we not only provide sparse representation of the features and condense the information in a few coefficients but also we reduce the dimensionality. The extracted K-SVD features are evaluated by a machine learning algorithm including a logistic regression classifier for the task of classifying high versus low breast cancer recurrence risk as determined by a validated gene expression assay. The features are evaluated using ROC curve analysis and leave one-out cross validation for different sparse representation and dimensionality reduction numbers. Optimal sparse representation is obtained when the number of dictionary elements is 4 (K=4) and maximum non-zero coefficients is 2 (L=2). We compare K-SVD with ANOVA based feature selection for the same prognostic features. The ROC results show that the AUC of the K-SVD based (K=4, L=2), the ANOVA based, and the original features (i.e., no dimensionality reduction) are 0.78, 0.71. and 0.68, respectively. From the results, it can be inferred that by using sparse representation of the originally extracted multi-parametric, high-dimensional data, we can condense the information on a few coefficients with the highest predictive value. In addition, the dimensionality reduction introduced by K-SVD can prevent models from over-fitting.

  8. Value of whole body MRI and dynamic contrast enhanced MRI in the diagnosis, follow-up and evaluation of disease activity and extent in multiple myeloma

    Energy Technology Data Exchange (ETDEWEB)

    Dutoit, Julie C., E-mail: Julie.Dutoit@UGent.be; Vanderkerken, Matthias A., E-mail: Matthias.Vanderkerken@UGent.be; Verstraete, Koenraad L., E-mail: Koenraad.Verstraete@UGent.be

    2013-09-15

    Purpose: To evaluate the significance of dynamic contrast enhanced MRI (DCE-MRI) and whole body MRI (WB-MRI) in the diagnosis, prognosis and assessment of therapy for patients with monoclonal gammopathy of undetermined significance (MGUS) and multiple myeloma (MM). Materials and methods: The retrospective study includes 219 patients providing 463 WB-MRI and DCE-MRI investigations for the subgroups MGUS (n = 70), MM active disease (n = 126; this includes 70 patients with new diagnosis of MM, according to the International Staging System (ISS): 41.4% ISS stage I, 20.0% ISS stage II, 7.1% ISS stage III, 31.4% insufficient for staging; and 56 patients with ‘(re-)active disease’: 16.07% relapse, 32.14% progressive disease and 51.79% stable disease) and MM remission (n = 23; 60.87% complete remission, 17.39% very good partial remission and 21.74% partial remission). Investigations of patients with hereditary multiple exostoses (n = 5), neurofibromatosis (n = 7) and healthy persons (n = 9) were added as control subjects (n = 21). WB-MRI evaluation was done by evaluating thirteen skeletal regions, providing a ‘skeletal score’. DCE-MRI images of the spine, were analyzed with regions-of-interest and time-intensity-curves (TIC). Results: All TIC parameters can significantly differentiate between the predefined subgroups (p < 0.001). One hundred days after autologous stem cell transplantation a 75% decrease of the slope wash-in value (p < 0.001) can be seen. A cubic regression trend between ‘skeletal score’ and slope wash-in (adj.R{sup 2} = 0.412) could demonstrate a significant increase bone marrow perfusion if MM affects more than 10 skeletal regions (p < 0.001), associated with a poorer prognosis (p < 0.001). Conclusion: DCE-MRI evaluation of the spine is useful for diagnosis of MM, follow-up after stem cell transplantation and evaluation of disease activity. A combined evaluation with WB-MRI and DCE-MRI provides additional micro-vascular information on the

  9. A study of the breast cancer dynamics in North Carolina.

    Science.gov (United States)

    Christakos, G; Lai, J J

    1997-11-01

    This work is concerned with the study of breast cancer incidence in the State of North Carolina. Methodologically, the current analysis illustrates the importance of spatiotemporal random field modelling and introduces a mode of reasoning that is based on a combination of inductive and deductive processes. The composite space/time analysis utilizes the variability characteristics of incidence and the mathematical features of the random field model to fit it to the data. The analysis is significantly general and can efficiently represent non-homogeneous and non-stationary characteristics of breast cancer variation. Incidence predictions are produced using data at the same time period as well as data from other time periods and disease registries. The random field provides a rigorous and systematic method for generating detailed maps, which offer a quantitative description of the incidence variation from place to place and from time to time, together with a measure of the accuracy of the incidence maps. Spatiotemporal mapping accounts for the geographical locations and the time instants of the incidence observations, which is not usually the case with most empirical Bayes methods. It is also more accurate than purely spatial statistics methods, and can offer valuable information about the breast cancer risk and dynamics in North Carolina. Field studies could be initialized in high-rate areas identified by the maps in an effort to uncover environmental or life-style factors that might be responsible for the high risk rates. Also, the incidence maps can help elucidate causal mechanisms, explain disease occurrences at a certain scale, and offer guidance in health management and administration.

  10. Dynamic network participation of functional connectivity hubs assessed by resting-state fMRI

    Directory of Open Access Journals (Sweden)

    Alexander eSchaefer

    2014-05-01

    Full Text Available Network studies of large-scale brain connectivity have demonstrated that highly connected areas, or ‘hubs’, are a key feature of human functional and structural brain organization. We use resting-state functional MRI data and connectivity clustering to identify multi network hubs and show that while hubs can belong to multiple networks their degree of integration into these different networks varies dynamically over time. In addition, we found that these network dynamics were inversely related to positive self-generated thoughts reported by individuals and were further decreased with older age. Moreover, the left caudate varied its degree of participation between a default mode subnetwork and a limbic network. This variation was predictive of individual differences in the reports of past-related thoughts. These results support an association between ongoing thought processes and network dynamics and offer a new approach to investigate the brain dynamics underlying mental experience.

  11. Breast cancer detection using Ktrans MRI imaging to guide near infrared spectroscopy tomography

    Science.gov (United States)

    Feng, Jinchao; Jiang, Shudong; Xu, Junqing; Zhao, Yan; Gui, Jiang; Pogue, Brian W.; Paulsen, Keith D.

    2017-02-01

    The parametric image of Volume Transfer Coefficient (Ktrans) in MRI has been used to guide image reconstruction of Near-Infrared Spectral Tomography (NIRST). The image reconstruction used direct regularization, in which no segmentation has been involved. A total of 24 patients were involved in this study and the reconstructed results show that the tumor total hemoglobin (HbT) contrast could be used to differentiate the malignant from the benign cases (p-value= 0.018). The addition of the MRI information allows more accurate and definitive HbT values from the NIRST.

  12. Combined MRI-PET dissects dynamic changes in plant structures and functions.

    Science.gov (United States)

    Jahnke, Siegfried; Menzel, Marion I; van Dusschoten, Dagmar; Roeb, Gerhard W; Bühler, Jonas; Minwuyelet, Senay; Blümler, Peter; Temperton, Vicky M; Hombach, Thomas; Streun, Matthias; Beer, Simone; Khodaverdi, Maryam; Ziemons, Karl; Coenen, Heinz H; Schurr, Ulrich

    2009-08-01

    Unravelling the factors determining the allocation of carbon to various plant organs is one of the great challenges of modern plant biology. Studying allocation under close to natural conditions requires non-invasive methods, which are now becoming available for measuring plants on a par with those developed for humans. By combining magnetic resonance imaging (MRI) and positron emission tomography (PET), we investigated three contrasting root/shoot systems growing in sand or soil, with respect to their structures, transport routes and the translocation dynamics of recently fixed photoassimilates labelled with the short-lived radioactive carbon isotope (11)C. Storage organs of sugar beet (Beta vulgaris) and radish plants (Raphanus sativus) were assessed using MRI, providing images of the internal structures of the organs with high spatial resolution, and while species-specific transport sectoralities, properties of assimilate allocation and unloading characteristics were measured using PET. Growth and carbon allocation within complex root systems were monitored in maize plants (Zea mays), and the results may be used to identify factors affecting root growth in natural substrates or in competition with roots of other plants. MRI-PET co-registration opens the door for non-invasive analysis of plant structures and transport processes that may change in response to genomic, developmental or environmental challenges. It is our aim to make the methods applicable for quantitative analyses of plant traits in phenotyping as well as in understanding the dynamics of key processes that are essential to plant performance.

  13. Diagnostic value of dynamic contrast-enhanced MRI for submucosal palatal tumors

    Energy Technology Data Exchange (ETDEWEB)

    Matsuzaki, Hidenobu, E-mail: hidenobu@md.okayama-u.ac.jp [Department of Oral Diagnosis and Dentomaxillofacial Radiology, Okayama University Hospital, 5-1 Shikata-cho, 2-chome, Kita-ku, Okayama 700-8525 (Japan); Yanagi, Yoshinobu, E-mail: ya7@md.okayama-u.ac.jp [Department of Oral Diagnosis and Dentomaxillofacial Radiology, Okayama University Hospital, 5-1 Shikata-cho, 2-chome, Kita-ku, Okayama 700-8525 (Japan); Hara, Marina, E-mail: hara-m@cc.okayama-u.ac.jp [Department of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 5-1 Shikata-cho, 2-chome, Kita-ku, Okayama 700-8525 (Japan); Katase, Naoki, E-mail: katase-n@cc.okayama-u.ac.jp [Department of Oral Pathology and Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 5-1 Shikata-cho, 2-chome, Kita-ku, Okayama 700-8525 (Japan); Hisatomi, Miki, E-mail: tomi@md.okayama-u.ac.jp [Department of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 5-1 Shikata-cho, 2-chome, Kita-ku, Okayama 700-8525 (Japan); Unetsubo, Teruhisa, E-mail: gmd17107@s.okadai.jp [Department of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 5-1 Shikata-cho, 2-chome, Kita-ku, Okayama 700-8525 (Japan); Konouchi, Hironobu, E-mail: kono@md.okayama-u.ac.jp [Department of Oral Diagnosis and Dentomaxillofacial Radiology, Okayama University Hospital, 5-1 Shikata-cho, 2-chome, Kita-ku, Okayama 700-8525 (Japan); Takenobu, Toshihiko, E-mail: takenobu@kcgh.gr.jp [Department of Oral and Maxillofacial Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 5-1 Shikata-cho, 2-chome, Kita-ku, Okayama 700-8525 (Japan); and others

    2012-11-15

    Objectives: To evaluate the diagnostic value of dynamic contrast-enhanced MRI (DCE-MRI) for differentiating between benign and malignant tumors in the palate. Materials and methods: 26 patients with submucosal palatal tumors were preoperatively examined using DCE-MRI. Their maximum contrast index (CImax), time of CImax (Tmax), and washout ratios (WR300 and WR600) were determined from contrast index curves. The submucosal palatal tumors were divided into two groups according to their Tmax values: the early enhancement group (Tmax < 300 s) consisted of 9 malignant tumors and 6 benign tumors, while the late enhancement group (Tmax {>=} 300 s) included one malignant tumor and 10 benign tumors. We compared the following DCE-MRI parameters between the benign and malignant tumors: CImax and Tmax in all cases and CImax, Tmax, and the washout ratios in the early enhancement group. In addition, we performed a regression analysis of the relationships between tumor size and DCE-MRI parameters; i.e., CImax, Tmax, and washout ratios, among the malignant salivary gland tumors and pleomorphic adenomas. Results: In all cases and the early enhancement group, significant differences in Tmax were detected between the benign and malignant tumors (P < 0.001 and P < 0.05, respectively), and the optimal Tmax cutoff value for differentiating between them was found to be 165 s. None of the other parameters displayed significant differences between the benign and malignant tumors. Only the WR600 of the pleomorphic adenomas was significantly correlated with tumor size (R{sup 2} = 0.92, P < 0.001). Conclusions: Tmax is a useful parameter for distinguishing between benign and malignant submucosal palatal tumors.

  14. Comparison of arterial spin labeling and dynamic susceptibility contrast perfusion MRI in patients with acute stroke.

    Directory of Open Access Journals (Sweden)

    Yen-Chu Huang

    Full Text Available BACKGROUND: The aim of this study was to evaluate whether arterial spin labeling (ASL perfusion magnetic resonance imaging (MRI can reliably quantify perfusion deficit as compared to dynamic susceptibility contrast (DSC perfusion MRI. METHODS: Thirty-nine patients with acute ischemic stroke in the anterior circulation territory were recruited. All underwent ASL and DSC MRI perfusion scans within 30 hours after stroke onset and 31 patients underwent follow-up MRI scans. ASL cerebral blood flow (CBF and DSC time to maximum (T(max maps were used to calculate the perfusion defects. The ASL CBF lesion volume was compared to the DSC Tmax lesion volume by Pearson's correlation coefficient and likewise the ASL CBF and DSC T(max lesion volumes were compared to the final infarct sizes respectively. A repeated measures analysis of variance and least significant difference post hoc test was used to compare the mean lesion volumes among ASL CBF, DSC T(max >4-6 s and final infarct. RESULTS: Mean patient age was 72.6 years. The average time from stroke onset to MRI was 13.9 hours. The ASL lesion volume showed significant correlation with the DSC lesion volume for T(max >4, 5 and 6 s (r = 0.81, 0.82 and 0.80; p5 s (29.2 ml, p6 s (21.8 ml, p5 or 6 s were close to mean final infarct size. CONCLUSION: Quantitative measurement of ASL perfusion is well correlated with DSC perfusion. However, ASL perfusion may overestimate the perfusion defects and therefore further refinement of the true penumbra threshold and improved ASL technique are necessary before applying ASL in therapeutic trials.

  15. Dynamic Causal Modelling and physiological confounds: a functional MRI study of vagus nerve stimulation.

    Science.gov (United States)

    Reyt, Sébastien; Picq, Chloé; Sinniger, Valérie; Clarençon, Didier; Bonaz, Bruno; David, Olivier

    2010-10-01

    Dynamic Causal Modelling (DCM) has been proposed to estimate neuronal connectivity from functional magnetic resonance imaging (fMRI) using a biophysical model that links synaptic activity to hemodynamic processes. However, it is well known that fMRI is sensitive not only to neuronal activity, but also to many other psychophysiological responses which may be task-related, such as changes in cardio-respiratory activity. They are not explicitly taken into account in the generative models of DCM and their effects on estimated neuronal connectivity are not known. The main goal of this study was to report the face validity of DCM in the presence of strong physiological confounds that presumably cannot be corrected for, using an fMRI experiment of vagus nerve stimulation (VNS) performed in rats. First, a simple simulation was used to evaluate the principled ability of DCM to recover directed connectivity in the presence of a confounding factor. Second, we tested the experimental validity using measures of the BOLD correlates of left 5Hz VNS. Because VNS mostly activates the central autonomic regulation system, fMRI signals were likely to represent both direct and indirect vascular responses to such activation. In addition to the inference of standard statistical parametric maps, DCM was thus used to estimate directed neural connectivity in a small brain network including the nucleus tractus solitarius (NTS) known to receive vagal afferents. Though blood pressure changes may constitute a major physiological confound in this dataset, model comparison of DCMs still allowed the identification of the NTS as the input station of the VNS pathway to the brain. Our study indicates that current developments of DCM are robust to psychophysiological responses to some extent, but does not exclude the need to develop specific models of brain - body interactions within the DCM framework to better estimate neuronal connectivity from fMRI time series. Copyright 2010 Elsevier Inc. All

  16. Evaluation of static and dynamic MRI for assessing response of bone sarcomas to preoperative chemotherapy: Correlation with histological necrosis

    Directory of Open Access Journals (Sweden)

    Priyadarshi Amit

    2015-01-01

    Full Text Available Objectives: Preoperative chemotherapy plays a key role in management of bone sarcomas. Postoperative evaluation of histological necrosis has been the gold standard method of assessing response to preoperative chemotherapy. This study was done to evaluate the efficacy of static and dynamic magnetic resonance imaging (MRI for assessing response preoperatively. Materials and Methods: Our study included 14 patients (12 osteosarcomas and 2 malignant fibrous histiocytomas with mean age of 21.8 years, treated with preoperative chemotherapy followed by surgery. They were evaluated with static and dynamic MRI twice, before starting chemotherapy and again prior to surgery. Change in tumor volume and slope of signal intensity - time curve were calculated and correlated with percentage of histological necrosis using Pearson correlation test. Results: The change in dynamic MRI slope was significant (P = 0.001. Also, ≥60% reduction in slope of the curve proved to be an indicator of good histological response [positive predictive value (PPV =80%]. Change in tumor volume failed to show significant correlation (P = 0.071. Although it showed high negative predictive value (NPV = 85.7%, PPV was too low (PPV = 57.14%. Conclusions: Dynamic MRI correctly predicts histological necrosis after administration of preoperative chemotherapy to bone sarcomas. Hence, it can be used as a preoperative indicator of response to neoadjuvant chemotherapy. On the other hand, volumetric assessment by static MRI is not an effective predictor of histological necrosis. This study proves the superiority of dynamic contrast-enhanced study over volumetric study by MRI.

  17. Reproducibility of dynamic contrast-enhanced MRI and dynamic susceptibility contrast MRI in the study of brain gliomas: a comparison of data obtained using different commercial software.

    Science.gov (United States)

    Conte, Gian Marco; Castellano, Antonella; Altabella, Luisa; Iadanza, Antonella; Cadioli, Marcello; Falini, Andrea; Anzalone, Nicoletta

    2017-04-01

    Dynamic susceptibility contrast MRI (DSC) and dynamic contrast-enhanced MRI (DCE) are useful tools in the diagnosis and follow-up of brain gliomas; nevertheless, both techniques leave the open issue of data reproducibility. We evaluated the reproducibility of data obtained using two different commercial software for perfusion maps calculation and analysis, as one of the potential sources of variability can be the software itself. DSC and DCE analyses from 20 patients with gliomas were tested for both the intrasoftware (as intraobserver and interobserver reproducibility) and the intersoftware reproducibility, as well as the impact of different postprocessing choices [vascular input function (VIF) selection and deconvolution algorithms] on the quantification of perfusion biomarkers plasma volume (Vp), volume transfer constant (K (trans)) and rCBV. Data reproducibility was evaluated with the intraclass correlation coefficient (ICC) and Bland-Altman analysis. For all the biomarkers, the intra- and interobserver reproducibility resulted in almost perfect agreement in each software, whereas for the intersoftware reproducibility the value ranged from 0.311 to 0.577, suggesting fair to moderate agreement; Bland-Altman analysis showed high dispersion of data, thus confirming these findings. Comparisons of different VIF estimation methods for DCE biomarkers resulted in ICC of 0.636 for K (trans) and 0.662 for Vp; comparison of two deconvolution algorithms in DSC resulted in an ICC of 0.999. The use of single software ensures very good intraobserver and interobservers reproducibility. Caution should be taken when comparing data obtained using different software or different postprocessing within the same software, as reproducibility is not guaranteed anymore.

  18. CT-guided preoperative needle localization of MRI-detected breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Giagounidis, Elektra M. E-mail: giagounjdis@online.de; Markus, Ruwe; Josef, Luetzeler; Wemer, Audretsch; Mahdi, Rezai; Bernward, Kurtz

    2001-08-01

    To assess the value of accurate preoperative CT-guided needle localization of occult breast lesions, we reviewed a total of 39 needle-directed biopsies of breast tumors in 24 women. The average age was 52.9 years (range 31-67). All lesions were nonpalpable and mammographically, as well as sonographically occult. They were solely seen on MR-images. After demonstrating the suspicious region on CT scans, a hookwire was inserted. The correct position was confirmed by a control scan. The subsequent histopathological examination showed that 28 of the lesions (71.8%) were benign, among them mastopathy, fibrosis, fibroadenoma, papilloma, intramammary lymph node, liponecrosis and epitheliosis. Eleven lesions (28%) were malignant and showed either lobular, ductal or tubular cancer. Our results endorse that CT guided