Dynamic 3D-MR mammography: Is there a benefit of sophisticated evaluation for enhancement curves for clinical routine?

The purpose of the study was to compare standard analysis with pharmacokinetic analysis of time-intensity curves in dynamic three-dimensional (3D) MR mammography (MRM) for their capability of differentiating benign from malignant disease. Dynamic MRM of the whole breast was performed at 1.0 T using an axial fast low-angle shot (FLASH) 3D sequence. For the standard evaluation, the enhancement of the first minute (E(1)) and the slope of enhancement from minute 2 to 10 (SE(2-10)) were calculated. For pharmacokinetic analysis, the amplitude of enhancement (A), distribution time (t(21)), and elimination time (t(el)) were computed. Sixty-two histologically verified lesions were evaluated. The standard evaluation methods yielded a highly signifiant difference between benign and malignant disease for E(1) (P = .0008) and SE(2-10) (P = .0001). The pharmacokinetic parameters gained similarly significant P values (A, P = .0014; t(21), P = .0024; t(el), P = .0001). Both standard and pharmacokinetic analysis concordantly discriminated between benign and malignant lesions in discriminant analysis. Compared with standard analysis, a pharmacokinetic analysis of time-intensity curves is not beneficial for routine clinical diagnosis.