Magnetic resonance imaging reveals functional diversity of the vasculature in benign and malignant breast lesions

被引:76
作者
Furman-Haran, E [1 ]
Schechtman, E
Kelcz, F
Kirshenbaum, K
Degani, H
机构
[1] Weizmann Inst Sci, Dept Regulat Biol, IL-76100 Rehovot, Israel
[2] Ben Gurion Univ Negev, Dept Ind Engn & Management, IL-84105 Beer Sheva, Israel
[3] Univ Wisconsin Hosp, Dept Radiol, Madison, WI 53792 USA
[4] Illinois Masonic Med Ctr, Dept Radiol, Chicago, IL 60657 USA
关键词
angiogenesis; breast neoplasms; dnyamic contrast-enhanced magnetic resonance imaging; image processing; diagnosis;
D O I
10.1002/cncr.21225
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUND. Tumor perfusion through the microvascular network can be imaged noninvasively by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). The objective of the current study was to quantity the microvascular perfusion parameters in various human breast lesions and to determine whether they varied between benign lesions and malignancy and whether they were altered with increased invasiveness. METHODS. Perfusion parameters in 22 benign fibrocystic changes, 15 ductal carcinomas in situ (DCIS), 30 infiltrating ductal carcinomas (IDC), and 22 fibroadenomas were measured using high-resolution DCE-MRI. Pixel-by-pixel image analysis yielded parametric images of two perfusion indicators: the influx transcapillary transfer constant (k(trans)) and the efflux transcapillary rate constant (k(ep)). Correlations of lesion type and perfusion parameters were calculated using Spearman correlation. Logistic regression analysis evaluated the best predictors of the kinetic parameters that differentiate between IDC and benign lesions. RESULTS. The perfusion parameters exhibited a progressive increase from benign fibrocystic changes to DCIS and IDC, with a significant correlation between lesion type and the parameters' values (range of correlation coefficients, 0.56-0.76; P < 0.0001). In addition, k(trans) increased from low-grade DCIS to high-grade DCIS. Fibroadenomas were characterized uniquely by high k(trans) but low k(ep). Stepwise logistic regression selected k(trans). as the best predictor for distinguishing benign fibrocystic changes from IDC, yielding 93% sensitivity and 96% specificity. ONCLUSIONS. The microvascular perfusion parameters in breast lesions were elevated with invasiveness. Quantification of these parameters using high-resolution DCE-MRI was helpful for differentiating between breast lesions and should improve breast carcinoma diagnosis.
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页码:708 / 718
页数:11
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