Assessing heterogeneity of lesion enhancement kinetics in dynamic contrast-enhanced MRI for breast cancer diagnosis

The current study investigates the feasibility of using texture analysis to quantify the heterogeneity of lesion enhancement kinetics in order to discriminate malignant from benign breast lesions. A total of 82 biopsy-proven breast lesions (51 malignant, 31 benign), originating from 74 women subjected to dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) were analysed. Pixel-wise analysis of DCE-MRI lesion data was performed to generate initial enhancement, post-initial enhancement and signal enhancement ratio (SER) parametric maps; these maps were subsequently subjected to co-occurrence matrix texture analysis. The discriminating ability of texture features extracted from each parametric map was investigated using a least-squares minimum distance classifier and further compared with the discriminating ability of the same texture features extracted from the first post-contrast frame. Selected texture features extracted from the SER map achieved an area under receiver operating characteristic curve of 0.922 +/- 0.029, a performance similar to post-initial enhancement map features (0.906 +/- 0.032) and statistically significantly higher than for initial enhancement map (0.767 +/- 0.053) and first post-contrast frame (0.756 +/- 0.060) features. Quantifying the heterogeneity of parametric maps that reflect lesion washout properties could contribute to the computer-aided diagnosis of breast lesions in DCE-MRI.