Evaluation of 3T MR Quantitative T1 Perfusion in Differential Diagnosising Human Breast Lesions
|Course||Medical Imaging and Nuclear Medicine|
|Keywords||Breast neoplasms MRI quantitative T1 perfusion Differential Diagnosis Capillary permeability Neoadjuvant chemotherapy Magnetic resonance imaging T1 perfusion|
Objective:To assess the value of 3T MR quantitative T1 perfusion in diagnosis of suspicious breast lesions.Methods:99 patients (yielded 110 lesions) with suspicious breast lesions underwent MRI examinations. A 3.0-T scanner was used to obtain MR quantitative T1 perfusion pharmacokinetic parameters:Ktrans (volume transfer constant), Kep (exchange rate constant) and Ve (extravascular extracellular volume fraction). According to pathology result, The mean Ktrans, Kep and Ve of malignant, benign and normal glandular tissues were calculated. Additionally, the areas under the ROC curve (AUC) of Ktrans, Kep and Ve between malignant and benign lesions were compared.Reasults:There were 17patients responders and 7 non-responders according to RECIST method, and there were 19 patients responders and 5 non-responders according to volume method. The mean Ktrans, Kep and Ve of malignant lesions (n=87) were (1.010±0.580) min-1、(1.634±1.481) min-1, (0.735±0.273); The mean Ktrans, Kep and Ve of benign lesions (n=23) were (0.322±0.189) min-1、(0.417±0.324) min-1、(0.847±0.291); and normal glandular tissue (n=83) were (0.051±0.028) min-1, (0.133±0.125) min-1、(0.597±0.354), respectively. The mean Ktrans among the three, the mean Kep between benign and malignant; normal glandular and malignant were statistically significant (P<0.05), while the mean Ve between benign and malignant was not statistically significant (P>0.05). The area under the ROC curve (AUC) of Ktrans, Kep and Ve between malignant and benign lesions were 0.934,0.941 and 0.659, respectively. And the sensitivity were 77.01%,91.95%,56.32%; the specificity were 95.65%,86.96%,78.26% if the maximum Youden’index was taken as cut-off.Conclusion:The differentiation of benign from malignant breast lesions by Ktrans, Kep is applicable, and those parameters show great efficacy in differential diagnosis of human breast lesions. Evaluation of 3T MR T1 perfusion in assessment of the response to neoadjuvant chemotherapy in human breast cancerObjective:To evaluate the value of 3T MR T1 perfusion in assessment of the response to neoadjuvant chemotherapy (NAC).Methods:24 women with breast carcinoma (24 all were invasive ductal carcinoma) underwent MRI T1 perfusion examination before, after the second and final cycle of NAC. For each patient and each MRI examination, the maximum diameter and volume of tumor, Ktrans (volume transfer constant), Kep (exchange rate constant), Ve (extravascular extracellular volume fraction), PeakT (Peak Time), MxSlp (Maximum Slope rate) and CER (contrast enhancement ratio) were compared.Reasults:(1) There were 17patients responders and 7 non-responders according to RECIST method, (2) There were 19 patients responders and 5 non-responders according to volume method. (3) Significant difference were found between responders and non-responders prior to treament in the Ktrans according to volume method. (4) In both responder group, there was significant difference in the Ktrans, Kep between prior to NAC and 2nd cycle of NAC; and prior to NAC and final cycle of NAC. (5) Significant difference was found in non-responders group prior to treament in Ktrans. (6) In both responder group, there was significant difference in the PeakT between prior to NAC and 2nd cycle of NAC.Conclusion:(1) To use the volume of tumors is the same to use the maximum diameter in assessment of the response to neoadjuvant chemotherapy in breast cancer, However pre-treatment Ktrans play an anticipational role in volume evaluation method. (2) The assessment of the response to neoadjuvant chemotherapy in breast cancer by MR T1 perfusion is applicable, and Ktrans, Kep, PeakT can quantitatively evaluate the response though Ve, MxSlp and CER did not show efficacy.