Analysis of Volumetric Perfusion Quantitative Parameters Using CS-VIBE Breast Dynamic Contrast Enhanced MR Imaging

Abstract

Purpose: To evaluate the diagnostic performance of three-dimensional volume of interest (3D-VOI) perfusion quantitative parameters using CS-VIBE DCE-MRI and investigate the relationship of the prognostic factors.

Materials and methods: The volumetric perfusion quantitative parameters of K^trans, K_ep, V_e, V_p, of 124 pathologically proven breast masses in 93 patients were obtained using the two-compartment extended Tofts model. Also, the perfusion parameters of AUC, TTP, Emax, wash-in, and washout were automatically calculated using post-processing software. The relationship between the perfusion quantitative parameters and lesion size, pathology, and prognostic factors of malignancy was evaluated.

Results: K^trans and K_ep were significantly higher in the malignant than the benign lesions (p < 0.001), and the AUROC of K^trans and K_ep was 0.802 and 0.815, respectively. The area under the DCE curve, TTP, Emax, wash-in, and wash-out were significantly different between the benign and malignant lesions (p < 0.05). In multiple linear regression analysis, K^trans and K_ep were significantly different between benign and malignant tumors. Malignant tumors larger than 2cm were significantly different from those smaller than 2cm in K^trans, K_ep, V_p, area under the DCE curve, TTP, Emax, and wash-in values (p < 0.05). TTP was significantly lower in higher Ki-67 index (p < 0.05).

Conclusion: Perfusion quantitative parameters may be applied as a feasible imaging biomarker to discriminate malignant from benign tumors. In malignant lesions, perfusion parameters were not associated with histopathological results but only in tumor size.

Keywords: Breast; diagnosis; dynamic contrast-enhanced MRI; lesions; neoplasms; perfusion.