Can semi-quantitative evaluation of uncertain type II time-intensity curves improve diagnosis in breast DCE-MRIReport as inadecuate




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Objective-Background: Qualitativeassessment of uncertain type II time-intensity curves TICs in breastDCE-MRI is problematic and operator dependent. The aim of this work is toevaluate if a semi-quantitative assessment of uncertain TICs could improveoverall diagnostic performance. Methods: In this study 49 lesions from 44patients were retrospectively analysed. Pereach lesion one region-of-interest ROI- averaged TIC was qualitativelyevaluated by two radiologists in consensus: all the ROIs resulted in type IIuncertain TIC. The same TICs were semi-quantitatively re-classified on thebasis of the difference between the signal intensities of the last-time-pointand of the peak: this difference was classified according to two differentcut-off ranges ±5% and ±3%. All patients were cytological or histologicalbiopsy proven. Fisher test and McNemar test were performed to evaluate ifresults were statistically significant p < 0.05. Results: Using ±5%cut-off 16 TICs were reclassified as type III and 12 as type I while 21 werereclassified again as type II. Using ±3% 22 TICs were reclassified as type IIIand 16 as type I while 11 were reclassified again as type II. The semi-quantitative classification was compared to the histological-cytological results: thesensitivity, specificity, positive and negative predictive values obtained with±3% were 77%, 91%, 91% and 78% respectively while using ±5% were58%, 96%, 94% and 68% respectively. Using the ±5% cut-off 26-28 93% TICswere correctly reclassified while using the ±3% cut-off 34-38 90% TICs werecorrectly reclassified p < 0.05. Conclusions: Semi-quantitative methods inkinetic curve assessment on DCE-MRI could improve classification of qualitativelyuncertain TICs, leading to a more accurate classification of suspicious breastlesions.

KEYWORDS

Breast Cancer; Dynamic Contrast Enhanced-MRI; Time Intensity Curve; Tracer Kinetics; Semi-Quantitative Analysis

Cite this paper

Fusco, R. , Filice, S. , Granata, V. , Mandato, Y. , Porto, A. , D’Aiuto, M. , Rinaldo, M. , Bonito, M. , Sansone, M. , Sansone, C. , Rotondo, A. and Petrillo, A. 2013 Can semi-quantitative evaluation of uncertain type II time-intensity curves improve diagnosis in breast DCE-MRI?. Journal of Biomedical Science and Engineering, 6, 418-425. doi: 10.4236-jbise.2013.63A052.





Author: Roberta Fusco, Salvatore Filice, Vincenza Granata, Ylenia Mandato, Annamaria Porto, Massimiliano D’Aiuto, Massimo Rinaldo, Maur

Source: http://www.scirp.org/



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