Ductal Carcinoma in Situ of the Breast

Fietkau, Rainer

doi:10.1007/s00066-004-9192-1

Cited by 9 publications

(1 citation statement)

References 42 publications

(77 reference statements)

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“…More recent reports suggest that DCE-MRI may perform comparably to or better than x-ray mammography for diagnosis of DCIS (Boetes et al 1997, Gilles et al 1995, Kuhl et al 2007, Orel et al 1997, Menell et al 2005. Further improvements in the reliable detection of DCIS are desirable, particularly because diagnosis and treatment at this earliest pre-invasive stage yield cure rates of 95-98% (Fietkau 2004). Towards this end, an important clinical aim is to effectively distinguish DCIS from benign lesions such as hyperplasia, fibrocystic change and lobular carcinoma in situ, and also from enhancing normal parenchyma.…”

Section: Introductionmentioning

confidence: 99%

Characterizing early contrast uptake of ductal carcinomain situwith high temporal resolution dynamic contrast-enhanced MRI of the breast: a pilot study

et al. 2010

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Improvements in the reliable diagnosis of preinvasive ductal carcinoma in situ (DCIS) by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) are needed. In this study, we present a new characterization of early contrast kinetics of DCIS using high temporal resolution (HiT) DCE-MRI and compare it with other breast lesions and normal parenchyma. Forty patients with mammographic calcifications suspicious for DCIS were selected for HiT imaging using T(1)-weighted DCE-MRI with ∼7 s temporal resolution for 90 s post-contrast injection. Pixel-based and whole-lesion kinetic curves were fit to an empirical mathematical model (EMM) and several secondary kinetic parameters derived. Using the EMM parameterized and fitted concentration time curve for subsequent analysis allowed for calculation of kinetic parameters that were less susceptible to fluctuations due to noise. The parameters' initial area under the curve (iAUC) and contrast concentration at 1 min (C(1 min)) provided the highest diagnostic accuracy in the task of distinguishing pathologically proven DCIS from normal tissue. There was a trend for DCIS lesions with solid architectural pattern to exhibit a negative slope at 1 min (i.e. increased washout rate) compared to those with a cribriform pattern (p < 0.04). This pilot study demonstrates the feasibility of quantitative analysis of early contrast kinetics at high temporal resolution and points to the potential for such an analysis to improve the characterization of DCIS.

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