Effects of Tamoxifen and Aromatase Inhibitors on Breast Tissue Enhancement in Dynamic Contrast–enhanced Breast MR Imaging: A Longitudinal Intraindividual Cohort Study
Abstract:The effects of tamoxifen and AI on benign parenchymal enhancement differ. Whereas tamoxifen leads to a virtually complete suppression of enhancement, the effects of AI are less pronounced. Accordingly, whereas enhancement is unusual and deserves a more careful work-up in a patient in whom tamoxifen is used, this is not necessarily true for women in whom AIs are used. Online supplemental material is available for this article.
“…Most of the studies were performed in the USA (17/39 studies), the Korea (10/39 studies) and Japan (6/39 studies). Only one study 47 had a prospective study design. The patient population of the included studies ranged from 18 to 1275 patients.…”
Section: Resultsmentioning
confidence: 99%
“…BPE was described as percentage enhancement rates or a relative percentage enhancement in 11 studies, 22,24,30,32,46,47,[53][54][55]58,59 with the use of both pre-and post-contrast images. There was a wide heterogeneity in the time selection of images obtained after contrast agent injection for relative percentage enhancement or percentage enhancement rate calculation.…”
“…57 Wu et al 60 used a validated fully automated method that allowed segmentation and quantitative measure of fibroglandular tissues and BPE. 60 Qualitative and quantitative background parenchymal enhancement assessment Among the 11 studies that assessed BPE in both qualitative and quantitative methods, 7,20,22,24,29,30,32,34,35,46,47 27% (3/11) studies were published in 2015 (January-October 2015) and 73% (8/11) studies were published during 2010-2014. Most of the studies were performed in the USA (3/11 studies) and the Korea (3/11 studies).…”
“…7,20,22,24,25,27,30,31,39,45,46,55,56,60 In 8 of these 14 studies, breast MRI were performed ideally in the second week of the menstrual cycle. 7,22,24,25,27,45,56,60 In three studies, 37,47,58 the patients were post-menopausal females.…”
Objective: To perform a systematic review of the methods used for background parenchymal enhancement (BPE) evaluation on breast MRI. Methods: Studies dealing with BPE assessment on breast MRI were retrieved from major medical libraries independently by four reviewers up to 6 October 2015. The keywords used for database searching are "background parenchymal enhancement", "parenchymal enhancement", "MRI" and "breast". The studies were included if qualitative and/or quantitative methods for BPE assessment were described. Results: Of the 420 studies identified, a total of 52 articles were included in the systematic review. 28 studies performed only a qualitative assessment of BPE, 13 studies performed only a quantitative assessment and 11 studies performed both qualitative and quantitative assessments. A wide heterogeneity was found in the MRI sequences and in the quantitative methods used for BPE assessment. Conclusion: A wide variability exists in the quantitative evaluation of BPE on breast MRI. More studies focused on a reliable and comparable method for quantitative BPE assessment are needed. Advances in knowledge: More studies focused on a quantitative BPE assessment are needed.
“…Most of the studies were performed in the USA (17/39 studies), the Korea (10/39 studies) and Japan (6/39 studies). Only one study 47 had a prospective study design. The patient population of the included studies ranged from 18 to 1275 patients.…”
Section: Resultsmentioning
confidence: 99%
“…BPE was described as percentage enhancement rates or a relative percentage enhancement in 11 studies, 22,24,30,32,46,47,[53][54][55]58,59 with the use of both pre-and post-contrast images. There was a wide heterogeneity in the time selection of images obtained after contrast agent injection for relative percentage enhancement or percentage enhancement rate calculation.…”
“…57 Wu et al 60 used a validated fully automated method that allowed segmentation and quantitative measure of fibroglandular tissues and BPE. 60 Qualitative and quantitative background parenchymal enhancement assessment Among the 11 studies that assessed BPE in both qualitative and quantitative methods, 7,20,22,24,29,30,32,34,35,46,47 27% (3/11) studies were published in 2015 (January-October 2015) and 73% (8/11) studies were published during 2010-2014. Most of the studies were performed in the USA (3/11 studies) and the Korea (3/11 studies).…”
“…7,20,22,24,25,27,30,31,39,45,46,55,56,60 In 8 of these 14 studies, breast MRI were performed ideally in the second week of the menstrual cycle. 7,22,24,25,27,45,56,60 In three studies, 37,47,58 the patients were post-menopausal females.…”
Objective: To perform a systematic review of the methods used for background parenchymal enhancement (BPE) evaluation on breast MRI. Methods: Studies dealing with BPE assessment on breast MRI were retrieved from major medical libraries independently by four reviewers up to 6 October 2015. The keywords used for database searching are "background parenchymal enhancement", "parenchymal enhancement", "MRI" and "breast". The studies were included if qualitative and/or quantitative methods for BPE assessment were described. Results: Of the 420 studies identified, a total of 52 articles were included in the systematic review. 28 studies performed only a qualitative assessment of BPE, 13 studies performed only a quantitative assessment and 11 studies performed both qualitative and quantitative assessments. A wide heterogeneity was found in the MRI sequences and in the quantitative methods used for BPE assessment. Conclusion: A wide variability exists in the quantitative evaluation of BPE on breast MRI. More studies focused on a reliable and comparable method for quantitative BPE assessment are needed. Advances in knowledge: More studies focused on a quantitative BPE assessment are needed.
“…Lee et al, 139 Wang et al, 140 Velayudham et al Uchinami et al, 142 Buryova et al, 143 Popov et al, 144 Schrading et al, 145 Díaz-Gil et al, 146 Kossakowska et al 147 …”
Section: Metalloproteinases In the Development Of Liver Fibrosismentioning
Liver fibrosis is defined by excessive deposition of extracellular matrix. The fibrotic conditions result from the imbalance between synthesis and deposition of fibrous tissues and decomposition of these matrix proteins. This process can be reversed as a regular part of the healing process after hepatic damage or can become chronic. When the protein matrix synthesis predominates and the decomposition is suppressed, fibrosis will progress into irreversible cirrhosis or steatosis. Among the molecular players involved in fibrotic liver diseases, metalloproteinases of matrix metalloproteinase (MMP) and a disintegrin and metalloproteinase (ADAM) families are critical in the development of liver fibrosis and its resolution. Previously, MMPs were recognized as extracellular matrix degrading enzymes. Currently, they are also known as mediators in a variety of processes related to immunity and tissue repair. In this article, we have reviewed the models of liver fibrosis and findings on MMPs and ADAMs in hepatic fibrosis conditions.
Background parenchymal enhancement (BPE) is the degree to which normal breast tissue enhances on contrast‐enhanced magnetic resonance imaging (MRI). MRI‐density is a volumetric measure of breast density that is highly correlated with mammographic density, an established breast cancer risk factor. Endogenous estrogen concentrations are positively associated with postmenopausal breast cancer risk and BPE has been shown to be sensitive to hormonal exposures. The objective of our study was to examine the relationship between BPE and MRI‐density and serum hormone concentrations in postmenopausal women. This was a study of cancer‐free postmenopausal women undergoing contrast‐enhanced breast MRI (N = 118). At the time of MRI all women completed a self‐administered questionnaire and blood samples were collected for hormone analyses. Serum concentrations of estrone (E1), estradiol (E2) and bioavailable E2 were examined by category of BPE and MRI‐density. Compared to women with “minimal” BPE, those who had “marked” BPE had significantly higher serum concentrations of E1, E2 and bioavailable E2 (90% increase, p
trend across all categories = 0.001; 150% increase, p
trend = 0.001; and 158% increase, p
trend = 0.001, respectively). These associations were only affected to a minor extent by adjustment for BMI and other variables. After adjustment for BMI, no significant associations between MRI‐density and serum E1, E2 and bioavailable E2 were observed. Serum estrogen concentrations were significantly positively associated with BPE. Our study provides further evidence of the hormone‐sensitive nature of BPE, indicating a potential role for BPE as an imaging marker of endogenous and exogenous hormonal exposures in the breast.
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