Patterns of Peripheral Enhancement in Breast Masses: Correlation of Findings on Contrast Medium Enhanced MRI with Histologic Features and Tumor Angiogenesis

Buadu, Lawrence D.; Murakami, Junji; Murayama, Sadayuki; Hashiguchi, Norihisa; Sakai, Shuji; Toyoshima, Satoshi; Masuda, Kouji; Kuroki, Shin-Ichiro; Ohno, Shinji

doi:10.1097/00004728-199705000-00016

Cited by 74 publications

(63 citation statements)

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“…Enhancement patterns on dynamic imaging provide information about a variety of parameters that reflect vascular changes, such as vascular permeability, interstitial pressure, and extracellular space (1)(2)(3)(4). Since the microvascular properties of cancers differ from those of benign lesions, enhancement patterns may be used for differentiation of benign and malignant lesions (2,4 -7).…”

mentioning

confidence: 99%

Quantitative diffusion imaging in breast cancer: A clinical prospective study

Rubesova

Grell

Maertelaer

et al. 2006

Magnetic Resonance Imaging

229

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Purpose: To study the correlation between apparent diffusion coefficient (ADC) and pathology in patients with undefined breast lesion, to validate how accurately ADC is related to histology, and to define a threshold value of ADC to distinguish malignant from benign lesions. Materials and Methods:Seventy-eight patients (110 lesions) were referred for positive or dubious findings. Threedimensional fast low-angle shot (3D-FLASH) with contrast injection was applied. EPI diffusion-weighted imaging (DWI) with fat saturation was performed, and ROIs were selected on subtraction 3D-FLASH images before and after contrast injection, and copied on an ADC map. Inter-and intraobserver analyses were performed.Results: At pathology 22 lesions were benign, 65 were malignant, and 23 were excluded. The ADCs of malignant and benign lesions were statistically different. In malignant tumors the ADC was (mean Ϯ SEM) 0.95 Ϯ 0.027 ϫ 10 -3mm 2 /second, and in benign tumors it was 1.51 Ϯ 0.068 ϫ 10 -3 mm 2 /second. According to receiver operating characteristic (ROC) curves, we found a threshold between malignant and benign lesions for highest sensitivity and specificity (both 86%) around 1.13 Ϯ 0.10 ϫ 10 -3 mm 2 /second. For a threshold of 0.95 Ϯ 0.10 ϫ 10 -3 mm 2 /second, specificity was 100% but sensitivity was very low. Inter-and intraobserver studies showed good reproducibility. Conclusion:The ADC may help to differentiate benign and malignant lesions with good specificity, and may increase the overall specificity of breast MRI.

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confidence: 99%

Quantitative diffusion imaging in breast cancer: A clinical prospective study

Rubesova

Grell

Maertelaer

et al. 2006

Magnetic Resonance Imaging

229

199

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“…[1][2][3][4][5][6][7][8] Several morphologic characteristics and kinetic patterns on MR imaging in breast carcinoma are explained primarily by the histological structures and the degree of tumor angiogenesis. [9][10][11][12][13][14][15] In addition, tumor vascularity detected on imaging may be in‰uenced by the histological growth pattern of the carcinoma, such as scirrhous or solidtype carcinoma. 16 In our study, mass margin (Pº0.001) and kinetic pattern (P＝0.04) were signiˆcantly diŠerent among the 3 SCD groups.…”

Section: Discussionmentioning

confidence: 99%

“…4,5,[21][22][23] Buadu and associates 9 reported diŠerent patterns of rim enhancement and concluded that early rim enhancement with progression to the center was fairly speciˆc for carcinomas. Matsubayashi's group 10 reported that whereas early Fig.…”

Section: Magnetic Resonance In Medical Sciencesmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8] DiŠerences in the characteristics of MR enhancement between benign and malignant lesions are believed to re‰ect diŠerences in vascularity, vessel permeability, and extracellular diŠusion space. In addition, several morphologic characteristics and kinetic patterns on MR imaging in breast carcinoma are primarily explained by the histological structures of the lesions, [9][10][11] such as centralˆbrosis, central necrosis, marginalˆbrosis, and the degree of tumor angiogenesis. 9,10,[12][13][14][15] However, we previously reported that the tumor vascularity of breast carcinoma on power Doppler ultrasonography depended not only on the degree of tumor angiogenesis, but also on the growth pattern (solid versus``scirrhous'' type).…”

Section: Introductionmentioning

confidence: 99%

“…In addition, several morphologic characteristics and kinetic patterns on MR imaging in breast carcinoma are primarily explained by the histological structures of the lesions, [9][10][11] such as centralˆbrosis, central necrosis, marginalˆbrosis, and the degree of tumor angiogenesis. 9,10,[12][13][14][15] However, we previously reported that the tumor vascularity of breast carcinoma on power Doppler ultrasonography depended not only on the degree of tumor angiogenesis, but also on the growth pattern (solid versus``scirrhous'' type). 16 The purpose of our present study was to assess the relationship between the amount of scirrhous component in invasive ductal carcinoma and the morphologic and kinetic patterns on MR imaging.…”

Section: Introductionmentioning

confidence: 99%

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Dynamic High-Spatial-Resolution MR Imaging of Invasive Ductal Carcinoma: Influence of Histological Scirrhous Component on MR Descriptors

2006

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Purpose: The purpose of this study was to assess the relationship between the amount of scirrhous component in invasive ductal carcinoma and its MR characteristics.Materials and Methods: We retrospectively reviewed 71 consecutive patients with invasive ductal carcinoma smaller than 25 mm (average, 16.6 mm) in diameter. The scirrhous component was deˆned as invasive foci in small clusters of cancer cells showing desmoplasia. Invasive ductal carcinoma was subclassiˆed into 3 groups in accordance with the amount of the scirrhous component (scirrhous component degree; SCD): SCD I (scirrhous component less than 20z), SCD II (intermediate), and SCD III (more than 80z). Dynamic magnetic resonance (MR) imaging was performed using volumetric interpolated sequence. Prior to dynamic study, T 2 *-weightedˆrst-pass perfusion images were obtained before, during, and after bolus injection of 0.1 mmol Gd-DTPA W kg.Results: Twenty-eight lesions were classiˆed as SCD I, 14 as SCD II, and 29 as SCD III. Mass margin and signal intensity loss in the perfusion study were signiˆcantly diŠerent among the 3 SCD groups (Pº0.001). The kinetic patterns were signiˆcantly diŠerent among the 3 SCD groups (P＝0.04), and between SCD I W II and SCD III (P＝0.03). The presence of enhancing internal septations was signiˆcantly diŠerent between SCD I W II and SCD III carcinomas (P＝0.05). Central enhancement was only observed in SCD I carcinoma (4z; 3W 71).Conclusion: The histological predominance of the scirrhous component in invasive ductal carcinoma may be one explanation for the diŠerences in morphologic and kinetic patterns on MR imaging.

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