Role of dynamic contrast‐enhanced MRI in evaluating the association between contralateral parenchymal enhancement and survival outcome in ER‐positive, HER2‐negative, node‐negative invasive breast cancer

Shin, Gi Won; Zhang, Yang; Kim, Min Jung; Su, Min‐Ying; Moon, Hee Jung; Yoon, Jung Hyun; Park, Vivian Youngjean

doi:10.1002/jmri.26176

Cited by 17 publications

(33 citation statements)

References 38 publications

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“…The ROIs are then propagated to the precontrast and all the postcontrast images in the study. The ROI is typically small, consisting of a set number of pixels or a target diameter ranging from a few millimeters to a few centimeters . A few studies have utilized larger ROIs, encompassing as much as the normal fibroglandular tissue as possible .…”

Section: Approaches For Bpe Quantitationmentioning

confidence: 99%

“…PE may also be measured on later‐phase postcontrast images. The signal enhancement ratio (SER) has also been used in addition to or in place of PE . SER is defined as:

italicSER = \frac{S_{early} - S_{pre}}{S_{delayed} - S_{pre}} * 100 %

where S early is the mean signal intensity of the first postcontrast image and S delayed is the mean signal intensity from a delayed‐phase image.…”

Section: Approaches For Bpe Quantitationmentioning

confidence: 99%

“…Efficiency may improve through the use of interpolation between manually segmented slices or the use of an ROI encircling the fibroglandular tissue and applying a thresholding operation to define the fibroglandular tissue . Automated or semiautomated segmentation methods have also been employed to remove the skin and to define and remove the chest wall, typically using a form of edge detection or gradient tracing with appropriate constraints. Template‐ or atlas‐based methods have also been applied .…”

Section: Approaches For Bpe Quantitationmentioning

confidence: 99%

“…Automated or semiautomated segmentation methods have also been employed to remove the skin and to define and remove the chest wall, typically using a form of edge detection or gradient tracing with appropriate constraints. Template‐ or atlas‐based methods have also been applied . Several approaches for separating the fibroglandular tissue of interest from the surrounding fat tissue or nonenhancing fibroglandular tissue have also been described.…”

Section: Approaches For Bpe Quantitationmentioning

confidence: 99%

“…For example, simple thresholding operations have been described in applications where the T 1 images are fat‐suppressed or subtracted . The most common automated or semiautomated method for identifying the fibroglandular tissue uses K‐means or fuzzy‐C means clustering . In these types of approaches, an algorithm attempts to identify different classes of tissue based on their intensity differences, and can be applied to protocols with and without fat saturation.…”

Section: Approaches For Bpe Quantitationmentioning

confidence: 99%

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Background parenchymal enhancement on breast MRI: A comprehensive review

Liao

Bancroft

Strigel

et al. 2019

Magnetic Resonance Imaging

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The degree of normal fibroglandular tissue that enhances on breast MRI, known as background parenchymal enhancement (BPE), was initially described as an incidental finding that could affect interpretation performance. While BPE is now established to be a physiologic phenomenon that is affected by both endogenous and exogenous hormone levels, evidence supporting the notion that BPE frequently masks breast cancers is limited. However, compelling data have emerged to suggest BPE is an independent marker of breast cancer risk and breast cancer treatment outcomes. Specifically, multiple studies have shown that elevated BPE levels, measured qualitatively or quantitatively, are associated with a greater risk of developing breast cancer. Evidence also suggests that BPE could be a predictor of neoadjuvant breast cancer treatment response and overall breast cancer treatment outcomes. These discoveries come at a time when breast cancer screening and treatment have moved toward an increased emphasis on targeted and individualized approaches, of which the identification of imaging features that can predict cancer diagnosis and treatment response is an increasingly recognized component. Historically, researchers have primarily studied quantitative tumor imaging features in pursuit of clinically useful biomarkers. However, the need to segment less well-defined areas of normal tissue for quantitative BPE measurements presents its own unique challenges. Furthermore, there is no consensus on the optimal timing on dynamic contrastenhanced MRI for BPE quantitation. This article comprehensively reviews BPE with a particular focus on its potential to increase precision approaches to breast cancer risk assessment, diagnosis, and treatment. It also describes areas of needed future research, such as the applicability of BPE to women at average risk, the biological underpinnings of BPE, and the standardization of BPE characterization. Level of Evidence: 3 Technical Efficacy Stage: 5

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Section: Approaches For Bpe Quantitationmentioning

confidence: 99%

“…PE may also be measured on later‐phase postcontrast images. The signal enhancement ratio (SER) has also been used in addition to or in place of PE . SER is defined as:

italicSER = \frac{S_{early} - S_{pre}}{S_{delayed} - S_{pre}} * 100 %

where S early is the mean signal intensity of the first postcontrast image and S delayed is the mean signal intensity from a delayed‐phase image.…”

Section: Approaches For Bpe Quantitationmentioning

confidence: 99%

Section: Approaches For Bpe Quantitationmentioning

confidence: 99%

Section: Approaches For Bpe Quantitationmentioning

confidence: 99%

Section: Approaches For Bpe Quantitationmentioning

confidence: 99%

See 3 more Smart Citations

Background parenchymal enhancement on breast MRI: A comprehensive review

Liao

Bancroft

Strigel

et al. 2019

Magnetic Resonance Imaging

View full text Add to dashboard Cite

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Simultaneous evaluation of perfusion and morphology using GRASP MRI in hepatic fibrosis

Yoon

Lee

et al. 2021

Eur Radiol

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Background Parenchymal Enhancement on Breast MRI: Assessment and Clinical Implications

2021

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Purpose of Review To present recent literature regarding the assessment and clinical implications of background parenchymal enhancement on breast MRI. Recent Findings The qualitative assessment of BPE remains variable within the literature, as well as in clinical practice. Several different quantitative approaches have been investigated in recent years, most commonly region of interest-based and segmentation-based assessments. However, quantitative assessment has not become standard in clinical practice to date. Numerous studies have demonstrated a clear association between higher BPE and future breast cancer risk. While higher BPE does not appear to significantly impact cancer detection, it may result in a higher abnormal interpretation rate. BPE is also likely a marker of pathologic complete response after neoadjuvant chemotherapy, with decreases in BPE during and after neoadjuvant chemotherapy correlated with pCR. In contrast, pre-treatment BPE does not appear to be predictive of pCR. The association between BPE and prognosis is less clear, with heterogeneous results in the literature. Summary Assessment of BPE continues to evolve, with heterogeneity in approaches to both qualitative and quantitative assessment. The level of BPE has important clinical implications, with associations with future breast cancer risk and treatment response. BPE may also be an imaging marker of prognosis, but future research is needed on this topic.

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Role of dynamic contrast‐enhanced MRI in evaluating the association between contralateral parenchymal enhancement and survival outcome in ER‐positive, HER2‐negative, node‐negative invasive breast cancer

Abstract: 3 Technical Efficacy: Stage 4 J. Magn. Reson. Imaging 2018;48:1678-1689.

Cited by 17 publications

References 38 publications

Background parenchymal enhancement on breast MRI: A comprehensive review

Background parenchymal enhancement on breast MRI: A comprehensive review

Simultaneous evaluation of perfusion and morphology using GRASP MRI in hepatic fibrosis

Background Parenchymal Enhancement on Breast MRI: Assessment and Clinical Implications

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