Can semi-quantitative evaluation of uncertain (type II) time-intensity curves improve diagnosis in breast DCE-MRI?

作     者：Roberta Fusco Salvatore Filice Vincenza Granata Ylenia Mandato Annamaria Porto Massimiliano D’Aiuto Massimo Rinaldo Maurizio Di Bonito Mario Sansone Carlo Sansone Antonio Rotondo Antonella Petrillo Petrillo 

作者机构：Department of Breast Surgery and Oncology National Cancer Institute of Naples “Pascale Foundation” Naples Italy Department of Diagnostic and Laboratory Pathology National Cancer Institute of Naples “Pascale Foundation” Naples Italy Department of Diagnostic Imaging National Cancer Institute of Naples “Pascale Foundation” Naples Italy Department of Diagnostic Imaging Second University of Naples (SUN) Naples Italy Department of Electrical Engineering and Information Technology University “Federico II” of Naples Naples Italy 

出 版 物：《Journal of Biomedical Science and Engineering》 (生物医学工程（英文）)

年 卷 期：2013年第6卷第3期

页      面：418-425页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Breast Cancer Dynamic Contrast Enhanced-MRI Time Intensity Curve Tracer Kinetics Semi-Quantitative Analysis 

摘      要：Objective/Background: Qualitative assessment of uncertain (type II) time-intensity curves (TICs) in breast DCE-MRI is problematic and operator dependent. The aim of this work is to evaluate if a semi-quantitative assessment of uncertain TICs could improve overall diagnostic performance. Methods: In this study 49 lesions from 44 patients were retrospectively analysed. Per each lesion one region-of-interest (ROI)- averaged TIC was qualitatively evaluated by two radiologists in consensus: all the ROIs resulted in type II (uncertain) TIC. The same TICs were semi-quantitatively re-classified on the basis of the difference between the signal intensities of the last-time-point and of the peak: this difference was classified according to two different cut-off ranges (±5% and ±3%). All patients were cytological or histological biopsy proven. Fisher test and McNemar test were performed to evaluate if results 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 were reclassified again as type II. Using ±3% 22 TICs were reclassified as type III and 16 as type I while 11 were reclassified again as type II. The semi-quantitative classification was compared to the histological-cytological results: the sensitivity, specificity, positive and negative predictive values obtained with ±3% were 77%, 91%, 91% and 78% respectively while using ±5% were 58%, 96%, 94% and 68% respectively. Using the ±5% cut-off 26/28 (93%) TICs were correctly reclassified while using the ±3% cut-off 34/38 (90%) TICs were correctly reclassified (p 0.05). Conclusions: Semi-quantitative methods in kinetic curve assessment on DCE-MRI could improve classification of qualitatively uncertain TICs, leading to a more accurate classification of suspicious breast lesions.