Optimizing ultrafast dynamic contrast-enhanced MRI scan duration in the differentiation of benign and malignant breast lesions

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2024年5月7日

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Ying Cao,
Yao Huang,
Xianglong Chen,
Wei Wang,
Huifang Chen,
Ting Yin,
Dominik Nickel,
Changchun Li,
Junhua Shao,
Shi Zhang,
Xiaoxia Wang,
Jiuquan Zhang

摘要

Objective

To determine the optimal scan duration for ultrafast DCE-MRI in effectively differentiating benign from malignant breast lesions.

Methods

The study prospectively recruited participants who underwent breast ultrafast DCE-MRI from September 2021 to March 2023. A 30-phase breast ultrafast DCE-MRI on a 3.0-T MRI system was conducted with a 4.5-s temporal resolution. Scan durations ranged from 40.5 s to 135.0 s, during which the analysis is performed at three-phase intervals, forming eight dynamic sets (scan duration [SD]_40.5s: 40.5 s, SD_54s: 54.0 s, SD_67.5s: 67.5 s, SD_81s: 81.0 s, SD_94.5s: 94.5 s, SD_108s: 108.0 s, SD_121.5s: 121.5 s, and SD_135s: 135.0 s). Two ultrafast DCE-MRI parameters, maximum slope (MS) and initial area under the curve in 60 s (iAUC), were calculated for each dynamic set and compared between benign and malignant lesions. Areas under the receiver operating characteristic curve (AUCs) were used to assess their diagnostic performance.

Results

A total of 140 women (mean age, 47 ± 11 years) with 151 lesions were included. MS and iAUC from eight dynamic sets exhibited significant differences between benign and malignant lesions (all p < 0.05), except iAUC at SD_40.5s. The AUC of MS (AUC = 0.804) and iAUC (AUC = 0.659) at SD_67.5s were significantly higher than their values at SD_40.5s (AUC = 0.606 and 0.516; corrected p < 0.05). No significant differences in AUCs for MS and iAUC were observed from SD_67.5s to SD_135s (all corrected p > 0.05).

Conclusions

Ultrafast DCE-MRI with a 67.5-s scan duration appears optimal for effectively differentiating malignant from benign breast lesions.

Critical relevance statement

By evaluating scan durations (40.5–135 s) and analyzing two ultrafast DCE-MRI parameters, we found a scan duration of 67.5 s optimal for discriminating between these lesions and offering a balance between acquisition time and diagnostic efficacy.

Key Points

Ultrafast DCE-MRI can effectively differentiate malignant from benign breast lesions.

A minimum of 67.5-sec ultrafast DCE-MRI scan duration is required to differentiate benign and malignant lesions.

Extending the scan duration beyond 67.5 s did not significantly improve diagnostic accuracy.

Graphical Abstract