magnetic resonance shutter speed discriminates vascular properties of malignant and benign breast tumors in vivo

The pharmacokinetic analysis of dynamic-contrast-enhanced (DCE) MRI data yields Ktrans and kep, two parameters independently measuring the capillary wall contrast reagent transfer rate. The almost universally used standard model (SM) embeds the implicit assumption that equilibrium transcytolemmal wa...

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Bibliographic Details
Published in:Proceedings of the National Academy of Sciences - PNAS 2008-11, Vol.105 (46), p.17943-17948
Main Authors: Huang, Wei, Li, Xin, Morris, Elizabeth A, Tudorica, Luminita A, Seshan, Venkatraman E, Rooney, William D, Tagge, Ian, Wang, Ya, Xu, Jingang, Springer, Charles S
Format: Article
Language:English
Subjects:
Biological Sciences
Biopsies
Biopsy
Breast cancer
Breast Neoplasms - blood supply
Breast Neoplasms - pathology
Contrast Media - pharmacokinetics
Female
Humans
Kinetics
Lesions
Lobular carcinoma
Magnetic resonance imaging
Magnetic Resonance Imaging - instrumentation
Molecules
NMR
Nuclear magnetic resonance
Pathology
Pharmacokinetics
Physical Sciences
Radiology
Tumors
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Summary:The pharmacokinetic analysis of dynamic-contrast-enhanced (DCE) MRI data yields Ktrans and kep, two parameters independently measuring the capillary wall contrast reagent transfer rate. The almost universally used standard model (SM) embeds the implicit assumption that equilibrium transcytolemmal water exchange is effectively infinitely fast. In analyses of routine DCE-MRI data from 22 patients with suspicious breast lesions initially ruled positive by institutional screening protocols, the SM Ktrans values for benign and malignant lesions exhibit considerable overlap. A form of the shutter-speed model (SSM), which allows for finite exchange kinetics, agrees with the SM Ktrans value for each of the 15 benign lesions. However, it reveals that the SM underestimates Ktrans for each of the seven malignant tumors in this population. The fact that this phenomenon is unique to malignant tumors allows their complete discrimination from the benign lesions, as validated by comparison with gold-standard pathology analyses of subsequent biopsy tissue samples. Likewise, the SM overestimates kep, particularly for the benign tumors. Thus, incorporation of the SSM into the screening protocols would have precluded all 68% of the biopsy/pathology procedures that yielded benign findings. The SM/SSM difference is well understood from molecular first principles.
ISSN:0027-8424
1091-6490
DOI:10.1073/pnas.0711226105