Correlation between voxel-wise enhancement parameters on DCE-MRI and pathological prognostic factors in invasive breast cancers.

PURPOSE: To investigate the correlation between enhancement parameters on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and pathologic prognostic factors in invasive breast cancers (BCs). MATERIALS AND METHODS: A total of 25 invasive BCs were included: 22 invasive ductal, 2 invasive lobular and 1 invasive mucinous. The tumor volume was segmented using a semi-automatic software (Olea Sphere). The following voxel-wise enhancement parameters were extracted: (1) time to peak enhancement; (2) signal intensity at peak (SIP); (3) peak enhancement percentage (PEP); (4) post-initial enhancement percentage (PIEP). The following pathological prognostic factors were considered for potential correlation: tumor (pT) and nodal (pN) stage, grading, perivascular/perineural invasion, estrogen/progesterone receptor status, Ki-67 proliferation, and HER2 expression. Spearman and Pearson correlation coefficients were calculated according with type of variable and data distribution. RESULTS: Tumor volume was 2.8 ± 2.0 cm3 (mean ± standard deviation [SD]). Mean SIP correlated with pT (ρ = 0.424, p = 0.035); mean PEP correlated with HER2 overexpression (ϕ = 0.471, p = 0.017) and pT (ρ = 0.449, p = 0.024). The percentage of voxels with fast PEP directly correlated with pT (ρ = 0.482, p = 0.015) and pN (ρ = 0.446, p = 0.026), while the percentage of voxels with slow PEP inversely correlated with pT (ρ = -0.421, p = 0.039) and pN (ρ = -0.481, p = 0.015). Segmentation time was 14.6 ± 1.3 min (mean ± SD). CONCLUSION: In invasive BCs, DCE-MRI voxel-wise enhancement parameters correlated with HER2, pT, and pN.

Less is better? Intraindividual and interindividual comparison between 0.075 mmol/kg of gadobenate dimeglumine and 0.1 mmol/kg of gadoterate meglumine for cranial MRI.

PURPOSE: To retrospectively compare a reduced dose (RD) (0.075 mmol/kg) of gadobenate dimeglumine (RD-gadobenate) with standard single dose (SSD) (0.1 mmol/kg) of gadoterate meglumine (SSD-gadoterate) for cranial MRI. MATERIALS AND METHODS: Thirty-one patients (12 males; aged 52 ± 16 years) underwent cranial MRI with SSD-gadoterate and repeated the examination with RD-gadobenate after a median interval of 10 months. Signal-to-noise ratio (SNR) was obtained on contrast-enhanced images for enhancing lesions (n=10) as well as for right and left transverse venous sinuses, internal carotid arteries, and parotid glands. Moreover, a consecutive series of 100 cranial MRI with SSD-gadoterate (49 males; aged 51 ± 19 years) was compared with a consecutive series of 100 cranial MRI with RD-gadobenate (45 males; aged 54 ± 18 years). Two blinded neuroradiologists (R1, R2) judged contrast enhancement as sufficient, good, or optimal. Wilcoxon, Mann-Whitney, χ(2), and Cohen κ statistics were used. RESULTS: At intraindividual analysis, median SNR ranged 57-88 for SSD-gadoterate and 79-99 for RD-gadobenate, the latter being systematically higher, the difference being significant for both transverse venous sinuses (p ≤ 0.011), not significant for both internal carotid arteries and both parotid glands, and enhancing lesions (p ≤ 0.101). The two series of interindividual analysis were not significantly different for gender/age (p>0.415). Contrast enhancement was optimal in 59% (R1) and 76% (R2) of patients using RD-gadobenate, in 39% (R1) and 49% (R2) of patients using SSD-gadoterate (p ≤ 0.016), with substantial reproducibility (κ ≥ 0.606). CONCLUSION: Both analyses showed an equal or better contrast enhancement when using RD-gadobenate compared to SSD-gadoterate for routine cranial MRI. The high relaxivity of gadobenate allowed for a 25% dose reduction.