TY - JOUR
T1 - Value of whole breast magnetic resonance elastography added to MRI for lesion characterization
AU - Balleyguier, Corinne
AU - Lakhdar, Aicha Ben
AU - Dunant, Ariane
AU - Mathieu, Marie Christine
AU - Delaloge, Suzette
AU - Sinkus, Ralph
N1 - Publisher Copyright:
Copyright © 2017 John Wiley & Sons, Ltd.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - The purpose of this work was to assess the diagnostic value of magnetic resonance elastography (MRE) in addition to MRI to differentiate malignant from benign breast tumors, and the feasibility of performing MRE on the whole breast. MRE quantified biomechanical properties within the entire breast (50 slices) using an 11 min acquisition protocol at an isotropic image acquisition resolution of 2 × 2 × 2 mm3. Fifty patients were included. Finally, 43 patients (median age 52) with a suspect breast lesion detected by mammography and/or ultrasound were examined by MRI and MRE at 1.5 T. The viscoelastic parameters, i.e. elasticity (Gd), viscosity (Gl), the magnitude of the complex shear modulus (Formula presented.), and the phase angle (Formula presented.), were measured via MRE and correlated with MRI Breast Imaging—Reporting and Data System (BI-RADS) score, histological type, and histological grade. Stroma component and angiogenesis were also correlated with viscoelastic properties. In the 43 lesions, Gd decreased and y increased with the MRI BI-RADS score (pGd = 0.02, py = 0.002), whereas (Gl) and y were increased in malignant lesions (pGl = 0.045, py = 0.0004). The area under the curve increased from 0.84 for MRI BI-RADS alone to 0.92 with the MRI BI-RADS and y (AUC increase +0.08; 95% CI (−0.003; 0.16)). Lesion characterization using the y parameter increased the diagnostic accuracy. The phase angle y was found to have a significant role (p = 0.01) in predicting malignancy independently of the MRI BI-RADS. Interestingly, histological analysis showed no correlation between viscoelastic parameters and percentage and type of stroma, CD34 quantification of vessels, or histological grade. The combination of MRE and MRI improves the diagnostic accuracy for breast lesions in the studied cohort. In particular, the phase angle y was found to have a significant role in predicting malignancy in addition to BI-RADS.
AB - The purpose of this work was to assess the diagnostic value of magnetic resonance elastography (MRE) in addition to MRI to differentiate malignant from benign breast tumors, and the feasibility of performing MRE on the whole breast. MRE quantified biomechanical properties within the entire breast (50 slices) using an 11 min acquisition protocol at an isotropic image acquisition resolution of 2 × 2 × 2 mm3. Fifty patients were included. Finally, 43 patients (median age 52) with a suspect breast lesion detected by mammography and/or ultrasound were examined by MRI and MRE at 1.5 T. The viscoelastic parameters, i.e. elasticity (Gd), viscosity (Gl), the magnitude of the complex shear modulus (Formula presented.), and the phase angle (Formula presented.), were measured via MRE and correlated with MRI Breast Imaging—Reporting and Data System (BI-RADS) score, histological type, and histological grade. Stroma component and angiogenesis were also correlated with viscoelastic properties. In the 43 lesions, Gd decreased and y increased with the MRI BI-RADS score (pGd = 0.02, py = 0.002), whereas (Gl) and y were increased in malignant lesions (pGl = 0.045, py = 0.0004). The area under the curve increased from 0.84 for MRI BI-RADS alone to 0.92 with the MRI BI-RADS and y (AUC increase +0.08; 95% CI (−0.003; 0.16)). Lesion characterization using the y parameter increased the diagnostic accuracy. The phase angle y was found to have a significant role (p = 0.01) in predicting malignancy independently of the MRI BI-RADS. Interestingly, histological analysis showed no correlation between viscoelastic parameters and percentage and type of stroma, CD34 quantification of vessels, or histological grade. The combination of MRE and MRI improves the diagnostic accuracy for breast lesions in the studied cohort. In particular, the phase angle y was found to have a significant role in predicting malignancy in addition to BI-RADS.
KW - MRI
KW - breast cancer
KW - diagnosis
KW - magnetic resonance elastography
UR - http://www.scopus.com/inward/record.url?scp=85032302763&partnerID=8YFLogxK
U2 - 10.1002/nbm.3795
DO - 10.1002/nbm.3795
M3 - Article
C2 - 29073719
AN - SCOPUS:85032302763
SN - 0952-3480
VL - 31
JO - NMR in Biomedicine
JF - NMR in Biomedicine
IS - 1
M1 - e3795
ER -