+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Gadobenate dimeglumine as a contrast agent for dynamic breast magnetic resonance imaging: effect of higher initial enhancement thresholds on diagnostic performance

, : Gadobenate dimeglumine as a contrast agent for dynamic breast magnetic resonance imaging: effect of higher initial enhancement thresholds on diagnostic performance. Investigative Radiology 43(4): 236-242

Rationale and Objective: Gadobenate dimeglumine (Gd-BOPTA), a high-relaxivity contrast agent, has been recently proposed for dynamic MR imaging of the breast. The objective of this study was to optimize the diagnostic performance of Gd-BOPTA-enhanced dynamic breast MR imaging by using adjusted initial enhancement thresholds.Methods: Thirty-four patients with 36 breast lesions (malignant/benign = 28/8) underwent dynamic breast MRI with 0.1 mmol/kg Gd-BOPTA and 120-second time resolution. A score system based on shape (round/oval/lobular = 0; linear/dendritic/stellate = 1), margins (defined = 0; undefined = 1), pattern (homogeneous = 0; inhomogeneous = 1; rim = 2), kinetics (continuous = 0; plateau = 1; washout = 2), and initial enhancement was used. Initial enhancement was determined with standard (< 50% = 0; 50%-100% = 1; > 100% 2) and adjusted (< 100% = 0; 100%-240% = 1; > 240% 2) thresholds. Scores of 0 to 3 indicated benign lesions and scores of 4 to 8 malignant lesions. Diagnostic performance was assessed in terms of sensitivity, specificity, positive and negative predictive values, and overall accuracy.Results: The initial enhancement was > 100% for 26 malignant and 7 benign lesions and >240% for 16 and I lesions, respectively. The overall score was 5.89 +/- 1.34 with standard thresholds and 5.50 +/- 1.53 with adjusted thresholds (P = 0.003) for cancers, 4.00 +/- 1.93 and 3.25 +/- 1.75 (P = 0.028) for benign lesions, respectively. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy was 96%, 13%, 79%, 50%, and 78%, respectively, with standard thresholds and 96%, 75%, 93%, 86%, and 92%, respectively, with adjusted thresholds. A ductal carcinoma in situ was false negative whereas a fat necrosis and a papilloma were positive with both thresholds. Three fibroadenomas, 1 adenosis, and 1 fibrosis were false positive with standard thresholds but true negatives with adjusted thresholds.Conclusions: Lesion characterization with Gd-BOPTA requires higher thresholds for initial enhancement than those used with conventional Gd-chelates, leading to improved specificity, predictive values, and accuracy.


PMID: 18340247

DOI: 10.1097/RLI.0b013e318160678d

Other references

Bogoliubov, V.M.; Timofeev, M.F.; Fomichev, V.I.; Klemashev, I.S., 1976: Relation between central hemodynamics and hepatic blood flow. Klinicheskaia Meditsina 54(4): 115-119

Christopher, Kj, 1971: Broiler chicks--a new approach for more chicken meat. Farmer and parliament: 6 (12) 27-28

Vijayan, N., 1993: Head band for migraine headache relief. Application of an ice peak and local scalp pressure are the most commonly used non-pharmacological methods for temporary relief of migraine headache pain. An elastic band secured around the head with Velcro and firm rubber discs inserted under the...

Groning, E., 1985: Variabilitat und postlarvale Ontogenie von Archegonus (Archegonus) antecedens (Trilobita; Unter-Karbon). Senckenbergiana Lethaea, 654-6: 443-463

Best, J.B., 1959: The inference of intracellular enzymatic properties from kinetic data obtained on living cells. III. Mode of glucose entry into the yeast cell-elaboration by minimized X2 estimation and uranium poisoning. Journal of Cellular and Comparative Physiology 53: 187-204

Zielony, E.; Placzek-Popko, E.; Dyba, P.; Gumienny, Z.; Szatkowski, J.; Dobaczewski, L.; Karczewski, G., 2011: Deep level transient spectroscopy of hole traps related to CdTe self-assembled quantum dots embedded in ZnTe matrix. The capacitance-voltage (C-V) and deep level transient spectroscopy (DLTS) measurements have been made on a Schottky Ti-ZnTe (p-type) diode containing CdTe self-assembled quantum dots (QD) and control diode without dots. The C-V curve of the QD di...

Akbal, F.; Onar, A.N., 2003: Photocatalytic degradation of phenol. In this study photocatalytic degradation of phenol in the presence of UV irradiated TiO<sub>2</sub> catalyst and H<sub>2</sub>O<sub>2</sub> was investigated. Effects of TiO<sub>2</sub> and H<sub&g...

Yalin M.S.lim; Silva A.M.F., 1991: On the formation of alternate bars. Pages 171-178 1991

Orlandi, F.; Benda, N.; Menghini, G., 1955: The behavior of peroxidase reaction to benzidine in the leukocytes of blood preserved at +4 degrees C. Il Progresso Medico 11(16): 484-487

Rezanka, Tás.; Rezanka, P.; Sigler, K., 2009: Glycosides of arylnaphthalene lignans from Acanthus mollis having axial chirality. Glycosides of arylnaphthalene lignans having axial chirality were isolated from Acanthus mollis. Owing to the axial chirality, their structure, including absolute configuration, was determined by means of extensive spectroscopic data such as UV, I...