A simplified method for generating maximum slope maps in ultrafast dynamic contrast-enhanced breast magnetic...

Clinical measurement of the maximum slope (MS) using ultrafast dynamic contrast-enhanced (UF-DCE) breast magnetic resonance imaging (MRI) is typically performed by placing a region of interest (ROI) in the most enhanced area within a lesion. However, previous studies have not clarified whether visually identified enhanced areas consistently exhibit the highest MS values. These ROI-based MS measurements require MS maps to ensure appropriate ROI placement. However, generating MS maps requires specialized software capable of pixel-by-pixel MS calculations, which are available only at a few facilities. Therefore, this study proposed a simplified method for generating MS maps. This method involves subtracting consecutive UF-DCE images, applying temporal maximum intensity projection, normalizing the resulting image by dividing it by the pre-contrast image signal intensity, and converting it to a slope by dividing it by the temporal resolution. The MS maps generated using the proposed method were compared with those obtained using a robust pixel-by-pixel curve-fitting method, in addition to the final-phase UF-DCE images. In all cases with breast lesions (n = 13), the signal intensity distributions on the proposed MS maps closely resembled those on the curve-fitting maps, with a significantly higher similarity than those on the final-phase UF-DCE images (p < 0.001). The derived mean absolute error of MS values after regression-based modification was 0.78 ± 0.72 (%/s). The proposed method improves the reliability of ROI placement in conventional ROI-based MS measurements and supports the direct quantification of MS values from map pixel data.