Benign and malignant breast lesions: differentiation with echo-planar MR imaging

Area of Science:

• Radiology
• Oncology
• Biomedical Imaging

Background:

• Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is crucial for breast lesion characterization.
• Echo-planar imaging (EPI) offers faster acquisition times compared to conventional MRI sequences.
• Understanding the relationship between lesion enhancement and tumor vascularity is vital for accurate diagnosis.

Purpose of the Study:

• To quantify dynamic enhancement of breast lesions using both echo-planar imaging (EPI) and conventional MRI.
• To correlate imaging parameters with histologic findings and microvessel density.
• To evaluate the diagnostic performance of EPI in differentiating malignant breast lesions.

Main Methods:

• Twenty female patients with 22 breast lesions underwent both conventional and EPI MRI.
• Key parameters calculated from EPI data included T1 values, change in gadopentetate dimeglumine concentration, and extraction-flow products.
• These imaging parameters were correlated with histologic findings and assessed microvessel density.

Main Results:

• Malignant lesions demonstrated more rapid contrast uptake and higher extraction-flow products compared to benign lesions (P < .02).
• EPI achieved high diagnostic accuracy for malignancy, with 86% sensitivity and 93% specificity.
• Microvessel density was significantly higher in malignant lesions (P < .02), showing a positive correlation with extraction-flow product.

Conclusions:

• Echo-planar imaging is a promising technique for quantifying dynamic enhancement in breast lesions.
• Tumor angiogenesis, as indicated by microvessel density, significantly influences lesion enhancement patterns observed with EPI.
• EPI holds potential for improving the non-invasive assessment of breast cancer vascularity.