Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen, The Netherlands.
J Magn Reson Imaging. 2011 Aug;34(2):293-300. doi: 10.1002/jmri.22632.
To compare enhancement characteristics between invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC) on contrast enhanced MRI of the breast and to observe the magnitude of eventual differences as these may impair the diagnostic value of breast MRI in ILC.
We performed an analysis of enhancement characteristics on biphasic breast MRI in a series of 136 patients (103 IDC, 33 ILC) using an in-house developed application for pharmacokinetic modeling of contrast enhancement and a commercially available CAD application that evaluated the contrast-enhancement versus time curve.
Pharmacokinetic analysis showed that the most enhancing voxels in IDC had significantly higher K(trans) -values than in ILC (P < 0.01). No difference in v(e) -values was noted between groups. Visual assessment of contrast-enhancement versus time curves revealed wash-out curves to be less common in ILC (48% versus 84%). However, when using the CAD-application to assess the most malignant looking curve, the difference was blotted out (76% versus 86%).
ILC enhances slower than IDC but peak enhancement is not significantly less. The use of a CAD-application may help to determine the most malignant looking contrast-enhancement versus time curve, and hence facilitates lesion classification.
比较乳腺对比增强磁共振成像（MRI）中浸润性小叶癌（ILC）与浸润性导管癌（IDC）的强化特征，并观察这些差异的大小，因为这些差异可能会影响乳腺 MRI 在 ILC 中的诊断价值。
我们使用内部开发的用于对比增强药代动力学建模的应用程序和商业可用的 CAD 应用程序，对 136 例患者（103 例 IDC，33 例 ILC）的双相乳腺 MRI 的强化特征进行了分析，以评估对比增强与时间曲线。
药代动力学分析显示，IDC 中最强化的体素的 K(trans) 值明显高于 ILC（P < 0.01）。两组间 v(e) 值无差异。对比增强与时间曲线的视觉评估显示，ILC 中洗脱曲线较少（48%对 84%）。然而，当使用 CAD 应用程序评估最恶性的曲线时，差异就消失了（76%对 86%）。
ILC 的增强速度比 IDC 慢，但峰值增强并不显著降低。使用 CAD 应用程序可能有助于确定最恶性的对比增强与时间曲线，从而有助于病变分类。
