Quantitative MR Imaging and Spectroscopy Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran.
Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Magn Reson Med. 2018 Feb;79(2):1165-1171. doi: 10.1002/mrm.26743. Epub 2017 May 7.
To develop a one-step quantification approach that accounts for joint preprocessing and quantification of whole-range kinetics (early and late-phase washout) of dynamic contrast-enhanced (DCE) MRI of indeterminate adnexal masses.
Preoperative DCE-MRI of 43 (24 benign, 19 malignant) sonographically indeterminate adnexal masses were analyzed prospectively. A five-parameter sigmoid function was implemented to model the enhancement curves calculated within regions of interest. Diagnostic performance of five-parameter sigmoid model parameters (P through P ) was compared with pharmacokinetic (PK) modeling, semiquantitative analysis, and three-parameter sigmoid. Statistical analysis was performed using two-tailed student's t-test.
The results revealed that P , representing the enhancement amplitude, is significantly higher, and P , indicating the terminal phase, is generally negative in malignant lesions (P < 0.001). P (sensitivity = 79%, specificity = 87.5%, accuracy = 84%, area under the receiver operating characteristic curve = 91%) outperforms classification performances of PK and semiquantitative parameters. A combination of P and P shows comparable performance (sensitivity = 79%, specificity = 87.5%, accuracy = 84%, area under the receiver operating characteristic curve = 92%) to that of the combination of PK parameters, whereas the five-parameter sigmoid function maintains fewer assumptions than PK.
The presented one-step quantification approach is helpful for accurate discrimination of benign from malignant indeterminate adnexal masses. Accordingly, P has considerably high diagnostic performance and terminal slope (P ), as a previously overlooked feature, contributes more than widely accepted early-enhancement kinetic features. Magn Reson Med 79:1165-1171, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
开发一种一步式定量方法，用于对不确定附件肿块的动态对比增强（DCE）MRI 的全范围动力学（早期和晚期洗脱）进行联合预处理和定量。
前瞻性分析了 43 例（24 例良性，19 例恶性）经超声检查不确定的附件肿块的术前 DCE-MRI。采用五参数 S 型函数对感兴趣区域内计算的增强曲线进行建模。使用双尾学生 t 检验比较五参数 S 型模型参数（P 至 P ）、药代动力学（PK）建模、半定量分析和三参数 S 型的诊断性能。
结果表明，代表增强幅度的 P ，在恶性病变中明显更高，而表示终末相的 P ，通常为负值（P < 0.001）。P （敏感性= 79%，特异性= 87.5%，准确性= 84%，接收者操作特征曲线下面积= 91%）优于 PK 和半定量参数的分类性能。P 和 P 的组合表现出与 PK 参数组合相当的性能（敏感性= 79%，特异性= 87.5%，准确性= 84%，接收者操作特征曲线下面积= 92%），而五参数 S 型函数比 PK 具有更少的假设。
所提出的一步式定量方法有助于准确区分良性和恶性不确定附件肿块。因此，P 具有相当高的诊断性能，终端斜率（P ）作为以前被忽视的特征，比广泛接受的早期增强动力学特征贡献更大。磁共振医学 79：1165-1171，2018。© 2017 国际磁共振学会。
