Department of Radiology, New York University School of Medicine, New York, New York, USA.
Center for Biomedical Imaging, New York University School of Medicine, New York, New York, USA.
J Magn Reson Imaging. 2018 Jun;47(6):1685-1691. doi: 10.1002/jmri.25895. Epub 2017 Nov 15.
Potential clinical implications of the level of background parenchymal enhancement (BPE) on breast MRI are increasing. Currently, BPE is typically evaluated subjectively. Tests of concordance between subjective BPE assessment and computer-assisted quantified BPE have not been reported.
To compare subjective radiologist assessment of BPE with objective quantified parenchymal enhancement (QPE).
Cross-sectional observational study.
Between 7/24/2015 and 11/27/2015, 104 sequential patients (ages 23 - 81 years, mean 49 years) without breast cancer underwent breast MRI and were included in this study.
FIELD STRENGTH/SEQUENCE: 3T; fat suppressed axial T2, axial T1, and axial fat suppressed T1 before and after intravenous contrast.
Four breast imagers graded BPE at 90 and 180 s after contrast injection on a 4-point scale (a-d). Fibroglandular tissue masks were generated using a phantom-validated segmentation algorithm, and were co-registered to pre- and postcontrast fat suppressed images to define the region of interest. QPE was calculated.
Receiver operating characteristic (ROC) analyses and kappa coefficients (k) were used to compare subjective BPE with QPE.
ROC analyses indicated that subjective BPE at 90 s was best predicted by quantified QPE ≤20.2 = a, 20.3-25.2 = b, 25.3-50.0 = c, >50.0 = d, and at 180 s by quantified QPE ≤ 32.2 = a, 32.3-38.3 = b, 38.4-74.5 = c, >74.5 = d. Agreement between subjective BPE and QPE was slight to fair at 90 s (k = 0.20-0.36) and 180 s (k = 0.19-0.28). At higher levels of QPE, agreement between subjective BPE and QPE significantly decreased for all four radiologists at 90 s (P ≤ 0.004) and for three of four radiologists at 180 s (P ≤ 0.004).
Radiologists were less consistent with QPE as QPE increased.
3 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:1685-1691.
乳腺磁共振成像中背景实质强化（BPE）水平的潜在临床意义正在增加。目前，BPE 通常是主观评估的。尚未报道主观 BPE 评估与计算机辅助量化 BPE 之间的一致性测试。
比较主观放射科医生对 BPE 的评估与客观量化实质强化（QPE）。
横断面观察性研究。
2015 年 7 月 24 日至 11 月 27 日，104 例连续患者（年龄 23-81 岁，平均 49 岁）无乳腺癌接受乳腺 MRI 检查，并纳入本研究。
场强/序列：3T；脂肪抑制轴位 T2、轴位 T1 和轴位脂肪抑制 T1 静脉对比前后。
4 位乳腺成像者在对比后 90 和 180 秒对 4 分制（a-d）进行 BPE 分级。使用经过体模验证的分割算法生成纤维腺体组织掩模，并与预对比和后对比脂肪抑制图像配准以定义感兴趣区域。计算 QPE。
使用受试者工作特征（ROC）分析和kappa 系数（k）比较主观 BPE 与 QPE。
ROC 分析表明，90 秒时主观 BPE 最好由定量 QPE ≤20.2 = a、20.3-25.2 = b、25.3-50.0 = c、>50.0 = d 预测，180 秒时由定量 QPE ≤32.2 = a、32.3-38.3 = b、38.4-74.5 = c、>74.5 = d 预测。90 秒时主观 BPE 与 QPE 的一致性为轻度至中度（k = 0.20-0.36），180 秒时为轻度至中度（k = 0.19-0.28）。在较高的 QPE 水平下，四位放射科医生在 90 秒时（P ≤ 0.004）和三位放射科医生在 180 秒时（P ≤ 0.004），主观 BPE 与 QPE 的一致性显著降低。
随着 QPE 的增加，放射科医生与 QPE 的一致性降低。
3 级技术功效：第 3 阶段 J. Magn. Reson. Imaging 2018;47:1685-1691.
