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Comparative Study
. 2016 Mar;23(3):358-67.
doi: 10.1016/j.acra.2015.11.011. Epub 2016 Jan 7.

Assessment of Background Parenchymal Enhancement and Lesion Kinetics in Breast MRI of BRCA 1/2 Mutation Carriers Compared to Matched Controls Using Quantitative Kinetic Analysis

Alana A Lewin  1 , Sungheon Gene Kim  2 , James S Babb  2 , Amy N Melsaether  2 , Jason McKellop  2 , Melanie Moccaldi  3 , Ana Paula Klautau Leite  4 , Linda Moy  2
Affiliations
Comparative Study

Assessment of Background Parenchymal Enhancement and Lesion Kinetics in Breast MRI of BRCA 1/2 Mutation Carriers Compared to Matched Controls Using Quantitative Kinetic Analysis

Alana A Lewin et al. Acad Radiol. 2016 Mar.

Abstract

Rationale and objectives: To investigate whether quantitative kinetic analysis of lesions and background parenchyma in breast magnetic resonance imaging can elucidate differences between BRCA carriers and sporadic controls with high risk for breast cancer.

Materials and methods: Fifty-nine BRCA and 59 control cases (49 benign, 10 malignant) were examined in this study. Principal component analysis was applied for quantitative analysis of dynamic signal in background parenchyma (B) and lesion (L) in terms of initial enhancement ratio (IER) and delayed enhancement ratio (DER).

Results: Control B-IER, B-DER, L-IER, and L-DER were higher than BRCA cases in all women and in women with benign lesions; statistically significant differences in B-IER and B-DER (all women: P = 0.02 and P = 0.02, respectively; benign only: P = 0.005 and P = 0.005, respectively). In the control cohort, B-IER and B-DER were higher in the premenopausal women than in the postmenopausal women (P = 0.013 and 0.003, respectively), but not in the BRCA cohort; this led to significant differences in B-IER and B-DER between the control and the BRCA groups in the premenopausal women (P = 0.01 and 0.01, respectively) but not in the postmenopausal women.

Conclusion: Results suggest possible differences in the vascular properties of background parenchyma between BRCA carriers and noncarriers and its association with menopausal status.

Keywords: BRCA 1/2 mutation carrier; background parenchymal enhancement (BPE); dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI); principal component analysis (PCA).

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Figures

Figure 1
Figure 1
Representative example of the PCA-based analysis of DCE-MRI data. (a) Fat-suppressed T1-weighted images with contrast injection during the second image. Signal intensity range was kept constant to show the contrast enhancement. (b) Projection coefficient maps of the principal components in the descending order of eigenvalues. (c) The principal components used to compute the projection coefficient maps shown in (b). Plotted are the eigenvectors scaled so that the sum of their squares are equal to the corresponding eigenvalues.
Figure 2
Figure 2
Representative examples of the DCE images at 3 time points used to measure IER and DER for (a) BRCA premenopausal case, (b) BRCA postmenopausal case, (c) control premenopausal case, and (d) control postmenopausal case. The corresponding scaled primary eigenvectors are shown for each case to demonstrate how the eigenvectors represent background parenchymal enhancement.
Figure 3
Figure 3
(a) Mean B-IER and B-DER for all BRCA women and all controls. (b) Mean L-IER and L-DER for all BRCA women and all controls. (c) Mean B-IER and B-DER for benign BRCA and control cases only. (d) Mean L-IER and L-DER for benign BRCA and control cases only.
Figure 4
Figure 4
(a) Mean B-IER and B-DER for pre-menopausal BRCA patients and controls. (b) Mean L-IER and L-DER for pre-menopausal BRCA patients and controls. (c) Mean B-IER and B-DER for post-menopausal BRCA patients and controls. (d) Mean L-IER and L-DER for post-menopausal BRCA patients and controls.
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