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A One-Step Biomarker Quantification Methodology for Dce-Mri of Adnexal Masses: Capturing Kinetic Pattern From Early to Late Enhancement Publisher Pubmed



Fathi Kazerooni A1, 2 ; Nabil M3 ; Haghighat Khah H4 ; Parviz S5 ; Gity M5, 6 ; Saligheh Rad H1, 2
Authors
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Authors Affiliations
  1. 1. Quantitative MR Imaging and Spectroscopy Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Statistics, Faculty of Mathematical Sciences, University of Guilan, Rasht, Iran
  4. 4. Department of Diagnostic Imaging, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  5. 5. Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Department of Radiology, Medical Imaging Center, Tehran University of Medical Sciences, Tehran, Iran

Source: Magnetic Resonance in Medicine Published:2018


Abstract

Purpose: 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. Methods: 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 (P1 through P5) was compared with pharmacokinetic (PK) modeling, semiquantitative analysis, and three-parameter sigmoid. Statistical analysis was performed using two-tailed student's t-test. Results: The results revealed that P2, representing the enhancement amplitude, is significantly higher, and P5, indicating the terminal phase, is generally negative in malignant lesions (P < 0.001). P2 (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 P2 and P5 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. Conclusions: The presented one-step quantification approach is helpful for accurate discrimination of benign from malignant indeterminate adnexal masses. Accordingly, P2 has considerably high diagnostic performance and terminal slope (P5), 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. © 2017 International Society for Magnetic Resonance in Medicine
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