TY - JOUR
T1 - Effects of gadobutrol on background parenchymal enhancement and differential diagnosis between benign and malignant lesions in dynamic magnetic resonance imaging of the breast
AU - Tozaki, Mitsuhiro
AU - Yabuuchi, Hidetake
AU - Goto, Mariko
AU - Sasaki, Michiro
AU - Kubota, Kazunori
AU - Nakahara, Hiroshi
N1 - Funding Information:
This work was supported by a Grant from Bayer Yakuhin Ltd. (Osaka, Japan). Part of the statistical analyses was conducted by Kondo Photo Process Co. Ltd. (Osaka, Japan).
Publisher Copyright:
© 2021, The Japanese Breast Cancer Society.
PY - 2021/7
Y1 - 2021/7
N2 - Background: The high concentration of gadolinium in gadobutrol, which is widely used in Japan, helps visualize signal enhancement of neoplastic lesions, however, there was concern that high T1 relaxivity could decrease the contrast between the lesion and the background mammary gland. We evaluate the effect of gadobutrol on background parenchymal enhancement (BPE) and differential diagnosis between benign and malignant lesions in dynamic MRI of the breast. Methods: Ninety-nine patients were enrolled prospectively. Measurements of the following signal intensities (SIs) were obtained: breast tissue on a pre-contrast image (SIpre) and an early-phase image (SIearly); and the SIs of breast cancer on a pre-contrast image (SIpre-cancer) and an early-phase image (SIearly-cancer). We calculated the BPE ratio, i.e., (SIearly − SIpre)/SIpre and the cancer/BPE ratio, i.e., (SIearly-cancer − SIpre-cancer)/(SIearly on the affected side − SIpre on the affected side). These quantitative assessments were compared with the data from the recently published multicenter study (reference study without use of gadobutrol). In addition, two radiologists reinterpreted each of the MR images, and a third radiologist set the ROIs in the lesions and performed kinetic analysis as a Reader 3. Results: While there was no significant difference in the SI of breast cancer in the premenopausal patients between the two studies, that in postmenopausal patients was significantly higher in the present study than in the reference study (p = 0.002). Although there was no significant difference in the cancer/BPE ratio in the postmenopausal patients between the two studies, the cancer/BPE ratio in the premenopausal patients was significantly higher in the reference study than in the present study (p = 0.028). For differentiation between benign and malignant masses, the mass margin was found to be the most important term (p < 0.001). According to the data of Reader 3, visual washout was observed in all 18 patients in whom the interpretation was changed from “plateau” to “washout”. Conclusions: Gadobutrol may decrease the contrast between breast cancer and background parenchyma in premenopausal patients, and it may have a characteristic that “washout” does not easily occur, leading to “plateau” in patients with breast cancer.
AB - Background: The high concentration of gadolinium in gadobutrol, which is widely used in Japan, helps visualize signal enhancement of neoplastic lesions, however, there was concern that high T1 relaxivity could decrease the contrast between the lesion and the background mammary gland. We evaluate the effect of gadobutrol on background parenchymal enhancement (BPE) and differential diagnosis between benign and malignant lesions in dynamic MRI of the breast. Methods: Ninety-nine patients were enrolled prospectively. Measurements of the following signal intensities (SIs) were obtained: breast tissue on a pre-contrast image (SIpre) and an early-phase image (SIearly); and the SIs of breast cancer on a pre-contrast image (SIpre-cancer) and an early-phase image (SIearly-cancer). We calculated the BPE ratio, i.e., (SIearly − SIpre)/SIpre and the cancer/BPE ratio, i.e., (SIearly-cancer − SIpre-cancer)/(SIearly on the affected side − SIpre on the affected side). These quantitative assessments were compared with the data from the recently published multicenter study (reference study without use of gadobutrol). In addition, two radiologists reinterpreted each of the MR images, and a third radiologist set the ROIs in the lesions and performed kinetic analysis as a Reader 3. Results: While there was no significant difference in the SI of breast cancer in the premenopausal patients between the two studies, that in postmenopausal patients was significantly higher in the present study than in the reference study (p = 0.002). Although there was no significant difference in the cancer/BPE ratio in the postmenopausal patients between the two studies, the cancer/BPE ratio in the premenopausal patients was significantly higher in the reference study than in the present study (p = 0.028). For differentiation between benign and malignant masses, the mass margin was found to be the most important term (p < 0.001). According to the data of Reader 3, visual washout was observed in all 18 patients in whom the interpretation was changed from “plateau” to “washout”. Conclusions: Gadobutrol may decrease the contrast between breast cancer and background parenchyma in premenopausal patients, and it may have a characteristic that “washout” does not easily occur, leading to “plateau” in patients with breast cancer.
UR - http://www.scopus.com/inward/record.url?scp=85101543732&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85101543732&partnerID=8YFLogxK
U2 - 10.1007/s12282-021-01229-w
DO - 10.1007/s12282-021-01229-w
M3 - Article
C2 - 33625722
AN - SCOPUS:85101543732
SN - 1340-6868
VL - 28
SP - 927
EP - 936
JO - Breast Cancer
JF - Breast Cancer
IS - 4
ER -
