MR Quantification of the Washout Changes in Breast Tumors Under Preoperative Chemotherapy: Feasibility and Preliminary Results
Carl El Khoury1,
Vincent Servois1,
Fabienne Thibault1,
Anne Tardivon1,
Lilianne Ollivier1,
Martine Meunier1,
Caroline Allonier2 and
Sylvia Neuenschwander1
1 Département d'Imagerie, Institut Curie, 26, rue d'Ulm, Paris 75005,
France. 2 Department d'biostatistique, Institut Curie, Paris, France.
Fig. 1A.45-year-old woman with 3-cm clinical lesion in lower
quadrants of breast (case 8). Precontrast sagittal T1 fast spoiled
gradient-recalled echo image (TR/TE, 11/4.2; time of acquisition, 45 sec;
number of excitations, 1; section thickness, 4 mm; matrix size, 512 x
192; field of view, 24 x 19.2 cm) shows round low-signal lesion
(arrow).
Fig. 1B.45-year-old woman with 3-cm clinical lesion in lower
quadrants of breast (case 8). Postcontrast sagittal T1 fast spoiled
gradient-recalled echo image (11/4.2; time of acquisition, 45 sec; number of
excitations, 1; section thickness, 4 mm; matrix size, 512 x 192; field
of view, 24 x 19.2 cm) from acquisitions at 1 min 30 sec after contrast
administration shows early uptake of lesion.
Fig. 1C.45-year-old woman with 3-cm clinical lesion in lower
quadrants of breast (case 8). Late postcontrast sagittal T1 fast spoiled
gradient-recalled echo image shows peripheral decrease of signal
(arrows).
Fig. 1D.45-year-old woman with 3-cm clinical lesion in lower
quadrants of breast (case 8). Parametric image created by subtraction of
signal at 7 min 30 sec from maximum signal in each pixel during dynamic
acquisition shows regions of interest 1 and 2. Formula used to create image is
as follows: W = [Smax S(7 min 30
sec)].
Fig. 1E.45-year-old woman with 3-cm clinical lesion in lower
quadrants of breast (case 8). Graph shows two signal-to-time curves are given
within two regions of interest (ROI): ROI 1 is in bright part of tumor on
parametric image (with washout), and ROI 2 in dark part of lesion (no
washout).
Fig. 1F.45-year-old woman with 3-cm clinical lesion in lower
quadrants of breast (case 8). Parametric washout image shows tumor is isolated
from rest of breast. Surrounding pixels (arrows) correspond to
washout value smaller than 23 (i.e., cutoff value chosen by observer) and were
therefore excluded from volume processing.
Fig. 1G.45-year-old woman with 3-cm clinical lesion in lower
quadrants of breast (case 8). Applying cutoff and processing volume of
remaining pixels resulted in this parametric washout image.