Relationship of Temporal Resolution to Diagnostic Performance for Dynamic Contrast Enhanced MRI of the Breast

Purpose: To investigate the relationship between temporal resolution of dynamic contrast enhanced (DCE) magnetic resonance imaging (MRI) and classification of breast lesions as benign versus malignant. Materials and Methods: Patients underwent T-1 weighted DCE MRI with 15 s/acquisition temporal, resolution using 15 Tesla (n = 48) and 3.0T (n = 33) MRI scanners. Seventy nine patients had pathologically proven diagnosis and 2 had 2 years follow up showing no change in lesion size. The temporal resolution of DCE MRI was systematically reduced as a postprocessing step from 15 to 30, 45, and 60 s/acquisition by eliminating intermediate time points. Average wash in and wash out slopes, wash-out percentage changes, and kinetic curve shape (persistently enhancing, plateau or wash out) were compared or each temporal resolution. Logistic regression and receiver, operating characeteristic (ROC) curve analysis were used to compare kinetic parameters and diagnostic accuracy. Results: Sixty patients (74%) had malignant lesions and 21 patients (26%) had benign lesions. All temporal resolution parameters significantly predicted benign versus malignant diagnosis (P < 0.05). However, 45 s/acquisition and higher temporal resolution datasets showed higher accuracy than the 60 s/acquisition dataset by ROC curve analysis (0.72 versus 0.69 for average wash in slope; 0.85 versus 0.82, for average wash-out slope; and 0.88 versus 0.80 for kinetic curve shape assessment, for 45 s/acquisition versus 60 s/acquisition temporal-resolution datasets, respectively (P = 0.027). Conclusion: DCE MRI data with at least 45-s temporal resolution maximized the agreement between the kinetic parameters and correct classification of benign versus malignant diagnosis.