| Abstrakt: |
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. [ABSTRACT FROM AUTHOR] |
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