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Assessment of Quantitative Magnetic Resonance Imaging Background Parenchymal Enhancement Parameters to Improve Determination of Individual Breast Cancer Risk

Lam, Diana L., MD; Hippe, Daniel S., MS; Kitsch, Averi E., BS; Partridge, Savannah C., PhD; Rahbar, Habib, MD

Journal of Computer Assisted Tomography: January/February 2019 - Volume 43 - Issue 1 - p 85–92
doi: 10.1097/RCT.0000000000000774
Breast Imaging

Objectives The aims of this study were to identify optimal quantitative breast magnetic resonance imaging background parenchymal enhancement (BPE) parameters associated with breast cancer risk and compare performance to qualitative assessments.

Methods Using a matched case-control cohort of 46 high-risk women who underwent screening magnetic resonance imaging (23 who developed breast cancer matched to 23 who did not), fibroglandular tissue area, BPE area, and intensity metrics (mean, SD, quartiles, skewness, and kurtosis) were quantitatively measured at varying enhancement thresholds. Optimal thresholds for discriminating between cancer and control cohorts were identified for each metric and performance summarized using area under the receiver operating characteristic curve.

Results Women who developed breast cancer exhibited greater BPE area (adjusted P = 0.004) and higher intensity statistics (adjusted P < 0.004, except skewness and kurtosis with P > 0.99) than did control subjects, with areas under the receiver operating characteristic curve ranging from 0.75 to 0.78 at optimized thresholds.

Conclusions Elevated quantitative BPE parameters, related to both area and intensity of enhancement, are associated with breast cancer development.

From the Department of Radiology, University of Washington School of Medicine, Seattle Cancer Care Alliance, Seattle, WA.

Received for publication March 2, 2018; accepted May 22, 2018.

Correspondence to: Diana L. Lam, MD, Seattle Cancer Care Alliance, 825 Eastlake Ave E, G2-600, Seattle, WA 98109 (e-mail:

The authors declare no conflict of interest.

H.R. received funding for this project from an International Society for Magnetic Resonance in Medicine Seed Grant and Radiological Society of North America Research Scholar Grant. H.R. is also the principal investigator and receives funding from a National Cancer Institute grant (R01 CA203883).

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