Harmonization of Quantitative Parenchymal Enhancement in T1 -Weighted Breast MRI.

Abstract

BackgroundDifferences in imaging parameters influence computer‐extracted parenchymal enhancement measures from breast MRI.PurposeTo investigate the effect of differences in dynamic contrast‐enhanced MRI acquisition parameter settings on quantitative parenchymal enhancement of the breast, and to evaluate harmonization of contrast‐enhancement values with respect to flip angle and repetition time.Study TypeRetrospective.Phantom/PopulationsWe modeled parenchymal enhancement using simulations, a phantom, and two cohorts (N = 398 and N = 302) from independent cancer centers.Sequence Field/Strength1.5T dynamic contrast‐enhanced T1‐weighted spoiled gradient echo MRI. Vendors: Philips, Siemens, General Electric Medical Systems.AssessmentWe assessed harmonization of parenchymal enhancement in simulations and phantom by varying the MR parameters that influence the amount of T1‐weighting: flip angle (8°–25°) and repetition time (4–12 msec). We calculated the median and interquartile range (IQR) of the enhancement values before and after harmonization. In vivo, we assessed overlap of quantitative parenchymal enhancement in the cohorts before and after harmonization using kernel density estimations. Cohort 1 was scanned with flip angle 20° and repetition time 8 msec; cohort 2 with flip angle 10° and repetition time 6 msec.Statistical TestsPaired Wilcoxon signed‐rank‐test of bootstrapped kernel density estimations.ResultsBefore harmonization, simulated enhancement values had a median (IQR) of 0.46 (0.34–0.49). After harmonization, the IQR was reduced: median (IQR): 0.44 (0.44–0.45). In the phantom, the IQR also decreased, median (IQR): 0.96 (0.59–1.22) before harmonization, 0.96 (0.91–1.02) after harmonization. Harmonization yielded significantly (P < 0.001) better overlap in parenchymal enhancement between the cohorts: median (IQR) was 0.46 (0.37–0.58) for cohort 1 vs. 0.37 (0.30–0.44) for cohort 2 before harmonization (57% overlap); and 0.35 (0.28–0.43) vs. .0.37 (0.30–0.44) after harmonization (85% overlap).Data ConclusionThe proposed practical harmonization method enables an accurate comparison between patients scanned with differences in imaging parameters.Level of Evidence3Technical Efficacy Stage4