Signal Intensity Enhancement Research Articles

Adult pancreatoblastoma: clinical features and Imaging findings

The objective of this study was to illustrate the clinical, CT, MRI, and 18F-FDG PET/CT features of adult pancreatoblastoma, an extremely rare disease. In this study, the clinical and imaging features of seven adult patients with pathologically confirmed pancreatoblastoma were retrospectively analyzed. The following parameters were evaluated: size, location, shape, margination, solid-cystic ratio, CT attenuation values or signal intensity and contrast enhancement pattern. We also analyzed whether abnormal FDG uptake occurred during 18F-FDG PET/CT imaging. All seven patients were male (mean age 45 years; range 22–65 years). Six tumors were irregular in shape, exogenous, and grew outward from the pancreatic parenchyma, similar to branches growing from a tree trunk (85.7%). The tumor margins were clear in five patients (71.4%), and three tumors (42.9%) were encapsulated. Six tumors (71.4%) were solid, with homogeneous enhancement observed on contrast-enhanced CT and MRI. Dynamic-enhanced CT and MRI showed progressive enhancement for all tumors. On 18F-FDG PET/CT, one tumor exhibited abnormal FDG uptake, and two tumors exhibited no abnormal uptake (66.7%). In conclusion, adult pancreatoblastoma most commonly occurs in male patients, and it usually appears as an exophytic, irregular, and hypovascular mass with well-defined margins and progressive enhancement on CT and MRI. This type of tumor always grows out of the parenchyma of the pancreas, similar to branches growing outward from a tree trunk.

Different flavors of diffusion in paramagnetic systems: Unexpected NMR signal intensity and relaxation enhancements

The NMR community is well acquainted with different kinds of diffusion but, at the same time, there are several effects that are worth a better understanding for an improved design of molecular imaging and dynamic nuclear polarization experiments. Spin diffusion and chemical diffusion are known to play important roles in determining the NMR signal and relaxation enhancements caused by the presence of paramagnetic molecules in solution. Paramagnetic complexes are used as contrast agents in magnetic resonance imaging, due to their efficacy in selectively increase the relaxation rates of solvent water protons, as well as in dynamic nuclear polarization experiments to increase the NMR signal of desired molecules through polarization transfer from unpaired electrons. In this paper we review some recent, unexpected observations in these two areas, which seem related to spin and/or chemical diffusion, and demonstrate the need for a detailed understanding of the interplay of different phenomena. A deeper understanding of spin and chemical diffusion may thus result very important for an improved design of contrast agents for magnetic resonance imaging and for the optimization of hyperpolarization experiments.

Temporary anion states of fluorine substituted benzenes probed by charge transfer in O2−·C6H6−xFx (x = 0–5) ion–molecule complexes

The broadband photoelectron source realized by detaching O2 -·X (X = neutral unsaturated molecule) complexes offers a unique opportunity to probe temporary anion states of the unsaturated species. Detachment of the ion molecule complex typically accesses a dissociative portion of the neutral potential, creating a continuum electron source that can undergo scattering with X. We present the application of this new approach to electron-neutral scattering toward a study of the series of fluorinated benzenes via photoelectron spectroscopy of O2 -·C6H6-xFx (x = 0-6) measured with several photon energies. We compare these spectra to the reference O2 -·hexane spectrum and observe evidence of temporary anion states of C6H6-xFx for species with x = 0-5 in the form of enhanced signal intensity at electron kinetic energies coinciding with the energies of the temporary anions. Furthermore, we observe autodetachment features in the x = 3, 5 spectra. Results of calculations on the isolated symmetric isomer of C6H3F3 suggest that the molecule cannot support a weakly-bound non-valence state that could be associated with the observed autodetachment. However, C6HF5 - is predicted to support a valence bound state, which, if produced by charge transfer from O2 - with sufficient vibrational energy, may undergo autodetachment. Finally, the [O2·C6F6]- spectrum is unique insofar as the spectrum is substantially higher in binding energy and qualitatively different from the x = 0-5 spectra. This result suggests much stronger interactions and charge delocalization between O2 - and C6F6.

Within-network brain connectivity in Crohn's disease patients with gadolinium deposition in the cerebellum.

Patients with Crohn's disease (CD) undergo multiple gadolinium-based contrast agent injections across their lifespan to enhance signal intensity of the intestinal wall and differentiate active from quiescent inflammatory disease. Thus, CD patients are prone to gadolinium accumulation in the brain and represent a non-neurological population to explore gadolinium-related brain toxicity. Possible effects are expected to be greater on the cerebellar network due to the high propensity of the dentate nucleus to accumulate gadolinium. Herein, we provide a whole-brain network analysis of resting-state fMRI dynamics in long-term quiescent CD patients with normal renal function and MRI evidence of gadolinium deposition in the brain. Fifteen patients with CD and 16 healthy age- and gender-matched controls were enrolled in this study. Relevant resting-state networks (RSNs) were identified using independent component analysis (ICA) from functional magnetic resonance imaging data. An unpaired two-sample t test (with age and sex as nuisance variables) was used to investigate between different RSNs. Clusters were determined by using threshold-free cluster enhancement and a family-wise error corrected cluster significance threshold of p < 0.05. Patients showed significantly decreased resting-state functional connectivity (p < 0.05, FWE corrected) of several regions of the right frontoparietal (FPR) and the dorsal attention (DAN) RSNs. No differences between the two groups were found in the functional connectivity maps of all the other RSNs, including the cerebellar network. Our findings suggest a non-significant impact of gadolinium deposition on within-network cerebellar functional connectivity of long-term quiescent CD patients.

The effects of dual plating on the vascularity of the distal femur.

Dual plating of distal femoral fractures with medial and lateral implants has been performed to improve construct mechanics and alignment, in cases where isolated lateral plating would be insufficient. This may potentially compromise vascularity, paradoxically impairing healing. This study investigates effects of single versus dual plating on distal femoral vascularity. A total of eight cadaveric lower limb pairs were arbitrarily assigned to either 1) isolated lateral plating, or 2) lateral and medial plating of the distal femur, with four specimens per group. Contralateral limbs served as matched controls. Pre- and post-contrast MRI was performed to quantify signal intensity enhancement in the distal femur. Further evaluation of intraosseous vascularity was done with barium sulphate infusion with CT scan imaging. Specimens were then injected with latex medium and dissection was completed to assess extraosseous vasculature. Quantitative MRI revealed a mean reduction of 21.2% (SD 1.3%) of arterial contribution in the lateral plating group and 25.4% (SD 3.2%) in the dual plating group (p = 0.051); representing a mean decrease in arterial contribution of 4.2%. The only significant difference found between both experimental groups was regionally, at the lateral aspect of the distal femur with a mean drop in arterial contribution in the lateral plating group of 18.9% (SD 2.6%) versus 24.0% (SD 3.2%) in the dual plating group (p = 0.048), representing a mean decrease in arterial contribution of 5.1%. Gross dissection revealed complete destruction of periosteal vessels underneath either medial or lateral plates in both groups. The network of genicular branches contributing to the posterior and distal femoral condyles was preserved in all specimens. A medial vascular pedicle was found dividing from the superficial femoral artery at a mean 12.7 cm (SD 1.7) proximal to the medial epicondyle and was undisrupted in the dual plating group. Lateral locking-plate application resulted in mean 21.2% reduction in distal femur vascularity. Addition of medial plates did not further markedly decrease vascularity. As such, the majority of the vascular insult occurred with lateral plating alone. Supplemental medially based fixation did not lead to marked devascularization of the distal femur, and should therefore be considered in the setting of comminution and poor bone stock in distal femoral fractures. Further clinical research is required to confirm the results of this study. Cite this article: Bone Joint J 2020;102-B(4):530-538.

Development of an Integrated Tissue Pretreatment Protocol for Enhanced MALDI MS Imaging of Drug Distribution in the Brain.

The matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI MSI) technique has attracted intense interest in the visualization of drug distribution in tissues. Its capability to spatially resolve individual molecules makes it a unique tool in drug development and research. However, low drug content and severe ion suppression in tissues hinder its broader application to resolve drug tissue distribution, especially small molecule drugs with a molecular weight below 500 Da. In this work, an integrated tissue pretreatment protocol was developed to enhance the detection of central nervous system drugs in the mouse brain using MALDI MSI. To evaluate the protocol, brain sections from mice dosed intraperitoneally with donepezil, tacrine, clozapine, haloperidol, and aripiprazole were used. The tissue sections were pretreated serially by washing with ammonium acetate solution, incubation with trifluoroacetic acid vapor, and n-hexane washing before MALDI MSI. Compared with the untreated sample, the signal intensities for the test drugs increased by 4.7- to 31.5-fold after pretreatment. Besides the enhancement of signal intensity, fine optimization of pretreatment time and washing solvents preserved the spatial distribution of target drug molecules. The utility of the developed protocol also provided tissue-specific distribution for five drugs which were well resolved when imaged by MALDI MS.

Charge Distribution between Different Classes of Glycerophospolipids in MALDI-MS Imaging.

Matrix-assisted laser desorption ionization mass spectrometry imaging (MALDI-MSI) is widely used to visualize and analyze the distribution of membrane lipids in an increasingly large number of applications. In this context, different lipoforms of glycerophospholipids (GPLs) are among the prime targets of interest. For this group of analytes, however, ion suppression effects have been described to strongly favor the detection of certain GPL classes over others, thereby hampering the analysis of suppressed species and greatly restraining quantitative analysis. These effects are generally attributed to the distribution of available charge carriers during the MALDI process. Here, we present a systematic investigation of charge distribution between different classes of GPL under MALDI-MSI conditions. For this, we constructed arrays of artificial tissues with different formulated lipid composition that contained predefined amounts of only two specific GPL classes and analyzed them with MALDI-MSI in positive- and negative-ion modes. Next to a characterization of expected ion suppression effects, analysis of these binary systems revealed yet undescribed signal intensity enhancement for the combinations of certain GPL classes. Furthermore, the comprehensive data allowed us to compile a hierarchy of charge affinities for the investigated GPL classes in both polarities. Additional experiments revealed that laser post-ionization (MALDI-2) has great potential to overwrite changes in signal intensity caused by charge distribution among different GPL classes observed in standard MALDI-MSI.

Density Functional Computations of Vibrational Circular Dichroism Spectra beyond the Born-Oppenheimer Approximation.

Transition-metal complexes provide rich features in vibrational circular dichroism (VCD) spectra, including significant intensity enhancements, and become thus useful in structural and functional studies of molecules. Quite often, however, the vibrational spectral bands are mixed with the electronic ones, and interpretation of such experiments is difficult. In the present study, we elaborate on the theory needed to calculate the VCD intensities beyond the Born-Oppenheimer (BO) approximation. Within a perturbation approach, the coupling between the electronic and vibrational states is estimated using the harmonic approximation and simplified wave functions obtainable from common density functional theory (DFT) computations. Explicit expressions, including Slater determinants and derivatives of molecular orbitals, are given. On a model diamine complex, the implementation is tested and factors affecting spectral intensities and frequencies are investigated. For two larger molecules, the results are in a qualitative agreement with previous experimental data. Typically, the electronic-vibrational interaction Hamiltonian coupling elements are rather small (∼0 to 10 cm-1), which provides negligible contributions to vibrational frequencies and absorption intensities. However, significant changes in VCD spectra are induced due to the large transition magnetic dipole moment associated with the d-d metal transitions. The possibility to model the spectra beyond the BO limit opens the way to further applications of chiral spectroscopy and transition-metal complexes.

Application of low-rank approximation using truncated singular value decomposition for noise reduction in hyperpolarized 13 C NMR spectroscopy.

Dissolution dynamic nuclear polarization allows in vivo studies of metabolic flux using 13 C-hyperpolarized tracers by enhancing signal intensity by up to four orders of magnitude. The T1 for in vivo applications is typically in the range of 10-50 s for the different 13 C-enriched metabolic substrates; the exponential loss of polarization due to various relaxation mechanisms leads to a strong reduction of the signal-to-noise ratio (SNR). A common solution to the problem of low SNR is the accumulation/averaging of consecutive spectra. However, some limitations related to long delays between consecutive scans occur: in particular, following biochemical kinetics and estimate apparent enzymatic constants becomes time critical when measurement scans are repeated with the typical delay of about 3 T1 . Here we propose a method to dramatically reduce the noise, and therefore also the acquisition times, by computing, via truncated singular value decomposition, a low-rank approximation to the individual complex time-domain signals. Moreover, this approach has the additional advantage that the phase correction can be applied to the spectra already denoised, thus greatly reducing phase correction errors. We have tested the method on (1) simulated data; (2) performing dissolution of hyperpolarized 1-13 C-pyruvate in standard conditions and (3) in vivo data sets, using a porcine model injected with hyperpolarized Na-1-13 C-acetate. It was shown that the presented method reduces the noise level in all the experimental data sets, allowing the retrieval of signals from highly noisy data without any prior phase correction pre-processing. The effects of the proposed approach on the quantification of metabolic kinetics parameters have to be shown by full quantification studies.

Enhancement of the quantum dot photoluminescence using transfer-printed porous silicon microcavities

Enhancement of the photoluminescence signal intensity from organic and inorganic fluorophores increases the sensitivity of operation of optical sensors, detectors, and photonic diagnostic assays. Here, we have engineered and compared optical and fluorescence-enhancing properties of two types of one-dimensional porous silicon photonic crystals: a transfer-printed microcavity based on the freestanding photonic crystal and a conventional “one-piece” microcavity created on a monocrystalline silicon substrate. Comparative analysis of the eigenmodes and the photonic bandgaps of both types of microcavities demonstrated a high quality of transfer-printed microcavities and good correlation of their reflection spectra with the spectra of “one-piece” microcavities. Moreover, embedding of a highly concentrated solution of quantum dots (QDs) in the eigenmode localization region of transfer-printed microcavity was followed by three-fold reduction of the full-width-at-half-maximum of their luminescence spectrum at the microcavity eigenmode wavelength, thus confirming a weak coupling regime of QD exciton and microcavity eigenmode interaction and significant enhancement of QD luminescence within the microcavity.

Synthesis of 9-ethyl-3-isothiacyanato carbazole for turn on fluorescence for rapid and selective detection of Cd2+ in aqueous system

A remarkable instantaneous visual change from colorless to faint blue coloration is observed selectively for cadmium cation (Cd2+) using a simple carbazole derivative 9-ethyl-3-isothiocyanatocarbazole (CIT) in aqueous medium in presence of other heavy transition metal ions. Chemical characterization of synthesized 9-ethyl-3-isothiocyanatocarbazole is fully performed by FT-IR, 1H NMR, 13C NMR and single crystal XRD. The theoretical result and experimental values were found to be satisfactorily support each other. From the HOMO-LUMO energy calculation and different thermodynamic parameter, chemical activity and kinetic stability of the molecule has been established by studying density functional theory (DFT). No significant changes found in fluorescence intensity for CIT with varying temperature and pH in medium. The addition of Cd2+ ion in CIT solution exhibits a significant enhancement in fluorescence intensity at 482 nm (ФF = 0.16) and the colour changes instantaneously within a few second. The stoichiometric ratio of the sensing moiety formed in situ was found to be 2:1 from Job's plot and shows the presence of stable Chelation Enhanced Fluorescence (CHEF) mechanism. The average life time of the stable combined CIT with Cd2+ moiety is remarkably higher by 3.29 ns than the native ligand and with other metals. The detection limit is 0.95 μM (S/N = 2). Thus, reported carbazole derivative has excellent promptness, sensitivity and selectivity for the detection of Cd2+ ion in water medium.

Design of a Fluorescence Turn-on and Label-free Aptasensor Using the Intrinsic Quenching Power of G-Quadruplex to AMT.

A novel fluorescent aptasensor based on the G-quadruplex induced fluorescent quenching of psoralen and the competitive interactions between 4'-aminomethyl-4,5',8-trimethylpsoralen (AMT), adenosine triphosphate (ATP) and G-rich DNA functionalized split ATP aptamer was proposed. The binding of ATP to the G-rich DNA functionalized split aptamer induced a significant enhancement in fluorescence emission intensity while undergoing excitation at 340 nm. Under the optimal conditions, the developed aptasensor showed high selectivity and good accuracy for detecting ATP. The practicality of the proposed aptasensor has been confirmed by successfully analyzing ATP in spiked human blood serum samples with satisfactory results. As far as we know, this is the first time that the intrinsic quenching ability of G-quadruplex was applied to simply construct a fluorescence turn-on and label-free aptasensor. On account of the superiority of the simplicity of the design strategy, more work is expected in the future to develop a variety of novel sensors for other important analytes using the quenching capability of G-quadruplex through reasonable designs.

Influence of cavity and magnetic confinements on the signal enhancement and plasma parameters of laser-induced Mg and Ti plasmas

AbstractIn this study, we have spectroscopically investigated the plasma generated by a Q-switched Nd:YAG laser operating at its fundamental wavelength of 1064 nm focused on magnesium (Mg) and titanium (Ti) target samples in the air under atmospheric pressure. We employed circular cavities of radii (2.5, 3.0, and 3.5 mm) and a square cavity to investigate the cavity confinement effect on the spectral emission intensities of the plasmas. We observed that the circular cavity of radius 2.5 mm had the maximum signal enhancement, and this can be attributed to the compression of the plasma and reheating by the reflected shock waves. The maximum enhancement factor of the Mg I-518.4 nm line was reached at approximately 3.8, 3.4, and 2.8 with a circular cavity of radius 2.5, 3.0, and 3.5 mm, respectively, at a delay time of 350 ns and a laser energy of 350 mJ. By applying varying external magnetic fields (0.47, 0.62, 0.91, and 1.23 T) across the generated plasma, the plasma parameters such as electron temperature and number density have been investigated. From our results, we observed that the radius of the cavity had a tremendous effect on the enhancement of the emission signal intensities. We also found that the increase in the electron temperature and the number density can be attributed to the increase in the applied magnetic field and the laser energy. From our calculations, the value of β, which was less than 1 for all the cases, confirms that there was a plasma confinement at the presence of the magnetic field.

Gold Nanobones Enhanced Ultrasensitive Surface-Enhanced Raman Scattering Aptasensor for Detecting Escherichia coli O157:H7.

Sensitive, robust, and highly specific detection of Escherichia coli O157:H7, one of the most hazardous foodborne pathogens and the cause of numerous diseases, is needed to ensure public health. Herein, a one-pot step method is reported for the preparation of multifunctional gold nanobones (NBs) (GNRApt-1+RhB) from gold nanorods (GNRs) comediated by an aptamer (Apt-1) and the signal molecule rhodamine B (RhB) for surface-enhanced Raman scattering detection of E. coli O157:H7. The characterized result showed that Apt-1 and RhB were embedded in the gold NBs, and then, this combination exhibited good recognition, excellent stability, and significant Raman signal intensity enhancement. The Raman enhancement derived from a strong electromagnetic field distribution with the locations at the apex of both ends of the GNRApt-1+RhB and the signal stability was because of the firm embedment of Apt-1 (poly A20 + E. coli O157:H7 aptamers) and RhB on the surface of the GNRApt-1+RhB. Optimization experiments established that surface-enhanced Raman-scattered RhB absorption at 1350 cm-1 had a strong linear relationship (y = 180.30x - 61.49; R2 = 0.9982) with E. coli O157:H7 concentration over the range of 10-10,000 cfu/mL with a limit of detection of 3 cfu/mL. This novel aptasensor sensitively detects E. coli O157:H7 and has great promise for food pathogenic bacteria detection.

Complex evolution of photoluminescence during phase segregation of MAPb(I1-xBrx)3 mixed halide perovskite

Under illumination, the photoluminescence of a mixed-halide perovskite such as MAPb(I1-xBrx)3 is known to undergo a significant intensity enhancement while spectrally shifting to lower energies. The evolution of low energy photoluminescence is attributed to the formation of iodide rich domains due to phase segregation. This process is detrimental for optoelectronic devices however the mechanism is not well-understood. Here we present a real-time study of the photoluminescence evolution in MAPb(I1-xBrx)3 samples during light-induced phase segregation. We show that the evolution of photoluminescence proceeds via several intermediate stages making it more complex than previously suggested. Within the first few seconds of photo-excitation, we found a very rapid formation of a short-lived intense photoluminescence band with a peak energy even lower than the final emission of the fully segregated sample. We propose that this emission comes from small pure iodide nano-domains formed during the initial stage of photo-induced phase-segregation.

Facile Improvement of Negative Ion Mode Electrospray Ionization Using Capillary Vibrating Sharp-Edge Spray Ionization.

Electrospray ionization (ESI) is often affected by corona discharge when spraying 100% aqueous solutions as the voltage that induces discharge can be well below the onset voltage of ESI. As a result, it is especially challenging to perform native mass spectrometry in negative ion mode where 100% aqueous solution is preferred. Here we report a simple instrumentation method to improve the performance of ESI in negative ion mode based on capillary vibrating sharp-edge spray ionization. By attaching a fused silica capillary emitter to a vibrating glass slide, improved signal quality is achieved for various analytes in aqueous solutions over applying ESI alone. Compared to commercial ESI sources using nebulization gas to reduce discharge, 10-100-fold enhancement in signal intensity and 3-10-fold improvement in S/N are achieved for various kinds of molecules including DNA, peptides, proteins, and oligosaccharides. Finally, the new method demonstrates utility for native mass spectrometry analysis of proteins and G-quadruplex DNA. The present method is expected to have great potential to be adopted by the scientific community because of its improved analytical performance, simplicity, and low cost.

Development of potent reversible selective inhibitors of butyrylcholinesterase as fluorescent probes

Brain butyrylcholinesterase (BChE) is an attractive target for drugs designed for the treatment of Alzheimer’s disease (AD) in its advanced stages. It also potentially represents a biomarker for progression of this disease. Based on the crystal structure of previously described highly potent, reversible, and selective BChE inhibitors, we have developed the fluorescent probes that are selective towards human BChE. The most promising probes also maintain their inhibition of BChE in the low nanomolar range with high selectivity over acetylcholinesterase. Kinetic studies of probes reveal a reversible mixed inhibition mechanism, with binding of these fluorescent probes to both the free and acylated enzyme. Probes show environment-sensitive emission, and additionally, one of them also shows significant enhancement of fluorescence intensity upon binding to the active site of BChE. Finally, the crystal structures of probes in complex with human BChE are reported, which offer an excellent base for further development of this library of compounds.

Dextran-based Nanomicelle System with Directly Ester-bound Gadolinium Chelates as a Magnetic Resonance Imaging Contrast Agent for Tumor Detection.

There is a strong need to develop MRI contrast agents (CAs) with lower in vivo retention, stronger signal enhancement, and more specific imaging. Here, we report a novel dextran (DEX)-based nanomicelle system as an MRI CA with superior tumor imaging and relatively short intravascular persistence. Gadolinium (Gd)-chelate (DTPA-Gd) was conjugated directly to DEX hydroxyl via a degradable ester bond. DEX-DTPA-Gd was then modified with dodecylsuccinic anhydride to obtain the amphiphilic derivative, 2-dodecylsuccinic acid (DSA)-grafted DEX-DTPA-Gd. Nanomicelles were prepared by dissolving DSA-DEX-DTPA-Gd in water using ultrasonication. The physicochemical properties, cytotoxicity, and MRI efficiency of the synthesized CA were evaluated. The synthesized DSA-DEX-DTPA-Gd self-assembled into nanomicelles with an average diameter of 67.80 ± 5.21 nm. Within the given Gd concentration range, DSA-DEX-DTPA-Gd and Magnevist® exhibited similar cytotoxicity. DEX-based CAs resulted in a greater contrast enhancement of T1-weighted signal intensity in the tumor region than Magnevist®, and the tumors were clearly defined for at least 3 h. Simultaneously, the ester bond in DSA-DEX-DTPA-Gd facilitated the elimination of Gd chelates, compared with the relatively more stable amide linker. The DEX-based nanomicelle system with directly ester-bound DTPA-Gd may serve as an MRI CA with superior tumor imaging and relatively rapid elimination.

Study of interpulse delay effects on orthogonal dual-pulse laser-induced breakdown spectroscopy in bulk seawater

With the application of an orthogonal DP-LIBS excitation, when compared to SP-LIBS, significant emission intensity enhancements for a wide range of elements were obtained in seawater by using proper shorter interpulse delays.

Scoring System to Predict Malignancy for MRI-Detected Lesions in Breast Cancer Patients: Diagnostic Performance and Effect on Second-Look Ultrasonography.

PurposeTo design a scoring system to predict malignancy of additional MRI-detected lesions in breast cancer patients.Materials and MethodsEighty-six lesions (64 benign and 22 malignant) detected on preoperative MRI of 68 breast cancer patients were retrospectively included. The clinico-radiologic features were correlated with the histopathologic results using the Student's t-test, Fisher's exact test, and logistic regression analysis. The scoring system was designed based on the significant predictive features of malignancy, and its diagnostic performance was compared with that of the Breast Imaging-Reporting and Data System (BI-RADS) category.ResultsLesion size ≥ 8 mm (p < 0.001), location in the same quadrant as the primary cancer (p = 0.005), delayed plateau kinetics (p = 0.010), T2 isointense (p = 0.034) and hypointense (p = 0.024) signals, and irregular mass shape (p = 0.028) were associated with malignancy. In comparison with the BI-RADS category, the scoring system based on these features with suspicious non-mass internal enhancement increased the diagnostic performance (area under the receiver operating characteristic curve: 0.918 vs. 0.727) and detected three false-negative cases. With this scoring system, 22 second-look ultrasound examinations (22/66, 33.3%) could have been avoided.ConclusionThe scoring system based on the lesion size, location relative to the primary cancer, delayed kinetic features, T2 signal intensity, mass shape, and non-mass internal enhancement can provide a more accurate approach to evaluate MRI-detected lesions in breast cancer patients.