Abstract
OBJECTIVES: This study aimed to evaluate the efficacy of two combined ultrafast breast MRI kinetic parameters, combination 1 including time to enhancement [TTE], maximum slope [MS], and initial enhancement phase [IE phase] compared to combination 2 including relative enhancement [RE], maximum enhancement [ME], maximum relative enhancement [MRE], time to peak [TTP], and wash in rate in characterizing benign and malignant breast lesions. MATERIALS AND METHODS: This prospective study included 264 female patients with 273 breast lesions. The ultrafast protocol was done using the TWIST sequence. The parameters for combination 1 were generated manually; however, the parameters for combination 2 were generated semi-automatically. The overall performance of the ultrafast protocol was compared to the conventional dynamic MRI protocol. RESULTS: The ultrafast protocol was obtained in 77 s. The mean interpretation time was 5 ± 2.7 and 1 ± 0.5 min for combinations 1 and 2, respectively. Combination 1 showed an AUC of 0.910, a sensitivity of 76.5% and a specificity of 90%, while combination 2 showed an AUC of 0.869, a sensitivity of 76.5%, and a specificity of 85% in differentiating benign from malignant lesions. Upon combining all parameters, the AUC, sensitivity, and specificity in discriminating between the two groups increased to 0.944, 80.4%, and 85%, respectively. Both ultrafast techniques and conventional MRI demonstrated excellent performance in discriminating between benign and malignant lesions (AUC = 0.921 vs 0.940, respectively). CONCLUSION: Adding the semiautomatically generated parameters derived from ultrafast breast MRI can improve the performance in characterizing breast lesions. CRITICAL RELEVANCE STATEMENT: By studying ultrafast-derived semiautomatic, easily applicable parameters, we aim to reduce the acquisition and interpretation times of breast MRI without compromising performance, when used as a problem-solving modality in indeterminate breast lesions to characterize them as either benign or malignant. KEY POINTS: Adding semiautomatic ultrafast parameters to the MS and TTE improves the overall performance in characterizing breast lesions. The combined ultrafast parameters provide the highest discriminating power between benign and malignant breast lesions. Ultrafast MRI showed comparable performance to conventional dynamic contrast-enhanced MRI in the discrimination between benign and malignant breast lesions.