Intraindividual comparison of different methods for automated BPE assessment at breast MRI: a call for standardization
Background - - The level of background parenchymal enhancement (BPE) at breast MRI provides predictive and prognostic information and can have diagnostic implications. However, there is a lack of standardization regarding BPE assessment. - - Purpose - - To investigate how well results of quantita...
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| Main Authors: | , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
July 2024
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| In: |
Radiology
Year: 2024, Volume: 312, Issue: 1, Pages: 1-9 |
| ISSN: | 1527-1315 |
| DOI: | 10.1148/radiol.232304 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1148/radiol.232304 Verlag, lizenzpflichtig, Volltext: https://pubs.rsna.org/doi/10.1148/radiol.232304 
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| Author Notes: | Gustav Müller-Franzes, MSc, Firas Khader, MSc, Soroosh Tayebi Arasteh, MSc, Luisa Huck, MD, Maike Bode, MD, Tianyu Han, PhD, Teresa Lemainque, PhD, Jakob Nikolas Kather, MD, MSc, Sven Nebelung, MD, Christiane Kuhl, MD, Daniel Truhn, MD, MSc |
| Summary: | Background - - The level of background parenchymal enhancement (BPE) at breast MRI provides predictive and prognostic information and can have diagnostic implications. However, there is a lack of standardization regarding BPE assessment. - - Purpose - - To investigate how well results of quantitative BPE assessment methods correlate among themselves and with assessments made by radiologists experienced in breast MRI. - - Materials and Methods - - In this pseudoprospective analysis of 5773 breast MRI examinations from 3207 patients (mean age, 60 years ± 10 [SD]), the level of BPE was prospectively categorized according to the Breast Imaging Reporting and Data System by radiologists experienced in breast MRI. For automated extraction of BPE, fibroglandular tissue (FGT) was segmented in an automated pipeline. Four different published methods for automated quantitative BPE extractions were used: two methods (A and B) based on enhancement intensity and two methods (C and D) based on the volume of enhanced FGT. The results from all methods were correlated, and agreement was investigated in comparison with the respective radiologist-based categorization. For surrogate validation of BPE assessment, how accurately the methods distinguished premenopausal women with (n = 50) versus without (n = 896) antihormonal treatment was determined. - - Results - - Intensity-based methods (A and B) exhibited a correlation with radiologist-based categorization of 0.56 ± 0.01 and 0.55 ± 0.01, respectively, and volume-based methods (C and D) had a correlation of 0.52 ± 0.01 and 0.50 ± 0.01 (P < .001). There were notable correlation differences (P < .001) between the BPE determined with the four methods. Among the four quantitation methods, method D offered the highest accuracy for distinguishing women with versus without antihormonal therapy (P = .01). - - Conclusion - - Results of different methods for quantitative BPE assessment agree only moderately among themselves or with visual categories reported by experienced radiologists; intensity-based methods correlate more closely with radiologists’ ratings than volume-based methods. - - © RSNA, 2024 - - Supplemental material is available for this article. - - See also the editorial by Mann in this issue. |
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| Item Description: | Gesehen am 04.02.2025 Online veröffentlicht: 16. Juli 2024 |
| Physical Description: | Online Resource |
| ISSN: | 1527-1315 |
| DOI: | 10.1148/radiol.232304 |