University of Oulu

Niukkanen, A., Okuma, H., Sudah, M. et al. Quantitative Three-Dimensional Assessment of the Pharmacokinetic Parameters of Intra- and Peri-tumoural Tissues on Breast Dynamic Contrast-Enhanced Magnetic Resonance Imaging. J Digit Imaging 34, 1110–1119 (2021).

Quantitative three-dimensional assessment of the pharmacokinetic parameters of intra- and peri-tumoural tissues on breast dynamic contrast-enhanced magnetic resonance imaging

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Author: Niukkanen, A.1,2; Okuma, H.1,2; Sudah, M.1,2;
Organizations: 1Department of Clinical Radiology, Diagnostic Imaging Center, Kuopio University Hospital, PO BOX 100, 70029, KYS, Kuopio, Finland
2Institute of Clinical Medicine, School of Medicine, Clinical Radiology, University of Eastern Finland, Kuopio, Finland
3Institute of Clinical Medicine, School of Medicine, Oncology, University of Eastern Finland, Kuopio, Finland
4Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
5Physics and Technology, Research Unit of Medical Imaging, University of Oulu, Oulu, Finland
6Department of Radiology, Oulu University Hospital, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.9 MB)
Persistent link:
Language: English
Published: Springer Nature, 2021
Publish Date: 2021-12-03


We aimed to assess the feasibility of three-dimensional (3D) segmentation and to investigate whether semi-quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters are associated with traditional prognostic factors for breast cancer. In addition, we evaluated whether both intra-tumoural and peri-tumoural DCE parameters can differentiate the breast cancers that are more aggressive from those that are less aggressive. Consecutive patients with newly diagnosed invasive breast cancer and structural breast MRI (3.0 T) were included after informed consent. Fifty-six patients (mean age, 57 years) with mass lesions of > 7 mm in diameter were included. A semi-automatic image post-processing algorithm was developed to measure 3D pharmacokinetic information from the DCE-MRI images. The kinetic parameters were extracted from time-signal curves, and the absolute tissue contrast agent concentrations were calculated with a reference tissue model. Markedly, higher intra-tumoural and peri-tumoural tissue concentrations of contrast agent were found in high-grade tumours (n = 44) compared to low-grade tumours (n = 12) at every time point (P = 0.006–0.040), providing positive predictive values of 90.6–92.6% in the classification of high-grade tumours. The intra-tumoural and peri-tumoural signal enhancement ratios correlated with tumour grade, size, and Ki67 activity. The intra-observer reproducibility was excellent. We developed a model to measure the 3D intensity data of breast cancers. Low- and high-grade tumours differed in their intra-tumoural and peri-tumoural enhancement characteristics. We anticipate that pharmacokinetic parameters will be increasingly used as imaging biomarkers to model and predict tumour behavior, prognoses, and responses to treatment.

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Series: Journal of digital imaging
ISSN: 0897-1889
ISSN-E: 1618-727X
ISSN-L: 0897-1889
Volume: 34
Issue: 5
Pages: 1110 - 1119
DOI: 10.1007/s10278-021-00509-3
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Funding: Open access funding provided by University of Eastern Finland (UEF) including Kuopio University Hospital. This study received grants from The Cancer Society of Finland and the North Savo Regional Fund of the Finnish Cultural Foundation.
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