A One-Step Biomarker Quantification Methodology for DCE-MRI of Adnexal Masses: Capturing Kinetic Pattern from Early to Late Enhancement

Abstract

Objective: To develop a one-step quantification approach that accounts for joint preprocessing and quantification of wholerange kinetics (early and late-phase washout) of dynamic contrast-enhanced (DCE) MRI of indeterminate adnexal masses.
Results: The results revealed that P2, representing the enhancement amplitude, is significantly higher, and P5, indicating the terminal phase, is generally negative in malignant lesions (P < 0.001). P2 (sensitivity ¼ 79%, specificity ¼ 87.5%, accuracy ¼ 84%, area under the receiver operating characteristic curve ¼ 91%) outperforms classification performances of PK and semiquantitative parameters. A combination of P2 and P5 shows comparable performance (sensitivity ¼ 79%, specificity ¼ 87.5%, accuracy ¼ 84%, area under the receiver operating characteristic curve ¼ 92%) to that of the combination of PK parameters, whereas the five-parameter sigmoid function maintains fewer assumptions than PK. Conclusions: The presented one-step quantification approach is helpful for accurate discrimination of benign from malignant indeterminate adnexal masses. Accordingly, P2 has considerably high diagnostic performance and terminal slope (P5), as a previously overlooked feature, contributes more than widely accepted early-enhancement kinetic features. Magn Reson Med 000:000–000, 2017. VC 2017 International Society for Magnetic Resonance in Medicine.