Five-dimensional quantitative low-dose Multitasking dynamic contrast- enhanced MRI: Preliminary study on breast cancer.

PURPOSE To develop a low-dose Multitasking DCE technique (LD-MT-DCE) for breast imaging, enabling dynamic T1 mapping-based quantitative characterization of tumor blood flow and vascular properties with whole-breast coverage, a spatial resolution of 0.9 × 0.9 × 1.1 mm3 , and a temporal resolution of 1.4 seconds using a 20% gadolinium dose (0.02 mmol/kg). METHODS Magnetic resonance Multitasking was used to reconstruct 5D images with three spatial dimensions, one T1 recovery dimension for dynamic T1 quantification, and one DCE dimension for contrast kinetics. Kinetic parameters Fp , vp , Ktrans , and ve were estimated from dynamic T1 maps using the two-compartment exchange model. The LD-MT-DCE repeatability and agreement against standard-dose MT-DCE were evaluated in 20 healthy subjects. In 7 patients with triple-negative breast cancer, LD-MT-DCE image quality and diagnostic results were compared with that of standard-dose clinical DCE in the same imaging session. One-way unbalanced analysis of variance with Tukey test was performed to evaluate the statistical significance of the kinetic parameters between control and patient groups. RESULTS The LD-MT-DCE technique was repeatable, agreed with standard-dose MT-DCE, and showed excellent image quality. The diagnosis using LD-MT-DCE matched well with clinical results. The values of Fp , vp , and Ktrans were significantly different between malignant tumors and normal breast tissue (P < .001, < .001, and < .001, respectively), and between malignant and benign tumors (P = .020, .003, and < .001, respectively). CONCLUSION The LD-MT-DCE technique was repeatable and showed excellent image quality and equivalent diagnosis compared with standard-dose clinical DCE. The estimated kinetic parameters were capable of differentiating between normal breast tissue and benign and malignant tumors.