Quantification of breast tumor microvascular permeability with feruglose-enhanced MR imaging: Initial phase II multicenter trial

PURPOSE: To investigate use of the macromolecular contrast agent feruglose for differentiating and grading of human benign and malignant breast tumors on the basis of their microvascular characteristics. MATERIALS AND METHODS: Sixty-three women with 63 primary breast lesions were examined with dynamic T1-weighted gradient-echo magnetic resonance (MR) imaging after intravenous injection of feruglose. A two-compartment unidirectional kinetic model applied to the dynamic data yielded estimates of the endothelial transfer coefficient, K, and the fractional plasma volume of the tumors. These MR imaging-derived parameters were correlated with the histologic tumor grade and quantified according to the Scarf-Bloom-Richardson (SBR) score by means of Pearson product moment correlation analyses. Differences between malignant and nonmalignant breast lesions with respect, to. K-PS for feruglose were evaluated by means of the chi(2) test and by calculating the, sensitivity, specificity, and positive and negative predictive values. RESULTS: Histologic analysis revealed 26, benign and 37 malignant tumors. A moderate yet statistically significant correlation between K-PS and SBR score was found (R = 0.496, P < .001). No significant correlation was observed between fractional plasma volume and SBR score (R = 0.085, P = .507). The K-PS values were zero for 19 (73%) of the-26 benign tumors and were greater than zero for 27 (73%) of the 37 carcinomas. This distribution was significantly different (chi(2) = 13.035, P P = .001). With the criterion K-PS > 0 in carcinomas; sensitivity was 0.73, specificity was 0.73, and the positive predictive value was 0.79. CONCLUSION: Quantitative measures of tumor microvascular permeability can be used for breast tumor characterization. The probability of breast tumor microvascular hyperpermeability to be associated with malignancy is 79%. RSNA, 2003.