Microcirculation and microvasculature in breast tumors: Pharmacokinetic analysis of dynamic MR image series

The purpose of this study was to quantify microcirculation and microvasculature in breast lesions by pharmacokinetic analysis of Gd-DTPA-enhanced MRI series. Strongly T-1-weighted MR images were acquired in 18 patients with breast lesions using a saturation-recovery-TurboFLASH sequence. Concentration-time courses were determined for blood, pectoral muscle, and breast masses and subsequently analyzed by a two-compartment model to estimate plasma flow and the capillary transfer coefficient per unit of plasma volume (F/V-P, K-PS/V-P) as well as fractional volumes of the plasma and interstitial space (f(P), f(I)). Tissue parameters determined for pectoral muscle (f(P) = 0.04 +/- 0.01, f(I) = 0.09 +/- 0.01, F/V-P = 2.4 +/- 1.3 min(-1), and K-PS/V-P = 1.2 +/- 0.5 min(-1)) and 10 histologically proven carcinomas (f(P) = 0.20 +/- 0.07, f(I) = 0.34 +/- 0.16, F/V-P = 2.4 +/- 0.7 min(-1), and K-PS/V-P = 0.86 +/- 0.62 min(-1)) agreed reasonable well with literature data. Best separation between malignant and benign lesions was obtained by the ratio K-PS/F (0.35 +/- 0.17 vs. 1.23 +/- 0.65). The functional imaging technique presented appears promising to quantitatively characterize tumor pathophysiology. Its impact on diagnosis and therapy management of breast tumors, however, has to be evaluated in larger patient studies.