Pharmacokinetic analysis of ultrafast DCE-MRI for DCIS grading and prediction of DCIS upgrading to IDC

Motivation: Accurate grading and predicting the upgrade of DCIS can assist in surgical planning. Goal(s): This study investigates whether the pharmacokinetic parameters from ultrafast DCE-MRI can differentiate DCIS grade and predict the upgrade of DCIS at surgery. Approach: We reviewed data from 35 patients with DCIS who underwent a protocol that included preoperative ultrafast DCE-MRI (temporal resolution = 3-9 seconds) for the first minute after contrast administration. We measured pharmacokinetic parameters in DCIS from ultrafast images. Results: The results show that Kep separates low-grade DCIS from intermediate and high-grade DCIS. High-grade DCIS with short bolus arrival time is associated with an upgrade to IDC. Impact: Pharmacokinetic analysis of ultrafast DCE-MRI could distinguish low-grade DCIS from non-low-grade DCIS and could predict upgrade of high-grade DCIS to IDC.