Comparison of Renal Parenchymal Enhancement Using Different Concentration of Iodinated Contrast Media in MDCT

Many investigators have described comparisons of contrast media with different iodine concentrations in the enhancement of multiple organs and vessels on CT scans. Contrary to other solid organs, the kidney excretes waste products, including contrast media, via the cortex, medulla, and pelvicalyceal system. For the kidney, there are characteristic enhancing techniques such as the use of the arterial phase for cortex and venous phase for medullary during contrast CT imaging. In our study, we compared the degree of renal parenchymal enhancement in the Hounsfield Unit (HU) by the use of 350 and 370 mg I/ml in contrast enhanced computed tomography (CECT) abdomen at the origin of renal artery of right and left Kidney in the arterial phase for both groups. The comparison of renal parenchymal enhancement between the A group and B group showed that the renal parenchymal enhancement is higher in B group. This was a prospective randomized study in which 116 participants were allocated in two groups using the random convenience sampling method. The subjects were divided into two groups; Group A (350 mgI/ml and Group B (370 mgI/ml). All data were analyzed by an independent t-test to obtain the mean difference between all the variables using 350 mgI/ml and 370mgI/ml. Quantitative data like age, height, weight, Body Mass Index(BMI), pulse rate, creatinine, flow rate, contrast volume, and ejection fraction were presented as mean and standard deviation using an independent t-test. Qualitative data like gender was presented as a percentage. P-value was calculated using an independent t-test. P-value <0.05 was considered to be statistically significant. Data were analyzed by statistical Package for Social Science version 20.0 (IBM corporation, New York, 2014). Analyzing the data using the independent-test revealed that differences between the two groups were found to be statistically significant (P=0.029). The comparison of renal parenchymal enhancement between the A group and B group showed that the renal parenchymal enhancement is higher in the B group with a t = -2.213 and is statistically significant (P = 0.029). Non-ionic contrast medium of concentration 370 mg I/ml showed higher mean renal parenchyma peak enhancement as compared to 350 mg I/ml. Further, our study showed that the renal parenchymal enhancement pattern between A group and B group was affected by weight, BMI, and pulse rate and contrast volume.

Fibroglandular Tissue and Background Parenchymal Enhancement on Breast MR Imaging Correlates With Breast Cancer

ObjectivesTo evaluate the association of breast cancer with both the background parenchymal enhancement intensity and volume (BPEI and BPEV, respectively) and the amount of fibroglandular tissue (FGT) using an automatic quantitative assessment method in breast magnetic resonance imaging (MRI).Materials and MethodsAmong 17,274 women who underwent breast MRI, 132 normal women (control group), 132 women with benign breast lesions (benign group), and 132 women with breast cancer (cancer group) were randomly selected and matched by age and menopausal status. The area under the receiver operating characteristic curve (AUC) was compared in Cancer vs Control and Cancer vs Benign groups to assess the discriminative ability of BPEI, BPEV and FGT.ResultsCompared with the control groups, the cancer group showed a significant difference in BPEV with a maximum AUC of 0.715 and 0.684 for patients in premenopausal and postmenopausal subgroup, respectively. And the cancer group showed a significant difference in BPEV with a maximum AUC of 0.622 and 0.633 for patients in premenopausal and postmenopausal subgroup, respectively, when compared with the benign group. FGT showed no significant difference when breast cancer group was compared with normal control and benign lesion group, respectively. Compared with the control groups, BPEI showed a slight difference in the cancer group. Compared with the benign group, no significant difference was seen in cancer group.ConclusionIncreased BPEV is correlated with a high risk of breast cancer While FGT is not.

Background Parenchymal Enhancement on Breast MRI: Assessment and Clinical Implications

Purpose of Review To present recent literature regarding the assessment and clinical implications of background parenchymal enhancement on breast MRI. Recent Findings The qualitative assessment of BPE remains variable within the literature, as well as in clinical practice. Several different quantitative approaches have been investigated in recent years, most commonly region of interest-based and segmentation-based assessments. However, quantitative assessment has not become standard in clinical practice to date. Numerous studies have demonstrated a clear association between higher BPE and future breast cancer risk. While higher BPE does not appear to significantly impact cancer detection, it may result in a higher abnormal interpretation rate. BPE is also likely a marker of pathologic complete response after neoadjuvant chemotherapy, with decreases in BPE during and after neoadjuvant chemotherapy correlated with pCR. In contrast, pre-treatment BPE does not appear to be predictive of pCR. The association between BPE and prognosis is less clear, with heterogeneous results in the literature. Summary Assessment of BPE continues to evolve, with heterogeneity in approaches to both qualitative and quantitative assessment. The level of BPE has important clinical implications, with associations with future breast cancer risk and treatment response. BPE may also be an imaging marker of prognosis, but future research is needed on this topic.