Purpose: To describe and test a new fully automatic lesion detection system for breast DCE‐MRI.Materials and Methods: Studies were collected from two institutions adopting different DCE‐MRI sequences, one with and the other one without fat‐saturation. The detection pipeline consists of (i) breast segmentation, to identify breast size and location; (ii) registration, to correct for patient movements; (iii) lesion detection, to extract contrast‐enhanced regions using a new normalization technique based on the contrast‐uptake of mammary vessels; (iv) false positive (FP) reduction, to exclude contrast‐enhanced regions other than lesions. Detection rate (number of system‐detected malignant and benign lesions over the total number of lesions) and sensitivity (system‐detected malignant lesions over the total number of malignant lesions) were assessed. The number of FPs was also assessed.Results: Forty‐eight studies with 12 benign and 53 malignant lesions were evaluated. Median lesion diameter was 6 mm (range, 5–15 mm) for benign and 26 mm (range, 5–75 mm) for malignant lesions. Detection rate was 58/65 (89%; 95% confidence interval [CI] 79%–95%) and sensitivity was 52/53 (98%; 95% CI 90%–99%). Mammary median FPs per breast was 4 (1st–3rd quartiles 3–7.25).Conclusion: The system showed promising results on MR datasets obtained from different scanners producing fat‐sat or non–fat‐sat images with variable temporal and spatial resolution and could potentially be used for early diagnosis and staging of breast cancer to reduce reading time and to improve lesion detection. Further evaluation is needed before it may be used in clinical practice. J. Magn. Reson. Imaging 2011;.

OBJECTIVE. The purpose of this article is to assess changes in breast vascular maps on dynamic contrast-enhanced MRI (DCE-MRI) after primary chemotherapy in patients with locally advanced breast cancer (LABC).SUBJECTS AND METHODS. Thirty-four patients with unilateral LABC underwent DCE-MRI before and after anthracycline- and taxane-based primary chemotherapy. The number of vessels 30 mm or longer in length and 2 mm or larger in maximum transverse diameter were counted on maximum intensity projections of the first subtracted phase for each of the two breasts. Patients achieving pathologic response or small clusters of residual cancer cells after primary chemotherapy were considered as responders, and those with an inferior pathologic response were considered as nonresponders.RESULTS. The mean (± SD) number of vessels in the breast harboring the cancer and in the contralateral breast was 2.7 ± 1.3 and 1.1 ± 1.0 (p < 0.001), respectively, before primary chemotherapy and 1.3 ± 1.1 and 1.1 ± 1.1 (p = 0.147), r...