Harmonization of Quantitative Parenchymal Enhancement in T 1 -Weighted Breast MRI

Differences in imaging parameters influence computer-extracted parenchymal enhancement measures from breast MRI. To investigate the effect of differences in dynamic contrast-enhanced MRI acquisition parameter settings on quantitative parenchymal enhancement of the breast, and to evaluate harmonization of contrast-enhancement values with respect to flip angle and repetition time. Retrospective. We modeled parenchymal enhancement using simulations, a phantom, and two cohorts (N = 398 and N = 302) from independent cancer centers. 1.5T dynamic contrast-enhanced T -weighted spoiled gradient echo MRI. Vendors: Philips, Siemens, General Electric Medical Systems. We assessed harmonization of parenchymal enhancement in simulations and phantom by varying the MR parameters that influence the amount of T -weighting: flip angle (8°-25°) and repetition time (4-12 msec). We calculated the median and interquartile range (IQR) of the enhancement values before and after harmonization. In vivo, we assessed overlap of quantitative parenchymal enhancement in the cohorts before and after harmonization using kernel density estimations. Cohort 1 was scanned with flip angle 20° and repetition time 8 msec; cohort 2 with flip angle 10° and repetition time 6 msec. Paired Wilcoxon signed-rank-test of bootstrapped kernel density estimations. Before harmonization, simulated enhancement values had a median (IQR) of 0.46 (0.34-0.49). After harmonization, the IQR was reduced: median (IQR): 0.44 (0.44-0.45). In the phantom, the IQR also decreased, median (IQR): 0.96 (0.59-1.22) before harmonization, 0.96 (0.91-1.02) after harmonization. Harmonization yielded significantly (P