[Magnetic resonance mammography in suspected tumor recurrences].
Twenty patients with clinically suspected breast cancer recurrence underwent MRI before and after paramagnetic contrast agent administration (MR mammography, MRM), after negative (4/20), questionable (11/20) or positive (5/20) X-ray mammography (XM). Spin-echo T1-weighted images before and after the i.v. administration of Gd-DTPA (0.15 mmol/kg) were acquired at 1, 3, 5, 7 and 10 minutes. Tissue behavior was studied directly on the images (qualitative analysis) and with dynamic curves of the signal-to-noise ratio and of enhancement rate (quantitative analysis). The histologic examination was performed in all cases--18 of them by surgical excision and in two by needle biopsy only. Seven of seven recurrences exhibited early (at 1 and 3 minutes) and focal qualitative enhancement, exceeding 100% at the quantitative analysis. Twelve of thirteen non-recurrences exhibited no significant qualitative enhancement, less than 40% at the quantitative analysis, while the extant lesion exhibited multifocal delayed (at 5-10 minutes) qualitative enhancement, about 60% at the quantitative analysis, and slight bilateral diffuse enhancement (proliferative dysplasia). MRM had 100% sensitivity, 92.3% specificity, 87.5% positive predictive value and 100% negative predictive value. XM had 100%, 30.8%, 43.7% and 100%, respectively (if we consider as positive all the questionable XM cases). To conclude, MRM is confirmed as a useful imaging technique in suspected breast cancer recurrences, especially after questionable XM exams.
Melani
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E
Istituto di Radiologia, Università degli Studi, Genova.
Sardanelli
F
F
Ottonello
C
C
Parodi
R C
RC
Castaldi
A
A
Succi
S
S
D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002921:Cicatrix / Q000175:diagnosis / Q000000981:diagnostic imaging; D005069:Evaluation Studies as Topic; D005260:Female; D005348:Fibrocystic Breast Disease / Q000175:diagnosis / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011379:Prognosis; D012680:Sensitivity and Specificity
La mammografia con Risonanza Magnetica nelle sospette recidive tumorali.