Tumor recurrence versus fibrosis in the irradiated breast: differentiation with dynamic gadolinium-enhanced MR imaging.
To assess the value of magnetic resonance (MR) imaging of the breast in the differentiation of late postirradiation fibrosis from recurrent carcinoma, 35 women with a history of breast carcinoma treated conservatively with radiation therapy underwent MR imaging. Nine patients had recurrent tumors confirmed at biopsy and surgery. Twenty-six patients had a localized fibrotic mass confirmed at biopsy and/or during long-term clinical and radiologic follow-up. In all cases, a localized hypointense area was present on plain spin-echo T1-weighted images. In all recurrent tumors, dynamic gadolinium-enhanced T1-weighted images demonstrated early increased signal intensity of the lesion within 3 minutes after bolus injection. The signal intensity over time in localized fibrosis differed from that in tumor recurrence, with no substantial enhancement on post-contrast T1-weighted images. Short inversion time inversion recovery and spin-echo T2-weighted images were not useful in the differential diagnosis of recurrent tumor versus radiation fibrosis.
Department of Radiodiagnosis, Institut Curie, Paris, France.
T H
TH
Dao
A
A
Rahmouni
F
F
Campana
M
M
Laurent
B
B
Asselain
A
A
Fourquet
D000328:Adult; D000368:Aged; D001940:Breast / Q000473:pathology* / Q000528:radiation effects; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000532:radiotherapy; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D005355:Fibrosis; D006571:Heterocyclic Compounds; D006801:Humans; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000000981:diagnostic imaging; D009942:Organometallic Compounds; D012372:ROC Curve; D011832:Radiation Injuries / Q000175:diagnosis*
D003287:Contrast Media; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; C050823:gadolinium 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetate