Breast lesions: evaluation with dynamic contrast-enhanced T1-weighted MR imaging and with T2*-weighted first-pass perfusion MR imaging.
OBJECTIVE
To evaluate the diagnostic value of an imaging protocol that combines dynamic contrast-enhanced T1-weighted magnetic resonance (MR) imaging and T2*-weighted first-pass perfusion imaging in patients with breast tumors and to determine if T2*-weighted imaging can provide additional diagnostic information to that obtained with T1-weighted imaging.


METHODS
One hundred thirty patients with breast tumors underwent MR imaging with dynamic contrast-enhanced T1-weighted imaging of the entire breast, which was followed immediately with single-section, T2*-weighted imaging of the tumor.


RESULTS
With T2*-weighted perfusion imaging, 57 of 72 carcinomas but only four of 58 benign lesions had a signal intensity loss of 20% or more during the first pass, for a sensitivity of 79% and a specificity of 93%. With dynamic contrast-enhanced T1-weighted imaging, 64 carcinomas and 19 benign lesions showed a signal intensity increase of 90% or more in the first image obtained after the administration of contrast material, for a sensitivity of 89% and a specificity of 67%.


CONCLUSIONS
T2*-weighted first-pass perfusion imaging can help differentiate between benign and malignant breast lesions with a high level of specificity. The combination of T1-weighted and T2*-weighted imaging is feasible in a single patient examination and may improve breast MR imaging.
MR Center, Medical Division, Trondheim University Hospital, N-7006, Trondheim, Norway. kjell.kvistad@mr.ntnu.no
K A
KA
Kvistad
J
J
Rydland
J
J
Vainio
H B
HB
Smethurst
S
S
Lundgren
H E
HE
Fjøsne
O
O
Haraldseth
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000175:diagnosis*; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis; D003287:Contrast Media / Q000008:administration & dosage; D005188:False Negative Reactions; D005189:False Positive Reactions; D005240:Feasibility Studies; D005260:Female; D018226:Fibroadenoma / Q000175:diagnosis; D005348:Fibrocystic Breast Disease / Q000175:diagnosis; D005500:Follow-Up Studies; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007275:Injections, Intravenous; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008327:Mammography; D008875:Middle Aged; D015588:Observer Variation; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013382:Subtraction Technique; D016217:Ultrasonography, Mammary
D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA