[Can follow-up controls improve the accuracy of MR mammography? A retrospective analysis of MR mammography follow-up studies].
OBJECTIVE
To assess the change in diagnostic confidence between first and follow-up dynamic MR examination of the breast (MRM).


METHODS
The reports of a total of 175 MRM in 77 patients (mean age 50 years; 36-76) with 98 follow-up MRM were analyzed. All examinations were performed as a dynamic study (Gd-DTPA, 0.16 mmol/kg; 6-7 repetitive studies). The change in diagnostic confidence was retrospectively classified as follows: controlled lesion vanished during follow-up (category I); diagnostic confidence increases during follow-up (II), more likely benign (IIa), more suspicious (IIb); no difference in diagnostic confidence (III). Long-term follow-up over an average of four years was obtained for 57 patients with category IIa/III findings.


RESULTS
In 98 follow-up examinations, only two lesions vanished (2%). In 77/98 cases a category IIa lesion was diagnosed, in 11 cases a category IIb lesion. In 8 cases (8%) there was no change in diagnostic confidence during follow-up. Lesions in category IIb underwent biopsy in 10/11 cases, in one case long-term follow-up proved a completely regredient inflammatory change. In 8/11 suspicious findings (IIb) a malignant tumor was detected. The mean time interval between first and follow-up MRM was 8 months for I-IIb lesions, and 4 months for category III lesions. In the long-term follow-up two patients with a category IIa lesion developed a carcinoma in a different breast area after four and five years.


CONCLUSIONS
MRM follow up increases the diagnostic confidence if the time interval is adequate (> 4 months). A persistently or increasingly suspicious finding warrants biopsy.
Abteilung für Radiologische Diagnostik, Universitätsklinik, Universitätsklinikum Tübingen. abetsch@aol.com
A
A
Betsch
E
E
Arndt
W
W
Stern
D
D
Wallwiener
C D
CD
Claussen
M
M
Müller-Schimpfle
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008327:Mammography; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010173:Palpation; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors; D014463:Ultrasonography
D003287:Contrast Media; D019786:Gadolinium DTPA