title: MR imaging-detected breast lesions: histopathologic correlation of lesion characteristics and signal intensity data.
abstract: OBJECTIVE
  The aim of our study was to differentiate benign from malignant breast lesions that had been detected exclusively on MR imaging by analyzing qualitative and quantitative lesion characteristics.
  
  
  METHODS
  We performed 51 MR imaging-guided breast interventions (41 preoperative lesion localizations and 10 large-core needle biopsies) in 45 patients with exclusively MR imaging-detected lesions. All patients had previously undergone diagnostic dynamic contrast-enhanced MR imaging of the breast with a double breast coil at 1.0 T (n = 36) or 1.5 T (n = 15). The diagnostic MR images were evaluated on a workstation. Lesion morphology (size, shape, margin type, enhancement pattern), signal intensity parameters (time to peak enhancement, maximum slope of enhancement curve, washout, relative water content), and scores analogous to the Breast Imaging Reporting and Data System (BI-RADS) categories were correlated with histology.
  
  
  RESULTS
  Histology revealed malignancy in 37.3% (19/51) of the lesions. The positive predictive value for malignancy of exclusively MR imaging-detectable lesions increased as the analogous BI-RADS category increased. Late inhomogeneous contrast enhancement was the only morphologic criterion that was statistically significantly correlated with malignancy. Malignant and benign lesions did not differ significantly in any of the quantitatively evaluated signal intensity parameters. Carcinomas showed a tendency toward faster and stronger enhancement and stronger washout.
  
  
  CONCLUSIONS
  The classification of exclusively MR imaging-detectable breast lesions according to a combination of morphologic and perfusion parameters including the late enhancement pattern helps identify the lesions for which interventional MR imaging is required. Quantitative signal intensity data alone do not suffice.
authors.affiliation: Department of Diagnostic Radiology, University Hospital Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany.
authors.forename: Katja C
authors.initials: KC
authors.lastname: Siegmann
authors.forename: Markus
authors.initials: M
authors.lastname: Müller-Schimpfle
authors.forename: Fritz
authors.initials: F
authors.lastname: Schick
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Remy
authors.forename: Nikos
authors.initials: N
authors.lastname: Fersis
authors.forename: Peter
authors.initials: P
authors.lastname: Ruck
authors.forename: Corinna
authors.initials: C
authors.lastname: Gorriz
authors.forename: Claus D
authors.initials: CD
authors.lastname: Claussen
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged