Contrast-enhanced MRI of ductal carcinoma in situ: characteristics of a new intensity-modulated parametric mapping technique correlated with histopathologic findings.
OBJECTIVE
To identify morphologic and dynamic enhancement magnetic resonance imaging (MRI) features of pure ductal carcinoma in situ (DCIS) by using a new intensity-modulated parametric mapping technique, and to correlate the MRI features with histopathologic findings.


METHODS
Fourteen patients with pure DCIS on pathology underwent conventional mammography and contrast-enhanced (CE) MRI using the intensity-modulated parametric mapping technique. The MR images were reviewed and the lesions were categorized according to morphologic and kinetic criteria from the ACR BI-RADS-MRI Lexicon, with BI-RADS 4 and 5 lesions classified as suspicious.


RESULTS
With the use of a kinetic curve shape analysis, MRI classified seven of 14 lesions (50%) as suspicious, including four with initial-rapid/late-washout and three with initial-rapid/late-plateau. Using morphologic criteria, MRI classified 10/14 (71%) as suspicious, with the most prominent morphologic feature being a regional enhancement pattern. Using the intensity modulated parametric mapping technique, MRI classified 12/14 cases (86%) as suspicious. Parametric mapping identified all intermediate- and high-grade DCIS lesions.


CONCLUSIONS
The intensity-modulated parametric mapping technique for breast MRI resulted in the highest detection rate for the DCIS cases. Furthermore, the parametric mapping technique identified all intermediate- and high-grade DCIS lesions, suggesting that a negative MRI using the parametric mapping technique may exclude intermediate- and high-grade DCIS. This finding has potential clinical implications.
Mariano
Michelle N
MN
Department of Radiology, Stanford University Medical Center, Stanford, California, USA.
van den Bosch
Maurice A A J
MA
Daniel
Bruce L
BL
Nowels
Kent W
KW
Birdwell
Robyn L
RL
Fong
Kathy J
KJ
Desmond
Pam S
PS
Plevritis
Sylvia
S
Stables
Lara A
LA
Zakhour
Marowan
M
Herfkens
Robert J
RJ
Ikeda
Debra M
DM
D000328:Adult; D002278:Carcinoma in Situ / Q000473:pathology*; D044584:Carcinoma, Ductal / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies
D003287:Contrast Media