title: Contrast-enhanced MRI of ductal carcinoma in situ: characteristics of a new intensity-modulated parametric mapping technique correlated with histopathologic findings.
abstract: 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.
authors.affiliation: Department of Radiology, Stanford University Medical Center, Stanford, California, USA.
authors.forename: Michelle N
authors.initials: MN
authors.lastname: Mariano
authors.forename: Maurice A A J
authors.initials: MA
authors.lastname: van den Bosch
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Daniel
authors.forename: Kent W
authors.initials: KW
authors.lastname: Nowels
authors.forename: Robyn L
authors.initials: RL
authors.lastname: Birdwell
authors.forename: Kathy J
authors.initials: KJ
authors.lastname: Fong
authors.forename: Pam S
authors.initials: PS
authors.lastname: Desmond
authors.forename: Sylvia
authors.initials: S
authors.lastname: Plevritis
authors.forename: Lara A
authors.initials: LA
authors.lastname: Stables
authors.forename: Marowan
authors.initials: M
authors.lastname: Zakhour
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Herfkens
authors.forename: Debra M
authors.initials: DM
authors.lastname: Ikeda
mesh_terms: 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
chemical_list: D003287:Contrast Media