title: Washout of mass-like benign breast lesions at dynamic magnetic resonance imaging.
abstract: OBJECTIVE
  This study aimed to estimate the frequency and timing of washout in a series of pathologically proven benign mass-like breast lesions at dynamic magnetic resonance imaging.
  
  
  METHODS
  Institutional review board approval was obtained for this retrospective study. We evaluated enhancement kinetics of 33 pathologically confirmed benign breast lesions: fibroadenomas (n = 22), adenosis (n = 6), typical ductal hyperplasia (n = 2), fibroadenoma with ductal hyperplasia (n = 1), fibrosclerosis (n = 1), and inflammatory lesion (n = 1). Coronal 3-dimensional T1-weighted gradient-echo sequences were acquired before/after intravenous injection of 0.1 mmol/ kg gadoterate meglumine (time resolution, 111 seconds), 1 before and 5 after contrast injection. The time point at which the kinetic curve demonstrated a washout was recorded. Cumulative distribution of lesions showing washout was built. Paired comparisons of specificity for washout kinetics were performed using the McNemar test.
  
  
  RESULTS
  Of 33 lesions, washout was never observed in 20 (61%), whereas 13 (39%) showed washout during the study. Of these 13 lesions, only 1 (inflammatory mass) exhibited washout within the first 3 minutes (specificity, 97%), 9 within 6 minutes (specificity, 73%), and 13 within 8 minutes (specificity, 61%). Specificity of washout kinetics within 3 minutes (97%) was significantly larger than that from the sixth minute (73%) and thereafter (P < 0.016).
  
  
  CONCLUSIONS
  A prolonged observation for dynamic breast magnetic resonance imaging may result in false-positive washout, especially after 6 minutes. Late washout should not be considered a reliable marker of malignancy.
authors.affiliation: Unità di Radiologia, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Penampai
authors.initials: P
authors.lastname: Tannaphai
authors.forename: Rubina Manuela
authors.initials: RM
authors.lastname: Trimboli
authors.forename: Luca Alessandro
authors.initials: LA
authors.lastname: Carbonaro
authors.forename: Sara
authors.initials: S
authors.lastname: Viganò
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Leo
authors.forename: Francesco
authors.initials: F
authors.lastname: Sardanelli
mesh_terms: D000328:Adult; D001940:Breast / Q000473:pathology; D001941:Breast Diseases / Q000175:diagnosis*; D001943:Breast Neoplasms / Q000175:diagnosis; D003287:Contrast Media / Q000493:pharmacokinetics*; D003937:Diagnosis, Differential; D005260:Female; D018226:Fibroadenoma / Q000175:diagnosis; D005348:Fibrocystic Breast Disease / Q000175:diagnosis; D006801:Humans; D006965:Hyperplasia / Q000175:diagnosis; D007089:Image Enhancement / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D058922:Inflammatory Breast Neoplasms / Q000175:diagnosis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008536:Meglumine / Q000493:pharmacokinetics*; D008875:Middle Aged; D009942:Organometallic Compounds / Q000493:pharmacokinetics*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; C072417:gadoterate meglumine