title: Comparison of gadobenate dimeglumine-enhanced breast MRI and gadopentetate dimeglumine-enhanced breast MRI with mammography and ultrasound for the detection of breast cancer.
abstract: OBJECTIVE
  To compare gadobenate dimeglumine-enhanced magnetic resonance imaging (MRI) with gadopentetate dimeglumine-enhanced MRI, mammography, and ultrasound for breast cancer detection across different malignant lesion types and across different densities of breast tissue.
  
  
  METHODS
  In all, 153 women with Breast Imaging Reporting and Data System (BI-RADS) 3–5 findings on mammography and/or ultrasound underwent identical breast MRI exams at 1.5T with gadobenate dimeglumine and gadopentetate dimeglumine. Images were evaluated by three independent blinded radiologists. Mammography, ultrasound, and combined mammography and/or ultrasound findings were available for 108, 109, and 131 women. Imaging findings were matched with histology data by a fourth, independent, blinded radiologist. Malignant lesion detection rates and diagnostic performance were compared.
  
  
  RESULTS
  In all, 120, 120, and 140 confirmed malignant lesions were present in patients undergoing MRI+mammography, MRI+ultrasound, and MRI+mammography and/or ultrasound, respectively. Significantly greater cancer detection rates were noted by all three readers for comparisons of gadobenate dimeglumine-enhanced MRI with mammography (Δ15.8–17.5%; P < 0.0001), ultrasound (Δ18.3–20.0%; P < 0.0001), and mammography and/or ultrasound (Δ8.6–10.7%; P ≤ 0.0105) but not for comparisons of gadopentetate dimeglumine-enhanced MRI with conventional techniques (P > 0.05). The false-positive detection rates were lower on gadobenate dimeglumine-enhanced MRI than on conventional imaging (4.0–5.5% vs. 11.1% at mammography; 6.3–8.4% vs. 15.5% at ultrasound). Significantly improved cancer detection on MRI was noted in heterogeneously dense breast (91.2–97.3% on gadobenate dimeglumine-enhanced MRI vs. 77.2–84.9% on gadopentetate dimeglumine-enhanced MRI vs. 71.9-84.9% with conventional techniques) and for invasive cancers (93.2–96.2% for invasive ductal carcinoma [IDC] on gadobenate dimeglumine-enhanced MRI vs. 79.7–88.5% on gadopentetate dimeglumine-enhanced MRI vs. 77.0–84.4% with conventional techniques). Overall diagnostic performance for the detection of cancer was superior on gadobenate dimeglumine-enhanced MRI than on conventional imaging or gadopentetate dimeglumine-enhanced MRI.
  
  
  CONCLUSIONS
  Gadobenate dimeglumine-enhanced MRI significantly improves cancer detection compared to gadopentetate dimeglumine-enhanced MRI, mammography, and ultrasound in a selected group of patients undergoing breast MRI for preoperative staging or because of inconclusive findings at conventional imaging.
authors.forename: Fiona J
authors.initials: FJ
authors.lastname: Gilbert
authors.forename: Harrie C M
authors.initials: HC
authors.lastname: van den Bosch
authors.forename: Antonella
authors.initials: A
authors.lastname: Petrillo
authors.forename: Katja
authors.initials: K
authors.lastname: Siegmann
authors.forename: Johannes T
authors.initials: JT
authors.lastname: Heverhagen
authors.forename: Pietro
authors.initials: P
authors.lastname: Panizza
authors.forename: Hans-Björn
authors.initials: HB
authors.lastname: Gehl
authors.forename: Federica
authors.initials: F
authors.lastname: Pediconi
authors.forename: Felix
authors.initials: F
authors.lastname: Diekmann
authors.forename: Wei-Jun
authors.initials: WJ
authors.lastname: Peng
authors.forename: Lin
authors.initials: L
authors.lastname: Ma
authors.forename: Francesco
authors.initials: F
authors.lastname: Sardanelli
authors.forename: Paolo
authors.initials: P
authors.lastname: Belli
authors.forename: Stefano
authors.initials: S
authors.lastname: Corcione
authors.forename: Christian M
authors.initials: CM
authors.lastname: Zechmann
authors.forename: Matthieu
authors.initials: M
authors.lastname: Faivre-Pierret
authors.forename: Laura
authors.initials: L
authors.lastname: Martincich
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008536:Meglumine / Q000031:analogs & derivatives*; D008875:Middle Aged; D009942:Organometallic Compounds; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016217:Ultrasonography, Mammary / Q000379:methods*
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine; D019786:Gadolinium DTPA