Purpose
Although it is well known that breast magnetic resonance imaging (MRI) examinations should be performed with contrast use (1-5), the sensitivity and specificity of different contrast media in the detection of breast lesions and in image quality is not studied enough up to now. The aim of this study is to investigate the efficacy of 1 molar (containing 1 mol/ml gadobutrol) contrast material in the differentiation of malignant and benign breast lesions with MRI according to contrast uptake curves and patterns of lesion enhancement, with...
Methods and Materials
This prospective study was performed in Radiology Department of Yuzuncu Yil University Hospital between December 2008 and December 2009. Thirty-seven women (age range:22-77 years, mean:43,7 years) with a total of 76 breast lesions of BIRADS category III or higher based on mammographic or sonographic examination were included in this study. MRI examinations were performed with a 1,5 Tesla system (Siemens Symphony, Erlangen, Germany). T2-weighted fatsat turbo spin echo, T1-weighted fatsat 3D FLASH, and axial pre-contrast and dynamic post-contrast images with 0,2 ml/kg gadobutrol (GadovistR, Schering)...
Results
A total of 76 lesions in 37 women were observed on breast MRI examinations. Of the 76 lesions, 20 were malignant and 56 were benign based on MRI findings. Twenty-two of the benign lesions also had histopathologic diagnosis (3 granulomatous mastitis, 11 fibroadenoma, 3 adenosis, 2 papilloma, 1 intramammarian lymph node, 1 post-operative scar tissue and radiation necrosis (Tables 1 and 2).Due to the analysis with Chi-square test, 55,4% of the benign lesions were displaying Type I, 33,9% Type II,and 10,7% Type III contrast-time curve,...
Conclusion
Our study with high dose (0,2 ml/kg) gadobutrol resulted in a high sensitivity of 95%, and a specificity of 55,4% in the diagnosis of malignant breast lesions (p=0.001), where decreased specificity (regarding enhancement pattern) can lead to an increase in false positive results. As far as we are concerned, there is no study in the literature concerning CNR of breast lesions on MRI examinations. In our study using gadobutrol, the significant increase in CNR of malignant breast lesions can help in the diagnosis, even in...
References
1. Kuhl CK. Concepts for differential diagnosis in breast MR imaging. Magn Reson Imaging Clin N Am. 2006. 14(3):305-28.2. Macura KJ, Ouwerkerk R, Jacobs MA, Bluemke DA. Patterns of enhancement on breast MR images: interpretation and imaging pitfalls. RadioGraphics. 2006; 26:1719-34.3.Kvistad KA, Rydland J, Vainio J, Smethurst HB, Lundgren S, Fjosne HE, et al. Breast lesions: evaluation with dynamic contrast-enhanced T1-weighted MR imaging and with T2*-weighted first-pass perfusion MR imaging. Radiology. 2000; 216:545-53.4. Kuhl CK, Mielcareck P, Klaschik S, et al. Dynamic breast MR imaging:...