Aims and objectives
DCE breast MRI is an advanced imaging technique used to diagnose breast cancer with a reported sensitivity of 95-99% and specificity values of 72% in meta-analysis (1).
However,
breast MRI is a complex time-consuming examination for acquisition time.
Since 2014,
new breast MR protocols named FAST protocols have been developped,
chacterized by only one acquisition after contrast administration.
Many studies have demonstrated that these protocols have a similar sensitivity compared to conventional MRI protocols to detect breast cancer (2-7).
Nevertheless the realization of conventionnal enhancement...
Methods and materials
Population
120 women (mean age = 55 years old (28-88)) who underwent breast MRI between July 18th2016 and March 31th 2017 in whom an abnormal enhancing lesion was identified with subsequent pathological analysis (n=179: 69 benign,
7 borderline,
103 malignant lesions) were retrospectively and consicutively included,
regarless of MRI indication.
MR acquisition (Fig.1)
Patients were imaged in prone position on a 1.5 T GE Optima MR 450w GEM system using a dedicated 8-channel breast array coil (GE,
Milwaukee,
USA).
T1 and T2-weighted non fat-satured axial...
Results
Lesion description
The lesion was a mass in 70% (125/179),
a NME in 27.3% (49/179) and a focus in 2.7% (5/179).
The average lesion size was 18 mm (3-85 mm).
The size of 45/179 (25.1%) lesions was inferior to 10 mm; 49/179 (27.4%) lesions size ranged from 10 to 20 mm,
and 85/179 (47.5%) lesions were larger than 20 mm.
BI-RADS performance on FULL and FAST protocol readings
All cancers were detected on FAST protocol.
FAST protocol showed lower diagnostic performance (AUROC: 0.802) compared to...
Conclusion
Our study demonstrates that ultrafast sequence is useful to distinguish malignant from benign lesions with a shorter time to enhancement for breast carcinoma: a lesion that enhances within the first 31seconds after injection has 5.6 times more risk to be a cancer.
Thesesresults are in line with those previously published (8,10).
ULTRAFAST sequence can not be used alone as 3 breast cancers were missed (2 intra ductal carcinoma and 1 papillary carcinoma) because of a good but not optimal spatial resolution; explaining why we included...
Personal information
Audrey Milon
Service de Radiologie,
Hôpital Tenon,
4 rue de la Chine,
75020,
Paris,
France
Tel.: +33 1 56 01 78 30 / +33 6 76 31 20 83
Fax: +33 1 56 01 64 02
e-mail:
[email protected]
References
1.Peters NH,
Borel Rinkes IH,
Zuithoff NP,
Mali WP,
Moons KG,
Peeters PH.
Meta-analysis of MR imaging in the diagnosis of breast lesions.
Radiology.
2008;246(1):116–124.
2.Kuhl CK,
Schrading S,
Strobel K,
Schild HH,
Hilgers R-D,
Bieling HB.
Abbreviated breast magnetic resonance imaging (MRI): first postcontrast subtracted images and maximum-intensity projection—a novel approach to breast cancer screening with MRI.
Journal of Clinical Oncology.
2014;32(22):2304–2310.
3.Harvey SC,
Di Carlo PA,
Lee B,
Obadina E,
Sippo D,
Mullen L.
An abbreviated protocol for high-risk screening breast MRI saves...