References

 
AJR Am J Roentgenol 2002 Feb;178(2):465-72 Related Articles, Books, LinkOut

MR imaging of extracapsular silicone from breast implants: diagnostic pitfalls.

Berg WA, Nguyen TK, Middleton MS, Soo MS, Pennello G, Brown SL.

Department of Radiology, University of Maryland, University Imaging Center, 419 W. Redwood St., Ste. 110, Baltimore, MD 21201, USA.

OBJECTIVE: We sought to identify pitfalls in recognition of extracapsular silicone on MR imaging. MATERIALS AND METHODS: Three experienced observers reviewed MR images from 359 women with current (n = 320), prior (n = 15), or both current and prior (n = 24) silicone gel implants. Axial and sagittal fast spin-echo T2-weighted images with water suppression, axial inversion-recovery T2-weighted images with water suppression, and axial T2-weighted images with silicone suppression were obtained in a dedicated phased array breast coil on a 1.5-T magnet. Images were reviewed again when only one observer saw extracapsular silicone, and reasons for disagreement were recorded. RESULTS: Rupture was identified in 265 women (77%) with current silicone implants and 378 (55%) of 687 implants. Observers agreed in describing extracapsular silicone in 85 (12%) of 687 breasts with current silicone gel implants, of which 81 (95%) showed definite evidence of rupture on MR imaging. One observer reported extracapsular silicone in another 79 breasts. Confusion over contour deformity due to weakening versus breach of the capsule accounted for 33 (42%) of 79 disagreements. Another 20 (25%) of the 79 disagreements were attributed to poor conspicuity of extracapsular silicone on fast spin-echo T2-weighted images combined with intermittent observer failure to review inversion-recovery images. Subtlety of findings (n = 17, 22%) and technical issues (n = 9, 11%) with failed water suppression of pleural effusion or cysts and ghosting artifacts accounted for remaining disagreements. CONCLUSION: Extracapsular rupture is usually manifest as local spread of silicone in the breast and is not well-depicted on fast spin-echo T2-weighted images. Water-suppressed inversion-recovery T2-weighted images are often needed to identify extracapsular silicone. Distinction of the bulge in the fibrous capsule from herniation through the capsule remains problematic.

PMID: 11804919 [PubMed - indexed for MEDLINE]

 

Semin Roentgenol 2001 Jul;36(3):238-49 Related Articles, Books, LinkOut

Illustrated breast MR lexicon.

Morris EA.

Department of Radiology, Weill Medical College of Cornell University and Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021, USA.

A group of international breast MRI experts is currently working on a definitive lexicon for breast MRI that will incorporate both morphologic and kinetic features of lesions identified on breast MRI. The work to develop the lexicon is supported currently by the American College of Radiology (ACR). This article is aimed at introducing this material and should not be used as a definitive guide as the breast MRI lexicon is a work in progress. It is hoped that radiologists will use the terms and concepts presented here as a template to which future lexicon terminology can be added.
 
PMID: 11475070 [PubMed - in process]
 
J Magn Reson Imaging 2001 Jun;13(6):889-95 Related Articles, Books, LinkOut
Click here to read    http://www3.interscience.wiley.com/cgi-bin/abstract/82002645/START
Development, standardization, and testing of a lexicon for reporting contrast-enhanced breast magnetic resonance imaging studies.

Ikeda DM, Hylton NM, Kinkel K, Hochman MG, Kuhl CK, Kaiser WA, Weinreb JC, Smazal SF, Degani H, Viehweg P, Barclay J, Schnall MD.

Department of Radiology at Stanford University Medical School, 300 Pasteur Drive, Stanford, California 94105-5105, USA. dikeda@stanford.edu

The purpose of this study was to develop, standardize, and test reproducibility of a lexicon for reporting contrast-enhanced breast magnetic resonance imaging (MRI) examinations. To standardize breast MRI lesion description and reporting, seven radiologists with extensive breast MRI experience developed consensus on technical detail, clinical history, and terminology reporting to describe kinetic and architectural features of lesions detected on contrast-enhanced breast MR images. This lexicon adapted American College of Radiology Breast Imaging and Data Reporting System terminology for breast MRI reporting, including recommendations for reporting clinical history, technical parameters for breast MRI, descriptions for general breast composition, morphologic and kinetic characteristics of mass lesions or regions of abnormal enhancement, and overall impression and management recommendations. To test morphology reproducibility, seven radiologists assessed morphology characteristics of 85 contrast-enhanced breast MRI studies. Data from each independent reader were used to compute weighted and unweighted kappa (kappa) statistics for interobserver agreement among readers. The MR lexicon differentiates two lesion types, mass and non-mass-like enhancement based on morphology and geographical distribution, with descriptors of shape, margin, and internal enhancement. Lexicon testing showed substantial agreement for breast density (kappa = 0.63) and moderate agreement for lesion type (kappa = 0.57), mass margins (kappa = 0.55), and mass shape (kappa = 0.42). Agreement was fair for internal enhancement characteristics. Unweighted kappa statistics showed highest agreement for the terms dense in the breast composition category, mass in lesion type, spiculated and smooth in mass margins, irregular in mass shape, and both dark septations and rim enhancement for internal enhancement characteristics within a mass. The newly developed breast MR lexicon demonstrated moderate interobserver agreement. While breast density and lesion type appear reproducible, other terms require further refinement and testing to lead to a uniform standard language and reporting system for breast MRI. J. Magn. Reson. Imaging 2001;13:889-895. Copyright 2001 Wiley-Liss, Inc.

PMID: 11382949 [PubMed - indexed for MEDLINE]

 

 
J Magn Reson Imaging 2001 Jun;13(6):821-9 Related Articles, Books, LinkOut
Click here to read    http://www3.interscience.wiley.com/cgi-bin/abstract/82002384/START
Challenges to interpretation of breast MRI.

Kinkel K, Hylton NM.

Department of Radiology, University of California-San Francisco, San Francisco, California, USA. Karen.Kinkel@hcuge.ch

This review describes the current knowledge and challenges of lesion interpretation with MRI of the breast according to different image interpretation strategies. Particular emphasis is given to patient- and tumor-related factors that influence image interpretation. The impacts of the menstrual cycle, prior surgery, radiation therapy, and chemotherapy are summarized. Particular enhancement features of ductal carcinoma in situ (DCIS) or invasive lobular carcinoma are described. Finally, an adequate diagnosis at MRI of the breast should take into account the results of the patient's history, physical examination, and all imaging tests performed before MRI. J. Magn. Reson. Imaging 2001;13:821-829. Copyright 2001 Wiley-Liss, Inc.

Publication Types:
PMID: 11382939 [PubMed - indexed for MEDLINE]

 

 
AJR Am J Roentgenol 2001 May;176(5):1249-54 Related Articles, Books, LinkOut

Incidental enhancing lesions found on MR imaging of the breast.

Brown J, Smith RC, Lee CH.

Department of Diagnostic Radiology, Yale University School of Medicine, 333 Cedar St., New Haven, CT 06520, USA.

OBJECTIVE: This study was undertaken to determine the frequency and significance of foci of enhancement having no corresponding mammographic or clinical abnormality that are encountered on MR imaging of the breast performed to evaluate mammograms with equivocal findings. MATERIALS AND METHODS: Reports from MR examinations of 103 patients who underwent MR imaging of the breast to evaluate questionable mammographic findings were retrospectively reviewed. We identified cases that had focal enhancing lesions without a corresponding mammographic or palpable abnormality. Clinical history, mammograms, MR images, and follow-up information were reviewed. RESULTS: Of the 103 patients, 30 (29%) had incidental foci of enhancement. These women were significantly younger, more often premenopausal, and more likely to have dense breasts than those who did not have incidental foci. Tissue confirmation of the incidental foci was available for seven patients, mammographic follow-up was available for a mean interval of 22 months for 22 patients, and no follow-up was available for one. Cancer at the incidental sites was diagnosed in one of the 30 patients with multiple foci. She was also shown to have cancer at the site originally questioned mammographically (index site). None of the remaining patients has had a diagnosis of malignancy at the incidental sites. CONCLUSION: Incidental enhancing foci are common in women undergoing breast MR imaging for questionable findings on mammography, occurring in 29% of our patients. Our results suggest that unless malignancy is diagnosed elsewhere in the breast, these incidental foci are unlikely to be malignant.

PMID: 11312189 [PubMed - indexed for MEDLINE]

 

 
AJR Am J Roentgenol 2001 Feb;176(2):399-406 Related Articles, Books, LinkOut

MR imaging of the breast in patients with invasive lobular carcinoma.

Weinstein SP, Orel SG, Heller R, Reynolds C, Czerniecki B, Solin LJ, Schnall M.

Department of Radiology, The University of Pennsylvania Medical Center, 1 Silverstein Bldg., 3400 Spruce St., Philadelphia, PA 19104, USA.

OBJECTIVE: Our objective was to assess the usefulness of MR imaging in patients diagnosed with invasive lobular carcinoma of the breast. MATERIALS AND METHODS: Between July 1993 and September 1999, 32 women (33 cases) diagnosed with pure invasive lobular carcinoma of the breast underwent contrast-enhanced MR imaging examination. One woman was excluded because of lack of follow-up. Correlation was made between the mammographic and sonographic findings, the MR imaging findings, and the final pathology results for the remaining 32 cases. RESULTS: In 18 women who did not undergo excisional biopsy before the MR imaging, MR imaging showed more extensive tumor burden or the detection of the primary lesion that was occult on conventional imaging in seven (38.9%) of 18 women. In nine (50%) of 18 women, MR imaging performed equally as well as mammography and sonography. In one case (5.6%), MR imaging and mammography underestimated disease extent. In another patient (5.6%), MR imaging overestimated tumor burden, although mammography failed to show the cancer. In 14 patients who had excisional biopsy before the MR imaging, residual tumor was shown in eight women (57.1%) with extensive tumor or additional separate foci in five of the eight patients. In two cases (14.3%) that were interpreted as equivocal, residual tumor was shown in both cases on reexcision. In three cases (21.4%), the MR imaging was interpreted as negative, but microscopic tumor was shown around seroma on reexcision. False-positive enhancement was seen in one case (7.1%). CONCLUSION: MR imaging showed more extensive tumor than conventional imaging and affected the clinical management in 16 (50%) of 32 patients with invasive lobular carcinoma.

PMID: 11159081 [PubMed - indexed for MEDLINE]

 

 
J Magn Reson Imaging 2000 Dec;12(6):975-83 Related Articles, Books, LinkOut
Click here to read    http://www3.interscience.wiley.com/cgi-bin/abstract/76500638/START
Magnetic resonance imaging of breast cancer: clinical indications and breast MRI reporting system.

Ikeda DM, Baker DR, Daniel BL.

Department of Radiology, Stanford University Medical School, Stanford, California 94105-5105, USA. dikeda@stanford.edu

Magnetic resonance imaging (MRI) is well suited to the investigation of breast cancer by virtue of its noninvasive nature and its multiplanar imaging abilities. MRI investigations showed high sensitivity but modest specificity for breast cancer detection and diagnosis. Most early studies tested the ability of MRI to evaluate and diagnose findings in the breast discovered by other imaging tests or by breast physical examination (1-4). When it was discovered that MRI identified small breast cancers undetected by mammography or breast ultrasound, MRI was used to estimate breast cancer extent in known cancer cases for surgical planning (5,6). These investigations led to the use of MRI in a multitude of breast imaging applications, raising further questions about the use of MRI in everyday practice: What are the indications for breast MRI in general practice? What is its role in light of other imaging tests? What are its benefits and limitations in each setting? How do I report these studies? The purpose of this article is to review the clinical background regarding indications for the use of MRI and relevant cases in which MRI can impact patient management in breast disease, and to describe new developments in reporting breast MRI studies. J. Magn. Reson. Imaging 2000;12:975-983. Copyright 2000 Wiley-Liss, Inc.

Publication Types:
PMID: 11105039 [PubMed - indexed for MEDLINE]

 

 
J Magn Reson Imaging 2000 Dec;12(6):965-74 Related Articles, Books, LinkOut
Click here to read    http://www3.interscience.wiley.com/cgi-bin/abstract/76500663/START
Dynamic image interpretation of MRI of the breast.

Kuhl CK, Schild HH.

Department of Radiology, University of Bonn, Bonn, Germany. kuhl@uni-bonn.de

Dynamic breast MRI provides information on both lesion cross-sectional morphology and functional lesion features such as vascularity/perfusion and vessel permeability. This review gives an overview of the historical background of dynamic contrast-enhanced breast MRI. It explains the technique's pathophysiological basis, describes the various technical approaches that have been pursued and the corresponding interpretation guidelines that have been proposed (including their respective diagnostic accuracies), and presents established and evolving clinical applications of the "dynamic approach" to breast MRI. J. Magn. Reson. Imaging 2000;12:965-974. Copyright 2000 Wiley-Liss, Inc.

Publication Types:
PMID: 11105038 [PubMed - indexed for MEDLINE]

 

 
AJR Am J Roentgenol 2000 Jul;175(1):35-43 Related Articles, Books, LinkOut

Dynamic high-spatial-resolution MR imaging of suspicious breast lesions: diagnostic criteria and interobserver variability.

Kinkel K, Helbich TH, Esserman LJ, Barclay J, Schwerin EH, Sickles EA, Hylton NM.

Division of Radiology, Magnetic Resonance Science Center, University of California, San Francisco 94143-1290, USA.

OBJECTIVE: Our study was undertaken to develop diagnostic rules and to assess the reproducibility of dynamic and morphologic parameters for the characterization of suspicious breast lesions using dynamic high-spatial-resolution MR imaging. MATERIALS AND METHODS: Fifty-seven patients with suspicious mammographic or palpable findings underwent preoperative contrast-enhanced MR imaging of the breast using a three-time-point method of acquisition. Each lesion was prospectively analyzed by two independent radiologists for morphologic and visual dynamic enhancement characteristics. A classification and regression tree was used to examine the optimal order, cutoff points, and combination of imaging parameters to build a diagnostic rule separating benign from malignant lesions using histopathology findings as the standard of reference. Kappa statistics were used to determine observer variability. RESULTS: Among 23 benign and 34 malignant lesions (12 invasive, three ductal carcinoma in situ, and 19 mixed cancer), margin morphology (p = 0.001) and enhancement pattern (p = 0.001) were the most significant MR imaging findings for lesion characterization. Focal mass lesions were classified as malignant when spiculated margins or both the washout enhancement pattern and "nonsmooth" margins were present. Interobserver agreement was almost perfect for washout pattern and substantial for margin assessment. In the limited population tested retrospectively, the diagnostic rule yielded a sensitivity and positive predictive value of 97% each and a specificity and negative predictive value of 96% each. CONCLUSION: The washout enhancement pattern combined with lesion margin assessment on dynamic contrast-enhanced high-resolution MR imaging of the breast allows reproducible lesion characterization and may be a highly specific diagnostic tool.

PMID: 10882243 [PubMed - indexed for MEDLINE]

 

 
Br J Radiol 2000 Jun;73(870):665-71 Related Articles, Books, LinkOut
  
Pitfalls of breast MRI.

Coulthard A, Potterton AJ.

Department of Radiology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.

This article reviews some of the common pitfalls associated with breast MRI. Pitfalls can be broadly considered as "technical" (relating to patient factors or machine factors, which can influence image interpretation) or "non-technical" (relating to misinterpretation of imaging findings in the absence of technical problems). Awareness of potential pitfalls is important if MRI is to maximize its potential in breast imaging.

Publication Types:
PMID: 10911793 [PubMed - indexed for MEDLINE]

 

 
J Magn Reson Imaging 2000 Jun;11(6):601-6 Related Articles, Books, LinkOut
Click here to read    http://www3.interscience.wiley.com/cgi-bin/abstract/72504064/START
Correlation of high-resolution breast MR imaging with histopathology; validation of a technique.

Holland AE, Hendrick RE, Jin H, Russ PD, Barentsz JO, Holland R.

Department of Radiology, University Hospital Nijmegen, 6500 HB Nijmegen, The Netherlands. agnes_holland@hotmail.com

A high-resolution three-dimensional surface gradient coil set was used to obtain magnetic resonance (MR) images of breast specimens, using a gradient-echo pulse sequence (TR/TE 1000/8 msec, flip angle 75 degrees), with 117 micrometer in-plane resolution and 1 mm slice thickness. Breast tissues were obtained from one autopsy and three surgical specimens. High-resolution breast MR images and histopathology sections (7 micrometer thickness) were acquired in the same anatomical plane. Radiographs were acquired of the sliced specimens (approximately 5 mm thick) so that images from all three methods could be correlated. It was found that in vitro high-resolution breast MRI correlated well with low-resolution microscopic histology, demonstrating normal anatomy (lobules, ducts, connective tissue strands, blood vessels) and pathology (tumor content, margins, and presence of microcalcifications) of the breast more clearly than conventional pre-gadolinium breast MRI. High-resolution breast MRI may improve specificity, when added to a conventional breast MRI protocol. Copyright 2000 Wiley-Liss, Inc.

PMID: 10862058 [PubMed - indexed for MEDLINE]

 

 
Radiology 1999 Aug;212(2):543-9 Related Articles, Books, LinkOut
Click here to read
Breast MR imaging in patients with axillary node metastases and unknown primary malignancy.

Orel SG, Weinstein SP, Schnall MD, Reynolds CA, Schuchter LM, Fraker DL, Solin LJ.

Department of Radiology, University of Pennsylvania Medical Center, Philadelphia 19104, USA. orel@oasis.rad.upenn.edu

PURPOSE: To assess the usefulness of magnetic resonance (MR) imaging of the breast in patients with malignant axillary adenopathy and unknown primary malignancy. MATERIALS AND METHODS: Between October 1993 and December 1997, 38 women with malignant axillary adenopathy and negative mammographic and physical examination findings underwent contrast material-enhanced MR imaging. Sixteen patients were excluded due to axillary tail cancer (n = 7), lack of follow-up (n = 4), second primary malignancy (n = 3), or chemotherapy before MR imaging (n = 2). The study population comprised the remaining 22 patients. Histopathologic findings were available in 20 patients; follow-up MR imaging findings were available in two patients. RESULTS: MR imaging depicted a primary breast cancer in 19 patients (86%; identified at excisional biopsy or mastectomy in 17, resolved on follow-up MR images during treatment in two). MR imaging depicted 4-30-mm cancers (mean, 17 mm), which correlated closely with histopathologic size. Two patients (9%) had false-negative findings: (a) One had a 2-mm invasive ductal carcinoma, and (b) one had 17- and 20-mm invasive ductal carcinomas. Of the 19 patients, 11 underwent mastectomy, seven underwent breast-conservation therapy, and one did not undergo a surgical procedure. CONCLUSION: MR imaging is very sensitive for the detection of mammographically and clinically occult breast cancer in patients with malignant axillary adenopathy. In these patients, MR imaging offers potential not only for cancer detection but also for staging the cancer within the breast, which may be useful for treatment planning.

PMID: 10429716 [PubMed - indexed for MEDLINE]

 

 
Radiology 1999 Apr;211(1):101-10 Related Articles, Books, LinkOut
Click here to read    http://radiology.rsnajnls.org/cgi/content/full/211/1/101
Dynamic breast MR imaging: are signal intensity time course data useful for differential diagnosis of enhancing lesions?

Kuhl CK, Mielcareck P, Klaschik S, Leutner C, Wardelmann E, Gieseke J, Schild HH.

Department of Radiology, University of Bonn, Germany.

PURPOSE: To assess the relevance of the signal intensity time course for the differential diagnosis of enhancing lesions in dynamic magnetic resonance (MR) imaging of the breast. MATERIALS AND METHODS: Two hundred sixty-six breast lesions were examined with a two-dimensional dynamic MR imaging series and subtraction postprocessing. Time-signal intensity curves of the lesions were obtained and classified according to their shapes as type I, which was steady enhancement; type II, plateau of signal intensity; or type III, washout of signal intensity. Enhancement rates and curve types of benign and malignant lesions were compared. RESULTS: There were 101 malignant and 165 benign lesions. The distribution of curve types for breast cancers was type I, 8.9%; type II, 33.6%; and type III, 57.4%. The distribution of curve types for benign lesions was type I, 83.0%; type II, 11.5%; and type III, 5.5%. The distributions proved significantly different (chi 2 = 139.6; P < .001). The diagnostic indices for signal intensity time course were sensitivity, 91%; specificity, 83%; and diagnostic accuracy, 86%. The diagnostic indices for the enhancement rate were sensitivity, 91%; specificity, 37%; and diagnostic accuracy, 58%. CONCLUSION: The shape of the time-signal intensity curve is an important criterion in differentiating benign and malignant enhancing lesions in dynamic breast MR imaging. A type III time course is a strong indicator of malignancy and is independent of other criteria.

Publication Types:
PMID: 10189459 [PubMed - indexed for MEDLINE]

 

 

J Magn Reson Imaging 1999 Feb;9(2):187-96 Related Articles, Books, LinkOut
Click here to read    http://www3.interscience.wiley.com/cgi-bin/abstract/55001010/START
Do T2-weighted pulse sequences help with the differential diagnosis of enhancing lesions in dynamic breast MRI?

Kuhl CK, Klaschik S, Mielcarek P, Gieseke J, Wardelmann E, Schild HH.

Department of Radiology, University of Bonn, Germany. kuhl@uni-bonn.de

In this study, our purpose was to determine whether T2-weighted images are a useful diagnostic adjunct for lesion characterization in dynamic breast MRI. On a 1.5-T system, 205 enhancing benign and malignant breast tumors were examined. The standardized protocol consisted of a T2-weighted turbo spin echo (TSE) pulse sequence with and without spectral fat suppression (SPIR), followed by a two-dimensional dynamic series with subtraction postprocessing. In 59 cases, T2*-weighted gradient-echo images also were obtained. Two independent radiologists visually rated the lesions (101 malignant, 104 benign) as having either a low or a high signal with respect to the adjacent glandular tissue. To assess age dependency of lesion enhancement velocities and T2-TSE signal intensities, we compared the results for patients at or below the age of 50 (group A), between 40 and 50 (group B), and beyond the age of 50 (group C). In T2-weighted TSE images, breast cancers were iso- or hypointense with respect to breast parenchyma in 87% of cases, whereas fibroadenomas were hyperintense in 71%. Visual assessment of lesion appearance in T2-weighted TSE images allowed to distinguish between fibroadenomas and breast cancers, with a respective sensitivity, specificity, positive predictive value, and negative predictive value of 72%, 75%, 46%, and 90% for young patients; 94%, 66%, 78%, and 89% for the patients between 40 and 50; and 89%, 62%, 85%, and 68% for the patients over 50 years of age. No significant difference was found for the distribution of signal intensities of lesions in T2*-weighted images or in fat-suppressed images. In a contrast-enhancing breast lesion, careful analysis of T2-weighted TSE images can improve differential diagnosis. The accuracy of this criterion varies with age.

PMID: 10077012 [PubMed - indexed for MEDLINE]

 

 
Radiology 1997 Jul;204(1):123-9 Related Articles, Books, LinkOut

Fibroadenomas: MR imaging appearances with radiologic-histopathologic correlation.

Hochman MG, Orel SG, Powell CM, Schnall MD, Reynolds CA, White LN.

Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.

PURPOSE: To identify histopathologic correlates for the varied magnetic resonance (MR) imaging appearances of fibroadenomas. MATERIALS AND METHODS: Twenty-three fibroadenomas in 21 patients (aged 23-66 years) examined with gadolinium-enhanced MR imaging were graded for signal intensity on T2-weighted images, contrast material enhancement, shape, and internal septations and were correlated with histopathologic findings. RESULTS: Fibroadenomas demonstrated high T2 signal intensity with enhancement (n = 11), low T2 signal intensity with enhancement (n = 3), or low T2 signal intensity without enhancement (n = 9). Low T2 signal intensity and lack of enhancement were associated with more sclerotic stroma and older patient age. Lesion shape was lobular, oval, or round in 19 of 23 fibroadenomas (83%). Internal septations were identified within nine of 14 enhancing fibroadenomas (64%) and appeared to correlate with collagenous bands at histopathologic analysis. CONCLUSION: Fibroadenomas demonstrate marked histopathologic variability. The resultant variability in the MR appearance limits the ability to distinguish between benign and malignant masses on the basis of signal intensity and enhancement alone. Lobulation and internal septation, which appear to reflect intrinsic growth patterns of fibroadenomas, may provide a more reliable basis for distinction.

PMID: 9205233 [PubMed - indexed for MEDLINE]

 

 
AJR Am J Roentgenol 1997 May;168(5):1331-4 Related Articles, Books, LinkOut

The variability of fibroadenoma in contrast-enhanced dynamic MR mammography.

Brinck U, Fischer U, Korabiowska M, Jutrowski M, Schauer A, Grabbe E.

Department of Pathology, Georg-August-University Goettingen, Germany.

PMID: 9129437 [PubMed - indexed for MEDLINE]

 

 
Radiology 1996 Nov;201(2):427-32 Related Articles, Books, LinkOut

Three-dimensional RODEO breast MR imaging of lesions containing ductal carcinoma in situ.

Soderstrom CE, Harms SE, Copit DS, Evans WP, Savino DA, Krakos PA, Farrell RS Jr, Flamig DP.

Department of Radiology, Baylor University Medical Center, Dallas, Tex., USA.

PURPOSE: To assess whether rotating delivery of excitation off resonance (RODEO) breast magnetic resonance (MR) imaging can help detect ductal carinoma in situ (DCIS) lesions, determine tumor extent, and differentiate pure DCIS from DCIS with an invasive component. MATERIALS AND METHODS: Twenty-two patients with DCIS lesions were evaluated with three-dimensional RODEO MR imaging. Nineteen patients had available mammograms for review. RESULTS: MR imaging enabled detection of all 22 cases of DCIS, DCIS with microinvasion, or invasive ductal carcinoma with extensive intraductal component. A clumped enhancement pattern was seen on MR images in all cases of pure DCIS. Spiculated enhancement was seen in four of six (67%) patients who had DCIS with microinvasion and in nine of 11 (82%) who had invasive ductal carcinoma with extensive intraductal component. RODEO MR imaging enabled accurate determination of tumor extent in 21 of 22 (95%) patients. Mammography depicted 18 of 19 DCIS lesions. No mammographic feature helped differentiate pure DCIS from DCIS with microinvasion. Mammography enabled accurate determination of tumor extent in 14 of 19 (74%) patients. CONCLUSION: Three-dimensional RODEO MR imaging can be an adjunct to mammography because of its ability to enable better determination of tumor extent and differentiation of pure DCIS from DCIS with an invasive component.

PMID: 8888235 [PubMed - indexed for MEDLINE]

 

 
AJR Am J Roentgenol 1996 Aug;167(2):539-40 Related Articles, Books, LinkOut

Mucinous carcinoma of the breast: potential false-negative MR imaging interpretation.

Miller RW, Harms S, Alvarez A.

Publication Types:
PMID: 8686654 [PubMed - indexed for MEDLINE]

 

 
Radiology 1995 Sep;196(3):593-610 Related Articles, Books, LinkOut

MR imaging of the breast.

Weinreb JC, Newstead G.

Department of Radiology, New York University Medical Center, NY 10016, USA.

Studies suggest that magnetic resonance (MR) imaging may have a variety of roles in the detection and management of breast disease. However, because study methods and imaging techniques are not standard, there is still a great deal of uncertainty about its place in clinical practice. The authors review the current state of breast MR imaging and address a number of issues, including the basis for contrast material-enhanced imaging, techniques, and possible clinical roles, including treatment planning, evaluation of the posttreatment breast, evaluation of breast implants, characterization of breast masses, MR imaging-guided biopsy, and the potential for cancer screening. Although it is premature to recommend the routine use of breast MR imaging, contrast-enhanced MR imaging has potential as a comprehensive platform for the detection, localization, biopsy, and treatment of breast cancers.

Publication Types:
PMID: 7644617 [PubMed - indexed for MEDLINE]

 

 
AJR Am J Roentgenol 1986 Jan;146(1):119-25 Related Articles, Books, LinkOut

Magnetic resonance imaging in the diagnosis of breast disease.

Dash N, Lupetin AR, Daffner RH, Deeb ZL, Sefczek RJ, Schapiro RL.

Magnetic resonance imaging (MRI) of the breast was performed in 10 volunteers and 102 women with suspected breast disease, using a 0.35-T superconducting magnet. All patients had prior x-ray mammography. MRI was superior to mammography in differentiating solid from cystic lesions and equivalent to mammography in providing information regarding different parenchymal patterns. Of 21 surgically proven carcinomas of the breast, MRI correctly identified 18 and mammography identified 19. The major disadvantage of MRI is its inability to show calcifications, benign or malignant. Future studies will be needed to show the relative values of sonography and MRI in detecting small cysts. In addition, MRI in future should be able to demonstrate small, noncalcified masses in mammographically dense, fibrocystic breasts.

PMID: 3484399 [PubMed - indexed for MEDLINE]