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(Radiology. 2000;216:545-553.)
© RSNA, 2000

Breast Imaging

Breast Lesions: Evaluation with Dynamic Contrast-enhanced T1-weighted MR Imaging and with T2*-weighted First-Pass Perfusion MR Imaging1

Kjell A. Kvistad, MD, Jana Rydland, MD, Jari Vainio, MD, Hanne B. Smethurst, MD, Steinar Lundgren, MD, PhD, Hans E. Fjøsne, MD, PhD and Olav Haraldseth, MD, PhD

1 From the MR Center, Medical Division (K.A.K., J.R., J.V., O.H.), Departments of Pathology (H.B.S.), Oncology (S.L.), and Surgery (H.E.F.), Trondheim University Hospital, N-7006, Trondheim, Norway. Received June 29, 1999; revision requested August 11; final revision received December 13; accepted January 11, 2000. Supported by a grant from the Norwegian Cancer Society. Address correspondence to K.A.K. (e-mail: kjell.kvistad@mr.ntnu.no).

PURPOSE: To evaluate the diagnostic value of an imaging protocol that combines dynamic contrast-enhanced T1-weighted magnetic resonance (MR) imaging and T2*-weighted first-pass perfusion imaging in patients with breast tumors and to determine if T2*-weighted imaging can provide additional diagnostic information to that obtained with T1-weighted imaging.

MATERIALS AND METHODS: One hundred thirty patients with breast tumors underwent MR imaging with dynamic contrast-enhanced T1-weighted imaging of the entire breast, which was followed immediately with single-section, T2*-weighted imaging of the tumor.

RESULTS: With T2*-weighted perfusion imaging, 57 of 72 carcinomas but only four of 58 benign lesions had a signal intensity loss of 20% or more during the first pass, for a sensitivity of 79% and a specificity of 93%. With dynamic contrast-enhanced T1-weighted imaging, 64 carcinomas and 19 benign lesions showed a signal intensity increase of 90% or more in the first image obtained after the administration of contrast material, for a sensitivity of 89% and a specificity of 67%.

CONCLUSION: T2*-weighted first-pass perfusion imaging can help differentiate between benign and malignant breast lesions with a high level of specificity. The combination of T1-weighted and T2*-weighted imaging is feasible in a single patient examination and may improve breast MR imaging.

Index terms: Breast neoplasms, diagnosis, 00.311, 00.3115, 00.312, 00.319, 00.321, 00.324, 00.327, 00.329 • Breast neoplasms, MR, 00.121412, 00.12143, 00.12149 • Magnetic resonance (MR), perfusion study, 00.121419, 00.12144




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