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(Radiology. 2001;220:13-30.)
© RSNA, 2001

State of the Art

MR Imaging of the Breast for the Detection, Diagnosis, and Staging of Breast Cancer1

Susan G. Orel, MD and Mitchell D. Schnall, MD

1 From the Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104. Received June 12, 2000; revision requested July 17; revision received September 14; accepted October 2. Address correspondence to S.G.O. (e-mail: orel@oasis.rad.upenn.edu).

With the introduction of contrast agents, advances in surface coil technology, and development of new imaging protocols, contrast agent–enhanced magnetic resonance (MR) imaging has emerged as a promising modality for detection, diagnosis, and staging of breast cancer. The reported sensitivity of MR imaging for the visualization of invasive cancer has approached 100%. There are many examples in the literature of MR imaging–demonstrated mammographically, sonographically, and clinically occult breast cancer. Often, breast cancer detected on MR images has resulted in a change in patient care. Despite these results, there are many unresolved issues, including no defined standard technique for contrast-enhanced breast MR imaging, no standard interpretation criteria for evaluating such studies, no consensus on what constitutes clinically important enhancement, and no clearly defined clinical indications for the use of MR imaging. Furthermore, this technology remains costly, and issues of cost-effectiveness and cost competition from percutaneous biopsy have yet to be fully addressed. These factors along with the lack of commercially available MR imaging–guided localization and biopsy systems have slowed the transfer of this imaging technology from research centers to clinical breast imaging practices. Technical requirements, potential clinical applications, and potential pitfalls and limitations of contrast-enhanced MR imaging as a method to help detect, diagnose, and stage breast cancer will be described.

Index terms: Breast, MR, 00.121411, 00.121412, 00.121415, 00.12143 • Breast neoplasms, diagnosis, 00.31, 00.32, 00.81 • Breast neoplasms, MR, 00.121411, 00.121412, 00.121415, 00.12143 • Breast neoplasms, staging • State of the Art




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