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Breast Cancer: Regional Blood Flow and Blood Volume Measured with Magnetic Susceptibility–based MR Imaging—Initial Results¹

¹ From the Department of Radiology, NMR Center (J.P.D., L.G.) and Breast Imaging Center (P.J.S., E.D.Y., D.B.K.), Massachusetts General Hospital and Harvard Medical School, Boston, Mass. Received February 7, 2001; revision requested April 3; revision received August 10; accepted November 30. Supported by the Massachusetts General Hospital NMR Center. Address correspondence to L.G., Instituto de Ciencia y Tecnología de Polímeros, C.S.I.C., Juan de la Cierva 3, 28006 Madrid, Spain (e-mail: lgarrido@cetef.csic.es).

View larger version (35K): [in a new window]   Figure 1. Time course of R2* in several mammary vessels located in planes 5, 11, and 3 through the breast in a 46-year-old woman with invasive ductal carcinoma. The maximum amplitude of the curves was normalized to 1 for comparison of the AIF shape. The time course attributed to a vein in plane 3 (solid line) shows a delay with respect to that observed in arteries at planes 5 (dashed line) and 11 (dashed and dotted line).

View larger version (89K): [in a new window]   Figure 2a. Invasive ductal carcinoma in a 46-year-old subject. (a) High-spatial-resolution MR image of the breast was acquired with a three-dimensional gradient-echo sequence (23/5, 30° flip angle) at 6 minutes after the first administration of contrast agent. FV = feeding vessel, NGT = normal glandular tissue, T = tumor. (b) Time courses of R2* around a feeding vessel to the tumor (a, large and rapid change) and selected areas that correspond to invasive ductal carcinoma (b) and normal glandular tissue (c, very small change) at the locations indicated in a.

View larger version (25K): [in a new window]   Figure 2b. Invasive ductal carcinoma in a 46-year-old subject. (a) High-spatial-resolution MR image of the breast was acquired with a three-dimensional gradient-echo sequence (23/5, 30° flip angle) at 6 minutes after the first administration of contrast agent. FV = feeding vessel, NGT = normal glandular tissue, T = tumor. (b) Time courses of R2* around a feeding vessel to the tumor (a, large and rapid change) and selected areas that correspond to invasive ductal carcinoma (b) and normal glandular tissue (c, very small change) at the locations indicated in a.

View larger version (76K): [in a new window]   Figure 3a. High-spatial-resolution three-dimensional MR images (23/5, 30° flip angle) obtained in the same subject as in Figure 2 depict (a) EF, (b) rTBF, and (c) rTBV. High values of rTBF and rTBV are measured in the region that shows enhancement and high values of EF (50-110 mL/min/100 g). In b, feeding vessels to the tumor (fv T) and normal parenchyma (fv N) are visible in the right breast.

View larger version (82K): [in a new window]   Figure 3b. High-spatial-resolution three-dimensional MR images (23/5, 30° flip angle) obtained in the same subject as in Figure 2 depict (a) EF, (b) rTBF, and (c) rTBV. High values of rTBF and rTBV are measured in the region that shows enhancement and high values of EF (50-110 mL/min/100 g). In b, feeding vessels to the tumor (fv T) and normal parenchyma (fv N) are visible in the right breast.

View larger version (72K): [in a new window]   Figure 3c. High-spatial-resolution three-dimensional MR images (23/5, 30° flip angle) obtained in the same subject as in Figure 2 depict (a) EF, (b) rTBF, and (c) rTBV. High values of rTBF and rTBV are measured in the region that shows enhancement and high values of EF (50-110 mL/min/100 g). In b, feeding vessels to the tumor (fv T) and normal parenchyma (fv N) are visible in the right breast.

View larger version (21K): [in a new window]   Figure 4. Mean rTBV plotted against mean rTBF in tumors and benign breast diseases. There is a clear separation between malignant and other breast lesions.

View larger version (18K): [in a new window]   Figure 5. EF plotted against mean rTBF for all breast diseases (r2 = 0.28, P < .05). The correlation between EF and rTBF for benign lesions () is positive (r2 = 0.66, P < .008). For breast tumors (), EF and rTBF are not correlated (r2 = 0.08, P = .58), which indicates that contrast agent flux in breast tumors is limited by flow and vascular permeability and surface area or by only vascular permeability and surface area.