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Published online before print October 23, 2003, 10.1148/radiol.2293021045
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Quantification of Breast Tumor Microvascular Permeability with Feruglose-enhanced MR Imaging: Initial Phase II Multicenter Trial1

Heike E. Daldrup-Link, MD, Jana Rydland, MD, Thomas H. Helbich, MD, Atle Bjørnerud, PhD, Karl Turetschek, MD, Kjell Arne Kvistad, MD, PhD, Elisabeth Kaindl, MD, Thomas M. Link, MD, Karin Staudacher, MS, David Shames, MD, Robert C. Brasch, MD, Olav Haraldseth, MD and Ernst J. Rummeny, MD

1 From the Dept of Radiology, Univ Hosp, Technical Univ of Munich, Ismaningerstr 22, 81675 Munich, Germany (H.E.D.L., T.M.L., E.J.R.); MR-Ctr and Dept of Anaesthesia and Medical Imaging, Norwegian Univ of Science and Technology, Trondheim, Norway (J.R., K.A.K., O.H.); Dept of Radiology, Univ Hosp of Vienna, Austria (T.H.H., K.T., E.K.); Dept of Radiology, Univ Hosp of Oslo, Norway (A.B.); Div of Statistics, Amersham Health, Oslo, Norway (K.S.); and Ctr of Pharmaceutical and Molecular Imaging, Univ of California, San Francisco (D.S., R.C.B.). Received Aug 24, 2002; revision requested Oct 18; final revision received May 23, 2003; accepted May 27. Supported in part by NIH grant RO1 CA82923. Address correspondence to H.E.D.L. (e-mail: daldrup@roe.med.tum.de).



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  		Figure 1. Representative subtracted (postcontrast minus precontrast) T1-weighted gradient-echo MR images (repetition time msec/echo time msec of 14/1.4 with flip angle of 25°) of breast tumors after injection of feruglose. Top row: Benign fibroadenoma (arrow, {blacktriangleup}) in left breast demonstrates enhancement that parallels the blood enhancement curve ({blacksquare}). Middle row: Low-grade carcinoma in right breast. Bottom row: High-grade carcinoma in right breast. In the middle and bottom rows, carcinomas (arrows, {blacktriangleup}) show a steadily increasing contrast enhancement while blood enhancement remains nearly constant. This is indicative of microvascular hyperpermeability to macromolecular feruglose. High-grade cancer shows an even higher enhancement compared with that of low-grade cancer. Normal breast tissue ({bullet}) shows only minor enhancement, which parallels the blood enhancement curve.

 


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  		Figure 2. Representative tumor microvascular permeability (KPS) maps obtained from feruglose-enhanced dynamic gradient-echo MR images (14/1.4 with flip angle of 25°). Top row: Fibroadenoma (arrow) in left breast. Middle row: Low-grade carcinoma (arrow) in left breast. Bottom row: High-grade carcinoma (arrow) in right breast. Benign fibroadenoma demonstrates zero microvascular permeability to macromolecular feruglose. Carcinomas show increased KPS values. Microvascular hyperpermeability to feruglose appears to be characteristic for malignancy.

 




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