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Contrast-enhanced MR Imaging of the Breast at 3.0 and 1.5 T in the Same Patients: Initial Experience¹

¹ From the Departments of Radiology (C.K.K., P.J., N.M., H.H.S., J.G.) and Gynecology (O.Z.), University of Bonn, Sigmund-Freud-Str 25, 53105 Bonn, Germany, and Philips Medical Systems, Best, the Netherlands (J.G.). From the 2004 RSNA Annual Meeting. Received March 27, 2005; revision requested May 24; revision received May 26; accepted June 21; final version accepted July 26. Address correspondence to C.K.K. (e-mail: kuhl{at}uni-bonn.de).

View larger version (82K): [in a new window]   Figure 1a: Multicentric ductal invasive cancer in 48-year-old woman. (a) Maximum intensity projection of subtracted images of first postcontrast subtracted acquisition at 1.5-T dynamic MR imaging (2D gradient echo, 290/4.6, 90° flip angle, transverse orientation, 512 x 394 matrix). (b) Maximum intensity projection of subtracted images of first postcontrast subtracted acquisition at 3.0-T dynamic MR imaging (2D gradient echo, 290/2.3, 73° flip angle, transverse orientation, 512 x 512 matrix). Large ductal invasive cancer in the upper inner quadrant (arrow) and smaller lesion in the upper outer quadrant (arrowhead) are seen in a. These lesions plus additional enhancing lesions (arrows) are seen in b.

View larger version (88K): [in a new window]   Figure 1b: Multicentric ductal invasive cancer in 48-year-old woman. (a) Maximum intensity projection of subtracted images of first postcontrast subtracted acquisition at 1.5-T dynamic MR imaging (2D gradient echo, 290/4.6, 90° flip angle, transverse orientation, 512 x 394 matrix). (b) Maximum intensity projection of subtracted images of first postcontrast subtracted acquisition at 3.0-T dynamic MR imaging (2D gradient echo, 290/2.3, 73° flip angle, transverse orientation, 512 x 512 matrix). Large ductal invasive cancer in the upper inner quadrant (arrow) and smaller lesion in the upper outer quadrant (arrowhead) are seen in a. These lesions plus additional enhancing lesions (arrows) are seen in b.

View larger version (131K): [in a new window]   Figure 2a: Fibroadenoma in 49-year-old woman. (a) Dynamic subtraction MR image of first postcontrast acquisition (2D gradient echo, 300/4.6, 90° flip angle, transverse orientation) at 1.5 T. (b) Dynamic subtraction MR image of first postcontrast acquisition (2D gradient echo, 290/2.3, 73° flip angle, transverse orientation) at 3.0 T. Note the enhancing mass in upper outer quadrant (arrow) in a. Lesion shows slightly heterogeneous enhancement, and no other features of internal architecture are visible. Lesion was classified as BI-RADS category 3 owing to its smooth borders, oval shape, and rapid enhancement. Lesion (arrow) is also visible in b; however, dark septations are resolved and visible. Lesion was classified as BI-RADS category 2 at 3.0 T.

View larger version (120K): [in a new window]   Figure 2b: Fibroadenoma in 49-year-old woman. (a) Dynamic subtraction MR image of first postcontrast acquisition (2D gradient echo, 300/4.6, 90° flip angle, transverse orientation) at 1.5 T. (b) Dynamic subtraction MR image of first postcontrast acquisition (2D gradient echo, 290/2.3, 73° flip angle, transverse orientation) at 3.0 T. Note the enhancing mass in upper outer quadrant (arrow) in a. Lesion shows slightly heterogeneous enhancement, and no other features of internal architecture are visible. Lesion was classified as BI-RADS category 3 owing to its smooth borders, oval shape, and rapid enhancement. Lesion (arrow) is also visible in b; however, dark septations are resolved and visible. Lesion was classified as BI-RADS category 2 at 3.0 T.

View larger version (94K): [in a new window]   Figure 3a: Lobular invasive pT1a breast cancer (4 mm) in 52-year-old woman. (a) Dynamic MR image of precontrast acquisition (2D gradient echo, 300/2.3, 72° flip angle, transverse orientation, 1024 x 680 matrix) at 3.0 T. (b) First postcontrast acquisition obtained with same technique as in a. (c) Subtracted image of same acquisition as in b. (d) Close-up view of c. Although the lesion (arrow) is smaller than 5 mm (corresponding to a focus of enhancement according to the BI-RADS lexicon), it is possible to delineate morphologic details, such as spicules.

View larger version (96K): [in a new window]   Figure 3b: Lobular invasive pT1a breast cancer (4 mm) in 52-year-old woman. (a) Dynamic MR image of precontrast acquisition (2D gradient echo, 300/2.3, 72° flip angle, transverse orientation, 1024 x 680 matrix) at 3.0 T. (b) First postcontrast acquisition obtained with same technique as in a. (c) Subtracted image of same acquisition as in b. (d) Close-up view of c. Although the lesion (arrow) is smaller than 5 mm (corresponding to a focus of enhancement according to the BI-RADS lexicon), it is possible to delineate morphologic details, such as spicules.

View larger version (89K): [in a new window]   Figure 3c: Lobular invasive pT1a breast cancer (4 mm) in 52-year-old woman. (a) Dynamic MR image of precontrast acquisition (2D gradient echo, 300/2.3, 72° flip angle, transverse orientation, 1024 x 680 matrix) at 3.0 T. (b) First postcontrast acquisition obtained with same technique as in a. (c) Subtracted image of same acquisition as in b. (d) Close-up view of c. Although the lesion (arrow) is smaller than 5 mm (corresponding to a focus of enhancement according to the BI-RADS lexicon), it is possible to delineate morphologic details, such as spicules.

View larger version (125K): [in a new window]   Figure 3d: Lobular invasive pT1a breast cancer (4 mm) in 52-year-old woman. (a) Dynamic MR image of precontrast acquisition (2D gradient echo, 300/2.3, 72° flip angle, transverse orientation, 1024 x 680 matrix) at 3.0 T. (b) First postcontrast acquisition obtained with same technique as in a. (c) Subtracted image of same acquisition as in b. (d) Close-up view of c. Although the lesion (arrow) is smaller than 5 mm (corresponding to a focus of enhancement according to the BI-RADS lexicon), it is possible to delineate morphologic details, such as spicules.

View larger version (104K): [in a new window]   Figure 4a: Bilateral fibroadenomas in 58-year-old woman. (a, b) Two sections of a dynamic subtraction MR imaging series (first postcontrast acquisition, 2D gradient echo, 300/4.6, 90° flip angle, transverse orientation, 512 x 394 matrix, acquisition time of 110 seconds) at 1.5 T. (c, d) Two sections of postcontrast fat-suppressed T1-weighted spiral-segmented three-dimensional MR image of (c) left and (d) right breasts at 3.0 T (9/2.8, 25° flip angle, 80 sections acquired, 1–2-mm section thickness, 250-mm field of view, 0.5 x 0.5 x 1.0-mm pixel size [noninterpolated], acquisition time of 90 seconds) demonstrate enhancing mass (arrow). In a and b, some motion occurred that degraded the quality of the subtraction images; note the two enhancing masses in the right and left breasts (arrow). Image quality is superior in c and d. Note the strong enhancement of the parenchyma, which is due to the long time interval after contrast material injection, at 3.0 T. Note the excellent visualization of dark septations in c and (to a lesser extent) in d.

View larger version (105K): [in a new window]   Figure 4b: Bilateral fibroadenomas in 58-year-old woman. (a, b) Two sections of a dynamic subtraction MR imaging series (first postcontrast acquisition, 2D gradient echo, 300/4.6, 90° flip angle, transverse orientation, 512 x 394 matrix, acquisition time of 110 seconds) at 1.5 T. (c, d) Two sections of postcontrast fat-suppressed T1-weighted spiral-segmented three-dimensional MR image of (c) left and (d) right breasts at 3.0 T (9/2.8, 25° flip angle, 80 sections acquired, 1–2-mm section thickness, 250-mm field of view, 0.5 x 0.5 x 1.0-mm pixel size [noninterpolated], acquisition time of 90 seconds) demonstrate enhancing mass (arrow). In a and b, some motion occurred that degraded the quality of the subtraction images; note the two enhancing masses in the right and left breasts (arrow). Image quality is superior in c and d. Note the strong enhancement of the parenchyma, which is due to the long time interval after contrast material injection, at 3.0 T. Note the excellent visualization of dark septations in c and (to a lesser extent) in d.

View larger version (131K): [in a new window]   Figure 4c: Bilateral fibroadenomas in 58-year-old woman. (a, b) Two sections of a dynamic subtraction MR imaging series (first postcontrast acquisition, 2D gradient echo, 300/4.6, 90° flip angle, transverse orientation, 512 x 394 matrix, acquisition time of 110 seconds) at 1.5 T. (c, d) Two sections of postcontrast fat-suppressed T1-weighted spiral-segmented three-dimensional MR image of (c) left and (d) right breasts at 3.0 T (9/2.8, 25° flip angle, 80 sections acquired, 1–2-mm section thickness, 250-mm field of view, 0.5 x 0.5 x 1.0-mm pixel size [noninterpolated], acquisition time of 90 seconds) demonstrate enhancing mass (arrow). In a and b, some motion occurred that degraded the quality of the subtraction images; note the two enhancing masses in the right and left breasts (arrow). Image quality is superior in c and d. Note the strong enhancement of the parenchyma, which is due to the long time interval after contrast material injection, at 3.0 T. Note the excellent visualization of dark septations in c and (to a lesser extent) in d.

View larger version (161K): [in a new window]   Figure 4d: Bilateral fibroadenomas in 58-year-old woman. (a, b) Two sections of a dynamic subtraction MR imaging series (first postcontrast acquisition, 2D gradient echo, 300/4.6, 90° flip angle, transverse orientation, 512 x 394 matrix, acquisition time of 110 seconds) at 1.5 T. (c, d) Two sections of postcontrast fat-suppressed T1-weighted spiral-segmented three-dimensional MR image of (c) left and (d) right breasts at 3.0 T (9/2.8, 25° flip angle, 80 sections acquired, 1–2-mm section thickness, 250-mm field of view, 0.5 x 0.5 x 1.0-mm pixel size [noninterpolated], acquisition time of 90 seconds) demonstrate enhancing mass (arrow). In a and b, some motion occurred that degraded the quality of the subtraction images; note the two enhancing masses in the right and left breasts (arrow). Image quality is superior in c and d. Note the strong enhancement of the parenchyma, which is due to the long time interval after contrast material injection, at 3.0 T. Note the excellent visualization of dark septations in c and (to a lesser extent) in d.

View larger version (17K): [in a new window]   Figure 5: RERs for different parameter groups. Columns provide average RERs of lesions in each parameter group. RER of 1 indicates equivalent enhancement at 1.5 and 3.0 T. Note that with a longer repetition time (TR) and lower flip angle (FA), RER is well below 1, indicating that enhancement at 3.0 T remained substantially below the corresponding value at 1.5 T. Note that RER increases with shorter repetition times and higher flip angles. However, even if a shorter repetition time was used, the enhancement rates at 3.0 T were merely equivalent to those recorded at 1.5 T.