An interpretation model that incorporates breast MR architectural features can achieve high sensitivity and improve specificity for diagnosing breast cancer.

Additional investigation yielded a slightly modified model, but the diagnostic performance characteristics remain high, similar to those originally published.

No abstract

An interpretation model for evaluating magnetic resonance (MR) images of the breast was constructed that allowed differentiation of benign from malignant palpable or mammographically visible abnormalities. Architectural features define each node of the model. Investigation was subsequently made of the histologic findings in individuals within each node and of the frequency with which each histologic finding manifested as a particular architectural feature to determine whether nodal location and specific histologic findings are mutually predictive. The strongest associations were found between fibrocystic change and smooth masses, fibroadenoma and lobulated masses with nonenhancing internal septations, invasive ductal carcinoma (with or without ductal carcinoma in situ [DCIS]) and enhancing irregular or spiculated masses, invasive tubular carcinoma or radial scar and spiculated masses, medullary or colloid carcinoma and enhancing lobulated masses, invasive lobular carcinoma and the absence of a focal mass, DCIS and ductal enhancement, and DCIS (with or without invasive ductal carcinoma) and regional enhancement. Nodal location and histologic findings proved to be mutually predictive within the model; that is, the nodal location of MR imaging features within the model can be used to predict histologic findings and vice versa.

No abstract

No abstract

No abstract

A simultaneous bilateral back-projection method for 3D dynamic contrast-enhanced (DCE)-MRI of the breasts was developed and evaluated. Using a double-side band modulation of the RF slab excitation pulse, discontinuous volumes that included both breasts were simultaneously selected. The number of slice phase-encoding steps was undersampled by a factor of 2, and the resulting signal aliasing from one volume to the other was removed using SENSE processing. In-plane encoding was performed with an interleaved radial acquisition reconstructed using dynamic k-space-weighted image contrast (KWIC) temporal filtering. Image resolution was 0.5 ؋ 0.5 ؋ 3.0 mm 3 with an effective temporal resolution of 15 s for both breast volumes. Combined with the 2؋ acceleration from SENSE encoding, this is a 16؋ acceleration factor over a conventional MR bilateral breast scan. An initial evaluation of these methods was performed on a cohort of women who presented with palpable or mammographically visible breast abnormalities. A total of 73 abnormalities were found in 45 of the 54 bilateral examinations that were performed. In 11 of these cases there was a significant finding in the contralateral breast. Dynamic contrast-enhanced (DCE)-MRI of the breast has shown promising results for detecting breast abnormalities (1-4). The architectural features that are visible after enhancement have a high correlation to cancer (5,6), and the enhancement dynamics have also been shown to be highly correlated to benign or malignant lesions (7). Combined interpretations have been shown to improve diagnostic performance compared to that achieved by separate approaches (8 -10). However, even for a unilateral breast study, it is difficult to simultaneously acquire both highspatial-resolution data for architectural analysis and hightemporal-resolution data for contrast kinetic classification because of the different demands involved. The high-resolution images that are necessary to distinguish features for architectural interpretation require a relatively long acquisition time. For example, to image the entire breast, a 3D acquisition of 32 slices with a sampling matrix of 512 ϫ 384 takes ϳ2 min. Acquiring fewer slices or reducing the matrix size will speed acquisition, but at the cost of reduced coverage or spatial resolution. The importance of using a high frame rate for enhancement dynamics analyses was shown by Lucht et al. (11), who observed a significant increase in diagnostic performance when they used 28 points as compared to three time points.As the value of DCE-MRI of the breast becomes appreciated by clinicians and its usage increases, there will be a demand for bilateral acquisitions. However, the problem of imaging at a high frame rate while preserving spatial resolution is compounded in the case of bilateral imaging. In a conventional bilateral examination the acquisitions are interleaved, which doubles the scan repetition time (TR) and reduces the temporal resolution. A coarse representation of the contrast kinetics is the best that can be ac...