Contrast-Enhanced MRI of the Breast

Abstract

Munich: Karger, 1991. $64.75: pp 244. The diagnostic potential of magnetic resonance (MR) imaging for breast diseases was investigated soon after clinical imagers were developed. Primarily because of the substantial overlap in signal intensity and relaxation times between malignant and benign lesions, enthusiasm initially raised by the earlier studies rapidly waned. An important study by Sylvia Heywang, MD, and associates in 1985 revived interest in MR imaging of the breast. They showed that gadopentetate dimeglumine, by marked and selective enhancement, allowed differentiation of carcinoma from dysplasia and scar tissue. After her pioneering work, the application of MR imaging in the diagnosis of breast cancer has steadily increased. Although a number of investigators have contributed to the recent surge of publications, Heywang remains the leading expert, with more than 700 studies to her credit. Through this excellent book, she shares her immense knowledge and extensive experience in MR imaging of the breast.The book is divided into five sections. The first section summarizes the current state of breast imaging and succinctly discusses the strengths and limitations of the routinely used diagnostic modalities. In the second section, useful details on the positioning of patients and improving techniques for breast imaging are provided. More important, this section describes a method for MR imaging-guided biopsy that was previously published in the German language. In the third section, salient MR imaging features of various breast lesions are described and correlated with the findings of other modalities. This section is also a guide in the identification of artifacts and in the interpretation of ambiguities concerning the magnitude, rate, and pattern of signal enhancement after gadopentetate dimeglumine administration. Also discussed are the time-dependent changes in MR signal that are induced by surgery and radiation therapy. Inclusion of images depicting chemotherapy-induced alterations would have been appropriate in this section, particularly for demonstrating the potential application of MR imaging in the evaluation of tumor response to therapy. The last two sections describe the indications and possible future developments in MR imaging of the breast.Images, mostly acquired at 0.35 and 1 .O T, are of high quality. Careful labeling, correlations with mammographic. sonographic, and histopathologic findings, and detailed legends enhance the clarity and value of the book. All images were acquired in the transaxial plane. Inclusion of some sagittal and coronal images would have been helpful in demonstrating the value of the multiplanar capability of MR imaging in the delineation and volume estimation of lesions. However, the superiority of MR imaging in detecting recurrences, especially in dense breasts and those with silicone implants, has been demonstrated in several images. Besides more than 250 images, the book contains figures that illustrate the use of signal enhancement rate in differentiating variou...

Performance of a fully automatic lesion detection system for breast DCE‐MRI

“…Contrast enhancement of breast lesions shows large physiologic variations, mostly depending on differences in vascular permeability (22,23) and other technical and physiological parameters, including type and dose of contrast material (24,25). Differences may depend on lesion histology, on the timing of imaging or on inhomogeneities within the lesions, such as those observed in necrotic areas or in fibrosis.…”

Volume and Shape Preservation of Enhancing Lesions when Applying Non-rigid Registration to a Time Series of Contrast Enhancing MR Breast Images

“…Firstly, the amount of x-ray radiation over the years is in itself a health risk, albeit small. Secondly, the radiopaqueness of dense breast tissue makes the search for a primary tumour difficult, if not impossible [1]. Contrast enhanced magnet resonance (MR) imaging of the breast has shown promising results and is currently under investigation as a screening tool for young women at genetic risk of breast cancer in the UK [2].…”

First description and morphology of haemal nodes in piglets(Sus scrofa domestica)

“…In fat-or blood-containing lesions it may improve the specificity (Friedrich, 1998) and gives higher confidence and sensitivity in breast cancer examination than do conventional mammography and sonography only (Müller-Schimpfle et al, 1997). However, due to its own limitations (high costs, large number of slices per breast), contrast-enhanced MRI cannot be used alone, and it will not replace mammography (Heywang-Köbrunner and Beck, 1995).…”

“…Different methods of human MR mammography are still under research and development (Heywang-Köbrunner and Beck, 1995). Their importance in the complex examination of mammary glands will grow, which hopefully will allow MRI to gain ground in the diagnosis of mammary tumours in companion animals.…”

“…The four main curve types are: types 1a and 1b, where signal intensity increases persistently with time; type 2, which is a plateau curve; and type 3, which is a wash-out curve. Types 1a and 1b are typical of benign lesions, while types 2-3 are most often found in malignant lesions (Heywang-Köbrunner and Beck, 1995). We examined whether this characteristic could be applied to describe canine mammary tumours.…”