Contrast-enhanced MR imaging of the breast at 3.0 and 1.5 T in the same patients: initial experience.

PURPOSE To establish a pulse sequence for dynamic contrast material-enhanced magnetic resonance (MR) imaging of the breast at 3.0 T and to prospectively compare MR imaging at 3.0 T with MR imaging at 1.5 T in the same patients. MATERIALS AND METHODS A prospective intraindividual internal review board-approved study was performed in 37 women with 53 lesions (25 breast cancers, 28 benign focal lesions) who underwent contrast-enhanced dynamic bilateral subtraction MR imaging twice, once at 1.5 T with a standard technique (voxel size, 1.44 mm3) and once at 3.0 T (voxel size, 0.45-0.72 mm3) with variable repetition time and flip angle settings. Written informed consent was obtained. Sagittal single breast high-spatial-resolution MR imaging was performed with active fat suppression. Image quality, number and features of enhancing lesions, and Breast Imaging Reporting and Data System categories were compared by using the Wilcoxon matched-pairs signed rank test and Student t test for matched pairs. Diagnostic confidence was compared by using a receiver operating characteristic (ROC) analysis. RESULTS With repetition time prolonged to account for longer T1 relaxation times at 3.0 T and a flip angle of 60 degrees, enhancement rates at 3.0 T were substantially below those at 1.5 T. In two patients with benign lesions, enhancement was rated as insufficient to establish diagnosis. When parameter settings were kept equivalent, equivalent enhancement rates were observed with both systems. With these settings, 3.0-T MR imaging yielded homogeneous signal intensity over the entire field of view. No dielectric resonance effects were observed. Overall image quality scores for the dynamic series were slightly higher at 3.0 T (P<.01). A total of 49 lesions were prospectively identified with both systems. Owing to substantial patient motion at 1.5 T, two malignant lesions in one patient were visualized at 3.0 T only. At 3.0 T, differential diagnosis of enhancing lesions was possible with higher diagnostic confidence, as reflected by a larger area under the ROC curve (P<.05). CONCLUSION Initial experiences indicate that contrast-enhanced MR imaging at 3.0 T is nearing readiness for clinical use.

[1]  M D Schnall,et al.  Staging of suspected breast cancer: effect of MR imaging and MR-guided biopsy. , 1995, Radiology.

[2]  P. Drew,et al.  Role of magnetic resonance imaging in the diagnosis and single-stage surgical resection of invasive lobular carcinoma of the breast , 2003 .

[3]  C. Kuhl,et al.  Breast MR imaging during or soon after radiation therapy. , 2003, Radiology.

[4]  Peter Boesiger,et al.  Sensitivity‐encoded coronary MRA at 3T , 2004, Magnetic resonance in medicine.

[5]  B. Tomanek,et al.  Specificity of choline metabolites for in vivo diagnosis of breast cancer using 1H MRS at 1.5 T , 2005, European Radiology.

[6]  G. Glover,et al.  Characterization of breast lesion morphology with delayed 3DSSMT: An adjunct to dynamic breast MRI , 2000, Journal of magnetic resonance imaging : JMRI.

[7]  Raja Muthupillai,et al.  Implications of SENSE MR in routine clinical practice. , 2003, European journal of radiology.

[8]  C. Kuhl,et al.  Dynamic breast MR imaging: are signal intensity time course data useful for differential diagnosis of enhancing lesions? , 1999, Radiology.

[9]  Wei Huang,et al.  Detection of breast malignancy: diagnostic MR protocol for improved specificity. , 2004, Radiology.

[10]  Mitchell D Schnall,et al.  MR imaging screening of the contralateral breast in patients with newly diagnosed breast cancer: preliminary results. , 2003, Radiology.

[11]  3.0-T high-field magnetic resonance imaging of the female pelvis: preliminary experiences , 2005, European Radiology.

[12]  K. Horgan,et al.  Role of magnetic resonance imaging in the diagnosis and single‐stage surgical resection of invasive lobular carcinoma of the breast , 2002, The British journal of surgery.

[13]  P S Tofts,et al.  Quantitative Analysis of Dynamic Gd‐DTPA Enhancement in Breast Tumors Using a Permeability Model , 1995, Magnetic resonance in medicine.

[14]  D M Ikeda,et al.  Intensity-modulated parametric mapping for simultaneous display of rapid dynamic and high-spatial-resolution breast MR imaging data. , 2001, Radiographics : a review publication of the Radiological Society of North America, Inc.

[15]  M D Schnall,et al.  Diagnostic performance characteristics of architectural features revealed by high spatial-resolution MR imaging of the breast. , 1997, AJR. American journal of roentgenology.

[16]  Jacob Sosna,et al.  MR imaging of the prostate at 3 Tesla: comparison of an external phased-array coil to imaging with an endorectal coil at 1.5 Tesla. , 2004, Academic radiology.

[17]  Matthijs Oudkerk,et al.  First experiences in screening women at high risk for breast cancer with MR imaging , 2000, Breast Cancer Research and Treatment.

[18]  P. Chappuis,et al.  Re: Magnetic resonance imaging and mammography in women with a hereditary risk of breast cancer. , 2001, Journal of the National Cancer Institute.

[19]  E. Grabbe,et al.  Classification of hypervascularized lesions in CE MR imaging of the breast , 2002, European Radiology.

[20]  D. Yee,et al.  Neoadjuvant chemotherapy of locally advanced breast cancer: predicting response with in vivo (1)H MR spectroscopy--a pilot study at 4 T. , 2004, Radiology.

[21]  Peter Boesiger,et al.  Cardiac SSFP imaging at 3 Tesla , 2004, Magnetic resonance in medicine.

[22]  Jennifer B Kaplan,et al.  MR imaging findings in the contralateral breast of women with recently diagnosed breast cancer. , 2003, AJR. American journal of roentgenology.

[23]  H. D. de Koning,et al.  Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition. , 2004, The New England journal of medicine.

[24]  Ellen Warner,et al.  Surveillance of BRCA1 and BRCA2 mutation carriers with magnetic resonance imaging, ultrasound, mammography, and clinical breast examination , 2004, JAMA.

[25]  Hans H Schild,et al.  Three-dimensional dynamic susceptibility-weighted perfusion MR imaging at 3.0 T: feasibility and contrast agent dose. , 2005, Radiology.

[26]  Elizabeth A Morris,et al.  MRI of occult breast carcinoma in a high-risk population. , 2003, AJR. American journal of roentgenology.

[27]  J F Debatin,et al.  Improved diagnostic accuracy in dynamic contrast enhanced MRI of the breast by combined quantitative and qualitative analysis. , 1998, The British journal of radiology.

[28]  N. Hylton,et al.  Magnetic resonance imaging of the breast prior to biopsy. , 2004, JAMA.

[29]  Isabelle Bedrosian,et al.  Changes in the surgical management of patients with breast carcinoma based on preoperative magnetic resonance imaging , 2003, Cancer.

[30]  Xavier Golay,et al.  Determining the longitudinal relaxation time (T1) of blood at 3.0 Tesla , 2004, Magnetic resonance in medicine.

[31]  Ning-Yu An,et al.  Differentiation of clinically benign and malignant breast lesions using diffusion‐weighted imaging , 2002, Journal of magnetic resonance imaging : JMRI.

[32]  D M Ikeda,et al.  Lesion Diagnosis Working Group Report , 1999, Journal of magnetic resonance imaging : JMRI.

[33]  M. L. Lauzon,et al.  MR imaging of hyperacute subarachnoid and intraventricular hemorrhage at 3T: a preliminary report of gradient echo T2*-weighted sequences. , 2005, AJNR. American journal of neuroradiology.

[34]  R. Fimmers,et al.  Coronary MR angiography at 3.0 T versus that at 1.5 T: initial results in patients suspected of having coronary artery disease. , 2005, Radiology.

[35]  P. Pattany.  3T MR imaging: the pros and cons. , 2004, AJNR. American journal of neuroradiology.

[36]  C. Kuhl,et al.  Sensitivity encoding for diffusion-weighted MR imaging at 3.0 T: intraindividual comparative study. , 2005, Radiology.

[37]  Douglas C Noll,et al.  Small tip angle three‐dimensional tailored radiofrequency slab‐select pulse for reduced B1 inhomogeneity at 3 T , 2005, Magnetic resonance in medicine.

[38]  S. Harms.  Breast Cancer Staging Working Group Report , 1999, Journal of magnetic resonance imaging : JMRI.

[39]  Anton Valavanis,et al.  Resolution improvement in thick‐slab magnetic resonance digital subtraction angiography using SENSE at 3T , 2004, Journal of magnetic resonance imaging : JMRI.

[40]  W. Kaiser,et al.  Development, standardization, and testing of a lexicon for reporting contrast‐enhanced breast magnetic resonance imaging studies , 2001, Journal of magnetic resonance imaging : JMRI.

[41]  D Krebs,et al.  Breast MR imaging screening in 192 women proved or suspected to be carriers of a breast cancer susceptibility gene: preliminary results. , 2000, Radiology.

[42]  C. Kuhl,et al.  Acute and subacute ischemic stroke at high-field-strength (3.0-T) diffusion-weighted MR imaging: intraindividual comparative study. , 2005, Radiology.

[43]  C. Kuhl,et al.  Brain tumors: full- and half-dose contrast-enhanced MR imaging at 3.0 T compared with 1.5 T--Initial Experience. , 2005, Radiology.

[44]  J. Gilmore,et al.  Practical consideration for 3T imaging. , 2003, Magnetic resonance imaging clinics of North America.

[45]  E A Sickles,et al.  Dynamic high-spatial-resolution MR imaging of suspicious breast lesions: diagnostic criteria and interobserver variability. , 2000, AJR. American journal of roentgenology.

[46]  Elizabeth A Morris,et al.  MR imaging of the ipsilateral breast in women with percutaneously proven breast cancer. , 2003, AJR. American journal of roentgenology.