The role of contrast-enhanced high resolution MRI in the surgical planning of breast cancer |
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Authors: | Hideko Hiramatsu Kohji Enomoto Tadashi Ikeda Mario Murai Junji Fururawa Riyoshi Riruchi Roichi Oshio Nobuyoshi Hiraora Masari Ritajima Ryoichi Hiramatsu |
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Institution: | Departments of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160, Japan. |
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Abstract: | The role of contrast-enhanced high resolution MRI for planning surgery in breast cancer was evaluated. Of 72 patients examined,
57 patients had invasive ductal carcinoma, 2 had mucinous carcinoma, 1 had medullary carcinoma, 7 had invasive lobular carcinoma,
2 had ductal carcinoma in situ (DCIS) and 3 had Paget’s disease. A 1.5 T Signa imager (GE Medical Systems, Milwaukee, WI)
was used with a dedicated breast coil. The pulse sequence based on RARE (rapid acquisition with relaxation enhancement) was
used with a fat suppression technique. After examining both breasts, the affected breast alone was examined with Gd enhancement.
Linear and/or spotty enhancement on MRI was considered to suggest DCIS or intraductal spread in the area surrounding the invasive
cancer. Of 72 patients, 50 showed linear and/or spotty enhancement on MRI and 41 of those 50 patients had DCIS or intraductal
spread. In contrast, 22 of 72 patients were considered to have little or no intraductal spread on MRI and 17 of the 22 patients
had no or little intraductal spread on pathological examination. The sensitivity, specificity and accuracy for detecting intraductal
spread on MRI were 89%, 82% and 81%, respectively. Discrepancies in the estimated extent of intraductal spread were less than
2 cm in 90% of the patients according to pathological mapping. High resolution MRI was considered useful in detecting intraductal
spread and in estimating its extent, however, larger study using precise correlation with pathology is necessary. |
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Keywords: | Breast cancer MRI Intraductal spread EIC DCIS |
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