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To develop a 3.0 Tesla breast imaging protocol that combines high temporal and spatial resolution 3D MR sequences for quantitative time course and morphological analysis of breast lesions.
One hundred and sixty-five breast lesions classified by mammography or ultrasound as BIRADS 4 and 5 were included in this prospective IRB-approved study. The MRI protocol consisted of a coronal T2-weighted TIRM and a coronal combined high temporal and spatial resolution T1-weighted sequence before and after application of a standard-dose Gd-DOTA (VIBE with a high temporal resolution of SI 1.7 mm isotropic; TA 3.45 min for 17 measurements; FLASH with high spatial resolution of SI 1 mm isotropic; TA 2 min). Lesion size and morphology were assessed according to the BIRADS classification. ROIs for suspicious areas were manually drawn and evaluated for contrast-enhancement behavior by plotting intensity courses against time. Sensitivity and specificity with a 95% confidence interval and the negative predictive value (NPV) and positive predictive value (PPV) were calculated. Diagnostic accuracy was assessed. The histopathological diagnoses were used as the standard of reference.
All malignant breast lesions were identified correctly with a sensitivity of 100%, a specificity of 84% and a diagnostic accuracy of 95.7%. PPV was 0.94 and a NPV 1. All seven false positive lesions were lesions with atypia.
The proposed combined 3 Tesla MR imaging protocol, comprising both high temporal and spatial resolution, enabled an accurate detection and assessment of breast lesions with high sensitivity and specificity reducing false positive breast biopsies