Breast MR imaging with commercially available techniques: radiologic-pathologic correlation.

PURPOSE

To evaluate the clinical utility of dynamic gadolinium-enhanced magnetic resonance (MR) imaging of the breast with commercially available techniques in patients scheduled for excisional biopsy.

MATERIALS AND METHODS

A total of 91 breast abnormalities, 70 benign and 21 malignant, were evaluated. Thin-section three-dimensional gradient-echo images were obtained before and 2, 4, and 7 minutes after injection of contrast material. Three radiologists prospectively evaluated the mammograms and MR images.

RESULTS

The areas under the receiver operating characteristic curves were 0.820 for mammography and 0.893 for MR imaging (P = .67). Sensitivity of MR imaging was 82.5%, compared with 74.6% for mammography. Specificity of MR imaging was 82.5%, compared with 79.1% for mammography. Enhancement profiles showed early intense enhancement in malignancies but considerable overlap with enhancement of benign disease.

CONCLUSION

Breast MR imaging is a slightly more sensitive modality than mammography but not a highly specific technique for evaluating breast lesions. It has utility in several clinical situations but should not be used as a substitute for biopsy or general screening.