Milica Medved PhD, Presenter: Nothing to Disclose

Gillian Maclaine Newstead MD, Abstract Co-Author: Nothing to Disclose

Hiroyuki Abe MD, Abstract Co-Author: Nothing to Disclose

Sean Foxley, Abstract Co-Author: Nothing to Disclose

Marta A Zamora BS, Abstract Co-Author: Nothing to Disclose

Gregory Stanislaus Karczmar PhD, Abstract Co-Author: Nothing to Disclose

To evaluate the application of high spectral and spatial resolution (HiSS) MR imaging and compare HiSS images to standard clinical breast MR images in patients with suspected breast carcinoma.

Thirty eight patients were imaged after informed consent was obtained. All patients had clinical and/or conventional imaging findings suggestive of carcinoma. Conventional pre- and post- infusion breast MR images were acquired with a bilateral breast coil, including axial T2-weighted FSE, pre and post infusion dynamic T1-weighted SPGR, and sagittal T1-weighted SPGR fat-saturated images. Additional HiSS scans (either one 4 mm or two 3 mm (n=3) slices in previously selected area of interest) were added before and at 3.5 minutes after contrast media injection. HiSS data were acquired using echo-planar spectroscopic imaging with sub-millimeter spatial resolution and with high-resolution (2.6 – 5.2 Hz) spectra of water and fat resonances associated with each image voxel. Images with intensity proportional to water signal peak height were analyzed following previously published methods and compared to conventional MR images. A retrospective review of the conventional and HiSS images was conducted by an experienced observer using a workstation with a high resolution liquid crystal screen.

The histologic diagnoses were: 27 malignant (5 non-invasive) and 12 benign lesions. 1) Lesions were highly visible in HiSS images, even before contrast agent administration. 2) HiSS images showed better delimitation of lesion vs. enhancing parenchyma in 31/38 cases; crisper definition of lesion margins in 18/21 invasive lesions; and improved visualization of DCIS lesions in 4/5 cases. HiSS images were never of lower diagnostic utility then standard clinical images, although in two cases the slice imaged excluded the target lesion. 3) Overall, HiSS images provided significantly improved fat saturation.

HiSS images offered improved lesion visualization when compared to standard images, most notably allowing lesion visualization before the injection of contrast agent. The possibility of obtaining detailed morphological information prior to contrast agent administration should be further evaluated.

Medved, M, Newstead, G, Abe, H, Foxley, S, Zamora, M, Karczmar, G, Application of High Spectral and Spatial Resolution MR Imaging of Breast.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4415851.html