Jin Sil Kim, Presenter: Nothing to Disclose

Eun Suk Cha MD, Abstract Co-Author: Nothing to Disclose

Sangmin Lee, Abstract Co-Author: Nothing to Disclose

Jee Eun Lee, Abstract Co-Author: Nothing to Disclose

Jin Chung MD, Abstract Co-Author: Nothing to Disclose

To retrospectively compare the sensitivity of breast magnetic resonance imaging (MRI) and breast-specific gamma imaging (BSGI) in pathologically diagnosed ductal carcinoma-in-situ (DCIS), especially focusing in the cases with no calcification on mammography, and to investigate the detection of multifocal lesions of DCIS on the both modalities.

Thirty five patients with pathologically diagnosed DCIS from June 1, 2009, through December 31, 2011, underwent a protocol with both breast MRI and BSGI. Each imaging study was read by a separate dedicated breast radiologist. Patients were excluded if mammography is not available. We recorded whether patient had undergone vacuum-assisted breast biopsy or core biopsy in question before MRI. We recorded the presence or absence of calcification on mammography. The sensitivity for each modality was calculated.

There were 35 women, mean 48 years (range 26–69 years), enrolled onto the study that had both MRI and BSGI for pathologically diagnosed DCIS. Among them, 20 patients were diagnosed by core biopsy and 15 patients were diagnosed by vacuum-assisted directional biopsy before MRI. The sensitivities for MRI and BSGI in 20 patients underwent core biopsy were 95% (19 of 20 DCIS) and 90% (18 of 20 DCIS), respectively. Nineteen patients with DCIS had calcifications on mammography, but 16 patients with DCIS had no calcification at mammography. Of 16 cases with no calcification on mammography, 87.5% (14 of 16 DCIS) were detected with MRI and 37.5% (6 of 16 DCIS) were detected with BSGI. Of 19 cased with calcification on mammography, 94.7% (18 of 19 DCIS) were detected with MRI and 73.7% (14 of 19 DCIS). Of 5 cases of biopsy-proven DCIS with multifocal lesions on pathology, 80% (4 of 5 multifocal lesions) were detected with MRI and 20% (1 of 5 multifocal lesions) were detected with BSGI.

MRI has higher sensitivity for the detection of DCIS and is more helpful in cases of with no calcification on mammography than BSGI. Furthermore, MRI is superior to BSGI for detecting multifocal lesions of DCIS and may result in therapy change.

Breast MR can demostrate DCIS better than BSGI and is recommended  for surgical planning.

Kim, J, Cha, E, Lee, S, Lee, J, Chung, J, Preoperative Imaging of Ductal Carcinoma in Situ: Diagnostic Performance of MRI and Comparison with Breast-specific Gamma Imaging.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12031820.html