Marco Moschetta MD, Presenter: Nothing to Disclose

michele telegrafo, Abstract Co-Author: Nothing to Disclose

Leonarda Rella, Abstract Co-Author: Nothing to Disclose

Davide Antonio Carluccio, Abstract Co-Author: Nothing to Disclose

Amato Antonio Stabile Ianora, Abstract Co-Author: Nothing to Disclose

Giuseppe Angelelli, Abstract Co-Author: Nothing to Disclose

Diffusion-weighted imaging with background body signal suppression (DWIBS) has improved DWI potential by using a short TI inversion recovery (STIR)-echo planar imaging (EPI) sequence and free breathing to screen for breast lesions. DWIBS MR sequences provide both qualitative and quantitative imaging of breast lesions and are usually performed before contrast material injection (CMI) in the course of breast MR scan protocol. This study aims to assess whether the administration of gadolinium significantly affects DWIBS imaging.

200 patients were prospectively evaluated by MRI with STIR, TSE-T2, pre-CMI DWIBS, contrast enhanced THRIVE-T1 and post-CMI DWIBS sequences. Pre and post-CMI DWIBS were analyzed searching for the presence of breast lesions and calculating the ADC value. ADC values of ≤1.44x10-3 mm2/s were considered suspicious for malignancy. This analysis was then compared with the histological findings. Sensitivity, specificity, diagnostic accuracy (DA), positive predictive value (PPV) and negative (NPV) were calculated for both sequences and represented by ROC analysis. Pre and post-CMI ADC values were compared by using the paired t test.

In 150/200 (59%) patients, pre and post-CMI DWIBS indicated the presence of breast lesions, 53 (35%) with ADC values of >1.44 and 97 (65%) with ADC ≤ 1.44. Both pre-CMI and post-DWIBS sequences obtained sensitivity, specificity, DA, PPV and NPV values of 97%, 83%, 89%, 79% and 98%, respectively. The mean ADC value of benign lesions was 1.831 ± 0.18 × 10-3mm2/s before and 1.828 ± 0.18 ×10-3 mm2/s after CMI. The mean ADC value of the malignant lesions was 1.146 ± 0.16 × 10-3mm2/ s before and 1.144 ± 0.16 × 10-3mm2/s after CMI. No significant difference was found between pre and post CMI ADC values (p > 0.05).  

DWIBS imaging represent a useful diagnostic complement for characterizing breast lesions and its diagnostic accuracy is not influenced by CMI. Breast MR protocol could be modified by placing DWIBS after dynamic contrast enhanced sequences in order to maximize patient cooperation and preserve the diagnostic accuracy of breast MRI.

DWIBS sequences are not influenced by gadolinium injection. Breast MR protocol could be modified by placing DWIBS after dynamic contrast enhanced sequences in order to maximize patient cooperation and preserve the diagnostic accuracy of breast MRI.

Moschetta, M, telegrafo, m, Rella, L, Carluccio, D, Stabile Ianora, A, Angelelli, G, Effect of Gadolinium Injection on Diffusion-weighted Imaging with Background Body Signal Suppression (DWIBS) Imaging of Breast Lesions.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045543.html