Laura Martincich MD, Presenter: Consultant, General Electric Company Speaker, Bracco Group

Mathieu Faivre-Pierret MD, Abstract Co-Author: Nothing to Disclose

Christian Zechmann MD, Abstract Co-Author: Consultant, Bracco Group

Stefano Corcione MD, Abstract Co-Author: Nothing to Disclose

Fiona Jane Gilbert MD, Abstract Co-Author: Nothing to Disclose

Francesco Sardanelli MD, Abstract Co-Author: Consultant, Bracco Group Research grant, Bracco Group Consultant, Bayer AG Research grant, Bayer AG

Federica Pediconi MD, Abstract Co-Author: Nothing to Disclose

To intra-individually compare randomized 0.1 mmol/kg doses of gadobenate dimeglumine (MultiHance, Bracco) and gadopentetate dimeglumine (Magnevist, Bayer) for the detection and characterization of histologically-confirmed malignant breast lesions.

One hundred fifty-one women at 17 sites in Europe and China successfully underwent two breast MRI exams at 1.5T using 3D spoiled GRE sequences. One exam was performed with gadobenate dimeglumine and the other with gadopentetate dimeglumine. The two exams were separated by >2 but <7 days and were otherwise identical. Images, acquired at ≤2 min intervals after contrast injection, were evaluated independently by three blinded radiologists unaffiliated with enrolment centers. Histopathological confirmation was available for all malignant lesions. Determinations of diagnostic performance (sensitivity, specificity, accuracy, positive and negative predictive values [PPV and NPV]) were performed and compared (McNemar and Wald tests) by histological lesion-type.

Histologically-confirmed malignant lesions comprised 90 invasive ductal carcinomas (IDC), 30 invasive lobular carcinomas (ILC), 7 other types of invasive carcinoma, and 17 non-invasive carcinomas (ductal carcinoma in situ/lobular carcinoma in situ). Superior sensitivity for malignant lesion detection was noted by all readers for all lesion types with gadobenate dimeglumine compared to gadopentetate dimeglumine (IDC: 85-86 [94.4-95.6%] lesions detected and correctly diagnosed with gadobenate dimeglumine vs. 75-79 [83.3-87.8%] with gadopentetate dimeglumine, p≤0.0082; ILC: 28-30 [93.3-100%] vs. 24-25 [80-83.3%]; other invasive carcinomas: 5-7 [71.4-100%] vs. 5 [71.4%]; non-invasive carcinomas: 12-15 [70.6-88.2%] vs. 10-12 [58.8-70.6%]). Analyzed by breast region, superior sensitivity, specificity, accuracy, PPV and NPV for the detection and characterization of IDC, ILC and non-invasive carcinoma was noted for gadobenate dimeglumine.

Gadobenate dimeglumine at a dose of 0.1 mmol/kg bodyweight is superior to gadopentetate dimeglumine at equivalent dose for the detection and characterization of all malignant breast lesion types.

The improved diagnostic performance on breast MRI with gadobenate dimeglumine may have important implications for breast cancer screening and diagnosis.

Martincich, L, Faivre-Pierret, M, Zechmann, C, Corcione, S, Gilbert, F, Sardanelli, F, Pediconi, F, Intraindividual Crossover Comparison of Gadobenate Dimeglumine and Gadopentetate Dimeglumine for the Detection and Characterization of Histologically Confirmed Malignant Breast Lesions.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034312.html