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Differentiating benign and malignant breast lesions with T2*-weighted first pass perfusion imaging
K A Kvistad1, S Lundgren, H E Fjøsne
1MR-Center, University Hospital, Trondheim, Norway.
Purpose:
Invasive breast carcinomas and fibroadenomas are often difficult to differentiate in dynamic contrast-enhanced T1-weighted MR imaging of the breast, because both tumors can enhance strongly after contrast injection. The purpose of this study was to evaluate whether the addition of T2*-weighted first pass perfusion imaging can increase the differentiation of malignant from benign lesions.
Material And Methods:
Nine patients with invasive carcinomas and 10 patients with contrast enhancing fibroadenomas were examined by a dynamic contrast-enhanced T1-weighted 3D sequence immediately followed by a single slice T2*-weighted first pass perfusion sequence positioned in the contrast-enhancing lesion.
Results:
The carcinomas and the fibroadenomas were impossible to differentiate based on the contrast enhancement characteristics in the T1-weighted sequence. The signal loss in the T2*-weighted perfusion sequence was significantly stronger in the carcinomas than in the fibroadenomas (p = 0.0004).
Conclusion:
Addition of a T2*-weighted first pass perfusion sequence with a high temporal resolution can probably increase the differentiation of fibroadenomas from invasive carcinomas in contrast-enhanced MR imaging of the breast.