Clinical Experience of 3T Breast MRI in Detecting the Additional Lesions in Breast Cancer Patients

유방암 환자에서 추가 병변 평가를 위한 3 테슬러 유방자기공명영상의 임상적 경험

  • Lee, Ji-Hye (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Kim, Sung-Hun (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Kang, Bong-Joo (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Choi, Jae-Jeong (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Lee, Ah-Won (Department of Hospital Pathology, College of Medicine, The Catholic University of Korea)
  • 이지혜 (가톨릭대학교 의과대학 영상의학과) ;
  • 김성헌 (가톨릭대학교 의과대학 영상의학과) ;
  • 강봉주 (가톨릭대학교 의과대학 영상의학과) ;
  • 최재정 (가톨릭대학교 의과대학 영상의학과) ;
  • 이아원 (가톨릭대학교 의과대학 병원병리학과)
  • Received : 2010.06.09
  • Accepted : 2010.11.17
  • Published : 2010.12.30

Abstract

Purpose : The purpose of this study was to evaluate the diagnostic accuracy of 3.0-T breast MRI for detecting additional breast cancer soon after the initial diagnosis of breast cancer. Materials and Methods : From March to June 2009, 101 patients recently diagnosed breast cancer underwent breast MRI and surgery. Parameters analyzed on MRI were total extent of tumor, suspicious findings of multifocal, multicentric, or contralateral cancer. The diagnosis of MRI-detected cancer was confirmed by means of biopsy or surgical specimen evaluation after the localization. Results : MRI showed 37 additional suspicious findings in 34 patients. Twenty nine findings were true-positive (29/37, 78.4%), including 16 cases of multifocality, 11 cases of multicentricity and 2 cases of contralateral cancer. Among these cancers, 13 (44.8%) were ductal carcinoma in situ (DCIS) and 16 (55.1%) were infiltrating cancer. Eight findings were false-positive (8/37, 21.6%) including 6 cases of benign disease and 2 cases of high-risk lesions. Conclusion : In women with recently diagnosed breast cancer, 3.0-T MR imaging showed additional suspicious findings in 33.7%. The sensitivity and specificity for detecting additional breast cancer was 100% and 89.3%, respectively.

목적 : 본 연구는 유방암 진단 후 추가적으로 유방암을 발견하는 데 있어 3 테슬러 유방자기공명 영상의 진단적 정확성을 알아보고자 하였다. 대상 및 방법 : 2009년 3월부터 6월까지, 새롭게 유방암을 진단 받은 101명의 환자가 유방 자기공명 영상을 촬영하고 수술을 받았다. 자기공명영상에서는 종양의 범위와 다초점, 다중심, 반대측 유방암이 의심되는 소견에 대해 분석하였다. 자기공명영상으로 발견된 유방암은 조직검사나 위치결정술 후 수술로 진단되었다. 결과 : 34명 환자에서 37예의 암이 의심되는 소견이 추가적으로 자기공명영상에서 보였다. 16예의 다초점 유방암, 11예의 다중심 유방암 그리고 2예의 반대측 유방암을 포함하여 29예가 진양성이었다(29/37, 78.4%); 13 (44.8%)예는 관내상피암 그리고 16 (55.1%)예는 침윤성 암이었다. 6예의 양성 병변, 2예의 고위험병변을 포함하여 8예가 위양성이었다(8/37, 21.6%). 결론 : 3 테슬러 자기공명영상에서 최근에 유방암이 진단된 환자의 33.7%에서 추가적으로 암이 의심되는 소견이 보였다. 추가적으로 유방암을 발견하는 3 테슬러 자기공명영상의 민감도와 특이도는 각각 100%, 89.3% 였다

Keywords

References

  1. Elsamaloty H, Elzawawi MS, Mohammad S, Herial N. Increasing accuracy of detection of breast cancer with 3-T MRI. AJR Am J Roentgenol 2009;192:1142-1148 https://doi.org/10.2214/AJR.08.1226
  2. Orel SG, Schnall MD. MR imaging of the breast for the detection, diagnosis, and staging of breast cancer. Radiology 2001;220:13-30
  3. Riedl CC, Ponhold L, Flory D, et al. Magnetic resonance imaging of the breast improves detection of invasive cancer, preinvasive cancer, and premalignant lesions during surveillance of women at high risk for breast cancer. Clin Cancer Res 2007;13:6144-6152 https://doi.org/10.1158/1078-0432.CCR-07-1270
  4. Kuhl CK. Breast MR imaging at 3T. Magn Reson Imaging Clin N Am 2007;15:315-320 https://doi.org/10.1016/j.mric.2007.08.003
  5. Sasaki M, Shibata E, Kanbara Y, Ehara S. Enhancement effects and relaxivities of gadolinium-DTPA at 1.5 versus 3 Tesla: a phantom study. Magn Reson Med Sci 2005;4:145-149 https://doi.org/10.2463/mrms.4.145
  6. Liberman L, Morris EA, Dershaw DD, Abramson AF, Tan LK. MR imaging of the ipsilateral breast in women with percutaneously proven breast cancer. AJR Am J Roentgenol 2003;180:901-910 https://doi.org/10.2214/ajr.180.4.1800901
  7. Mameri CS, Kemp C, Goldman SM, Sobral LA, Ajzen S. Impact of breast MRI on surgical treatment, axillary approach, and systemic therapy for breast cancer. Breast J 2008;14:236- 244 https://doi.org/10.1111/j.1524-4741.2008.00568.x
  8. Schmitz AC, Peters NH, Veldhuis WB, et al. Contrast-enhanced 3.0-T breast MRI for characterization of breast lesions: increased specificity by using vascular maps. Eur Radiol 2008;18:355-364 https://doi.org/10.1007/s00330-007-0766-z
  9. Kuhl CK, Jost P, Morakkabati N, Zivanovic O, Schild HH, Gieseke J. Contrast-enhanced MR imaging of the breast at 3.0 and 1.5 T in the same patients: initial experience. Radiology 2006;239:666-676 https://doi.org/10.1148/radiol.2392050509
  10. Wiener JI, Schilling KJ, Adami C, Obuchowski NA. Assessment of suspected breast cancer by MRI: a prospective clinical trial using a combined kinetic and morphologic analysis. AJR Am J Roentgenol 2005;184:878-886 https://doi.org/10.2214/ajr.184.3.01840878
  11. Kriege M, Brekelmans CT, Boetes C, et al. Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition. N Engl J Med 2004;351:427- 437 https://doi.org/10.1056/NEJMoa031759
  12. Leach MO, Boggis CR, Dixon AK, et al. Screening with magnetic resonance imaging and mammography of a UK population at high familial risk of breast cancer: a prospective multicentre cohort study (MARIBS). Lancet 2005;365:1769-1778 https://doi.org/10.1016/S0140-6736(05)66481-1