Evaluation of the diagnostic value of high temporal and spatial resolution morphologic, dynamic, spectroscopic and diffusion-weighted magnetic resonance imaging in patients with breast lesions at 3 T

Introduction

To evaluate the diagnostic value of combined high temporal and spatial resolution morphologic, dynamic, ¹H-spectroscopic (3D-MRSI) and diffusion-weighted magnetic resonance imaging (MRI) in patients with breast lesions at 3 T using histology as the gold standard.

Materials and methods

Fifteen patients were examined on a 3 T system using a four-channel breast coil. The MRI protocol included: contrast-enhanced (CE) coronal volumetric interpolated breathhold examination with high temporal resolution (isotropic 1.7 mm, time of acquisition (TA) 11.7 seconds, 17 measurements); coronal magnetization prepared rapid gradient echo at expected maximum CE (1 mm isotropic, TA 2.03 minutes); repeated coronal volumetric interpolated breathhold examination, twice-refocused singleshot echo planar imaging sequence with inversion recovery fat-saturation employing four b values (TA 4.48 minutes), 3D-MRSI (10 × 10 × 10 mm³; TA 11 minutes). The lesion morphology was assessed. Regions of interest for suspicious areas were labelled manually and evaluated for elevated choline levels, decreased apparent diffusion coefficient (ADC) values and CE kinetics.

Results

Twenty-seven lesions were detected in 15 patients. Eleven lesions were diagnosed as malignant due to morphology, CE, elevated choline levels and lowered ADC values and were confirmed by histology. Sixteen lesions demonstrated monophasic or biphasic enhancement curves and no elevated choline levels or lowered ADC values, and proved to be benign by histology.

Conclusion

Combined high temporal and spatial resolution morphologic, dynamic, spectroscopic and diffusion-weighted MRI of the breast provides morphologic, kinetic, metabolic and functional information of breast lesions and is a valuable tool for differentiation of benignity and malignancy.