The Current Status of Breast MR Imaging Part I. Choice of Technique, Image Interpretation, Diagnostic Accuracy, and Transfer to Clinical Practice
Abstract
Compared with mammography and breast ultrasonography, contrast material–enhanced magnetic resonance (MR) imaging is a breast imaging technique that offers not only information on lesion cross-sectional morphology but also on functional lesion features such as tissue perfusion and enhancement kinetics. After an enthusiastic start to clinical breast MR imaging in the early 1990s, a variety of difficulties and obstacles were identified that hampered the transfer of the modality into clinical practice, including a lack of standardization regarding image acquisition and interpretation guidelines, a lack of MR-compatible interventional materials, and a lack of evidence regarding its diagnostic accuracy—particularly specificity and positive predictive value, as well as sensitivity for ductal carcinoma in situ. This article is the first of two on the current status of breast MR imaging. The pathophysiologic basis of breast MR and the effects on acquisition technique and diagnostic accuracy, the diverging demands of high spatial and temporal resolution, and the different approaches that exist for image acquisition are reviewed. Advantages and disadvantages of different pulse sequence parameters are discussed to help radiologists make a balanced and informed decision regarding choice of image acquisition protocol. Imaging findings in common benign and malignant changes are described, and current concepts for differential diagnosis, including the MR Breast Imaging Reporting and Data System lexicon, are discussed. Furthermore, obstacles that impeded the technique's transfer into clinical practice are discussed, and the progress made in recent years, especially regarding the development of guidelines, procedural standardization, and MR-guided interventions are outlined.
© RSNA, 2007
References
- 1
Folkman J - 2
Folkman J - 3
Schneider BP - 4
Pham CD - 5
Buadu LD - 6
Aref M - 7
Degani H - 8
Cohen FM - 9
Boné B - 10
Frouge C - 11
Su MY - 12
Lewin M - 13
Hulka CA - 14
Buckley DL - 15
Knopp MV - 16
Stomper PC - 17
Kuhl CK - 18
Kuhl CK - 19
Müller-Schimpfle M - 20
Kuhl CK - 21
Boetes C - 22
Schorn C - 23
Choyke PL - 24
Taylor JS - 25
Tofts PS - 26
Tofts PS - 27
Hochman MG - 28
Nunes LW - 29
Kuhl CK - 30
Heywang-Kobrunner SH - 31
Berg WA - 32
Teifke A - 33
Ikeda DM - 34
Ikeda DM - 35 American College of Radiology. ACR breast imaging reporting and data system (BI-RADS): breast imaging atlas. Reston, Va: American College of Radiology, 2003.
- 36
Liberman L - 37
Kuhl CK - 38
Kuhl CK - 39
Nunes LW - 40
Schnall MD - 41
Baum F - 42
Kinkel K - 43
Leong CS - 44
Kuhl CK - 45
Qayyum A - 46
Szabo BK - 47
Kuhl CK; Mielcarek P - 48
Liberman L - 49
Morakkabati-Spitz N - 50
Heywang-Köbrunner SH - 51
Heywang-Köbrunner SH - 52
Harms SE - 53
Gilles R - 54
Gilles R - 55
Fischer U - 56
Yeh ED - 57
Liberman L - 58
Morris EA - 59
Lee SG - 60
Bedrosian I - 61
Kuhl CK - 62
Warner E - 63
Stoutjesdijk MJ - 64
Smyczek-Gargya B - 65
Samson DJ - 66
Avril N - 67
Quan ML - 68
Kneeshaw PJ - 69
Kneeshaw PJ - 70
Weinstein SP - 71
Munot K - 72
Fischer U - 73
Bluemke DA - 74
Fischer U - 75
Westerhof JP - 76
Ikeda O - 77
Van Goethem M - 78
Hartman AR - 79
Hwang ES - 80
Neubauer H - 81
Kuhl CK - 82
Menell JH - 83
Esserman LJ - 84
Morrow M - 85
Orel SG - 86
Orel SG - 87
Kaiser WA - 88
Liu PF - 89
Schnall MD - 90
Sardanelli F - 91
Esserman L - 92
Beam CA - 93
Beam CA - 94
Nodine CF - 95 Mammography Quality Standards Act (MQSA) (as amended by MQSRA of 1998 and 2004) Title 42 USC §6a(2f) (1992).
- 96 Expertengruppe S3 Leitlinie der Deutschen Krebsgesellschaft. Nationale S3-leitlinie zu diagnostik, therapie und nachsorge des mammakarzinoms der frau. Deutsche Krebsgesellschaft Juli 2004.
- 97 U.S. General Accounting Office. Mammography: capacity generally exists to deliver services—report to the chairman, special committee on aging, U.S. Senate, GAO-02-532. Washington, DC: U.S. General Accounting Office, 2002.
- 98
Heywang-Köbrunner SH - 99
Fischer U - 100
Orel SG - 101
Kuhl CK - 102
Kuhl CK - 103
Fischer U - 104
Kuhl CK - 105
Lampe D - 106
Perlet C - 107
Perlet C - 108
Prat X - 109
Lehman CD - 110
Hrung JM - 111
Liberman L - 112
Lehman CD - 113
Daniel BL - 114
Berg WA - 115
LaTrenta LR