An investigative study was undertaken to determine the potential for a new magnetic resonance (MR) imaging technique, RODEO (rotating delivery of excitation off resonance), for use as a diagnostic imaging tool for the breast. The RODEO technique provides fat suppression with T1 weighting and is ideal for gadolinium-enhanced breast imaging. It is a short repetition time, steady-state sequence for high-resolution three-dimensional acquisitions and provides a clinically efficient imaging time of approximately 5 minutes for 128 sections. Imaging findings were correlated with serially sectioned pathologic specimens in 30 breasts with 47 malignant and 27 benign lesions. MR imaging had a sensitivity of 94% and a specificity of 37%. MR imaging depicted additional cancers not seen at mammography in 11 of the 30 patients (37%). The lesions not seen at mammography varied in size from 3 mm to 12 cm. RODEO MR imaging may be used to improve diagnosis of breast cancer in patients with mammographically dense breasts or silicone implants/injections and to stage disease in patients who are candidates for lumpectomy.
DCIS underestimations were 1.9 times more frequent with masses than with calcifications, 1.8 times more frequent with large-core biopsy than with vacuum-assisted biopsy, and 1.5 times more frequent with 10 or fewer specimens per lesion than with more than 10 specimens per lesion.
ADH was diagnosed 2.7 times more reliably at vacuum-assisted biopsy than at large-core biopsy (with no increase in complications) with most of the improvement as a result of acquisition of more than 10 specimens per lesion, but carcinoma was sufficiently underestimated with both methods to necessitate surgical biopsy.
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