Gadobenate Dimeglumine–enhanced MR Imaging Breast Vascular Maps: Association between Invasive Cancer and Ipsilateral Increased Vascularity

Abstract

Gadobenate dimeglumine is effective for MR imaging evaluation of breast vessels at doses as low as 0.05 mmol/kg. One-sided increased vascularity is an MR imaging finding frequently associated with ipsilateral invasive breast cancer.

Correlation of Whole-Breast Vascularity with Ipsilateral Breast Cancers Using Contrast-Enhanced MDCT

“…However, vascularity can increase not only within a breast cancer lesion but also in the ipsilateral breast as a whole. Recently, some studies have estimated whole-breast vascularity by laser Doppler perfusion imaging [15], PET [16], and MRI [17][18][19] and found an association between breast cancer and an ipsilateral increase of blood flow.Although contrast-enhanced CT of the breast has been used for assessment of axillary lymph node metastasis [20,21], diagnosis of local recurrence after breast-conserving surgery [22], or imaging intraductal extension of breast cancer preoperatively [23], it can also show tumor vascularity. Especially, MDCT can display high-quality angiographic images because of improved temporal and spatial resolution.…”

A new algorithm for automatic vascular mapping of DCE-MRI of the breast: Clinical application of a potential new biomarker

“…However, all studies in this realm highlight the requirement of further improvements for a higher reproducibility of vessel analysis. This study proposed the application of a validated vessel extraction algorithm [15] as a standardized quantification tool for breast vessel quantification, overcoming limitations of the only existing vessel score system [7], based on human visual analysis.…”

“…1), starting from the isotropic subtraction images. In particular, in order to obtain the best "angiographic effect" for both arteries and veins [7], the subtraction was performed between the first enhanced frame and the unenhanced frame.…”

“…In addition, some reports suggest that preoperative breast MRI in women with newly diagnosed cancer could potentially increase the rate of unnecessary biopsies and surgery [2]. Recent studies aimed to increase the specificity of breast DCE-MRI by adding a vessel analysis to the standard morphologic and kinetic criteria, therefore exploring the diagnostic value of vascularity [7][8][9]. During the past decade, this research issue has been approached in two ways: first, whole-breast vascularity, and second, local vascularity, that is, vessels adjacent to and feeding a lesion or lesions [9].…”

“…Indeed, it relies on a preliminary manual interaction while breast lesions are excluded by placing a square box over the lesion, and it has been tested on patients with relatively large lesions, large vessels, and no motion artifacts on subtracted images. Regarding the evaluation of the vascularity in the clinical practice, the unique quantitative approach existing has been introduced by Sardanelli et al [7] and it is based on the number of vessels per breast, with length of 30 mm or greater and maximal transverse diameter of 2 mm or greater. This method was used by a recent study [10] to assess the variation in whole-breast vascular maps on DCE-MRI after anthracycline-and taxane-based neoadjuvant chemotherapy (NAC) in patients with locally advanced breast cancer (LABC), showing a correlation between changes in breast vascular maps and pathologic tumor response.…”