![]() 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. They found a significant correlation between the number of breast vessels and tumor size ( r = 0.787), concluding that “this new method is a further important step in differentiating a carcinoma from a benign lesion”. They evaluated 18 breast cancer patients using 0.1 mmol/kg of gadopentetate dimeglumine and 3D sequences at 1.5 T. The first observation of increased vascularity associated with breast tumors using contrast-enhanced MRI was reported by Siewert et al. Recently researchers began to explore the diagnostic value of vessel analysis. Thus, a long list of potential signs are now available to breast MR readers. On unenhanced T1-weighted images, readers look for skin thickening and assess the integrity of the nipple line, and on contrast-enhanced MR images, they look for the “blooming” sign. Breast radiologists recognize the value of signs other than lesion morphology and dynamics: On T2-weighted images, readers search for diffuse or perilesional edema or the “hook” sign as well as for high signal intensity correlated with triple-negative hormonal receptor status. High spatial resolution enabled by high-power gradients, high-field-strength (3-T) magnets, and advanced imaging protocols such as parallel imaging have improved the image quality of breast MRI. New approaches to interpreting breast MRI are under development. Technology advances rapidly, but clinical applications follow more slowly. Moreover, the feasibility of 3D proton MR spectroscopy in this setting has recently been shown. ![]() Notwithstanding the hot debate about the use of this technology in the preoperative setting fueled by the disappointing results of the Comparative Effectiveness of Magnetic Resonance Imaging in Breast Cancer (COMICE) Trial and the discussion of its limitations, breast MRI has gained favor among clinical breast cancer specialists, as shown by the recommendations recently delivered by an interdisciplinary European Working Group composed of 23 breast cancer specialists including epidemiologists, geneticists, oncologists, radiologists, radiation oncologists, and surgeons.Īs the role of contrast-enhanced breast MRI in clinical practice is expanding, unenhanced MR techniques, especially diffusion-weighted imaging, are increasingly being proposed for breast investigation, opening a window to fascinating possible future scenarios. This was clearly shown in a survey by Bassett et al. Breast MRI is widely used in clinical practice today. ![]()
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