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Comparison of MDCT and MRI for Evaluating the Intraductal Component of Breast Cancer

¹ Department of Diagnostic Radiology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan.
² Present address: Section of Breast Imaging, Department of Radiology, 5841 S. Maryland Ave., MC2026, Chicago, IL 60637.
³ Department of Surgical Oncology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan.
⁴ Department of Pathology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan.

OBJECTIVE. The purpose of our study was to compare the accuracy of MDCT and MRI for evaluating the intraductal component of breast cancer.

MATERIALS AND METHODS. Sixty-nine patients with histologically proven invasive carcinoma underwent MDCT and MRI. Retrospectively, two radiologists performed a blinded review of the MDCT and MRI. Cases with intraductal component enhancement were classified into two morphologic types: ductal extension and segmental distribution. The lengths of the main tumor and of the intraductal component were measured in cases with ductal extension. For cases with segmental distribution, only the maximum length of the tumor was measured.

RESULTS. The sensitivity, specificity, and accuracy in detecting the intraductal component were 61%, 88%, and 71%, respectively, using MDCT; and 75%, 88%, and 80%, respectively, using MRI. MRI revealed the presence of the intraductal component with significantly higher sensitivity than did MDCT (p = 0.031). In the analysis of the length of the intraductal component in cases with ductal extension, which had relatively small intraductal components, underestimation by 15 mm or more was significantly less frequent with MRI than with MDCT (p = 0.008). There was no significant difference between MDCT and MRI in the evaluation of the maximum length of tumors in cases with segmental distribution, which had relatively large intraductal components.

CONCLUSION. Compared with MDCT, MRI revealed the presence of the intraductal component with higher sensitivity and equivalent specificity. In cases with ductal extension, MRI is more precise than MDCT for determination of the margin for surgical removal, with less underestimation of the extent of the intraductal component.

Keywords: breast cancer • MDCT • MRI • radiologic-pathologic correlation

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