Assessment of Suspected Breast Cancer by MRI: A Prospective Clinical Trial Using a Combined Kinetic and Morphologic Analysis
Jonathan I. Wiener1,
Kathy J. Schilling1,
Carol Adami1 and
Nancy A. Obuchowski2
1 Department of Radiology, Boca Raton Community Hospital, 800 Meadows Rd., Boca
Raton, FL 33486.
2 Department of Biostatistics and Epidemiology, The Cleveland Clinic, Cleveland,
OH.

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Fig. 1A. 72-year-old woman with breast cancer. Whole-volume
maximum-intensity-projection image shows typical bilateral infiltrating ductal
breast cancers with spiculated margins.
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Fig. 1B. 72-year-old woman with breast cancer. Kinetic color map of right
breast shows lesion contains extensive areas of bright yellow.
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Fig. 1C. 72-year-old woman with breast cancer. Graph of single voxel from
lesion shown in color in B indicates relative enhancement of greater
than 200% on first postcontrast time point and significant drop in signal on
subsequent time points.
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Fig. 1D. 72-year-old woman with breast cancer. Kinetic color map of
mammographically occult left breast lesion shows this lesion also has
malignant enhancement curves with central yellow regions and outer rim of reds
and pinks.
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Fig. 1E. 72-year-old woman with breast cancer. Graph of single voxel from
lesion shown in color in D exhibits pink color that indicates relative
enhancement on first time point of greater than 100%, with greater than 20%
relative washout on last time point.
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Fig. 2. 46-year-old woman with fibroadenoma. Kinetic color map shows
fibroadenoma has progressive enhancement curve, which is shown in orange. Note
motion artifact along skin surface.
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Fig. 3A. Standard (A) and magnified (B) mammograms obtained in
57-year-old woman with heterogeneously dense breasts show palpable mass in
right outer breast. Mediolateral oblique (A) and craniocaudal
(B) views from mammograms fail to reveal discrete mass.
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Fig. 3B. Standard (A) and magnified (B) mammograms obtained in
57-year-old woman with heterogeneously dense breasts show palpable mass in
right outer breast. Mediolateral oblique (A) and craniocaudal
(B) views from mammograms fail to reveal discrete mass.
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Fig. 3C. Standard (A) and magnified (B) mammograms obtained in
57-year-old woman with heterogeneously dense breasts show palpable mass in
right outer breast. Targeted sonogram confirms 2-cm suspicious mass in upper
outer breast.
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Fig. 3D. Standard (A) and magnified (B) mammograms obtained in
57-year-old woman with heterogeneously dense breasts show palpable mass in
right outer breast. Targeted sonogram confirms finding on MR image (not
shown): second 1.5-cm irregular mass with typical malignant enhancement curves
in upper inner quadrant. This lesion and lesion shown in C were
subsequently biopsied under sonographic guidance. Patient then required
mastectomy for two infiltrating ductal carcinomas and surrounding ductal
carcinoma in situ.
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Copyright © 2005 by the American Roentgen Ray Society.