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Contrast-Enhanced MR Mammography: Improved Lesion Detection and Differentiation with Gadobenate Dimeglumine

¹ Department of Radiological Sciences, University of Rome "La Sapienza," Viale le Regina Elena 324, 00161 Rome, Italy.
² Worldwide Medical & Regulatory Affairs, Bracco Imaging SpA, Milano, Italy.
³ Worldwide Medical & Regulatory Affairs, Bracco Diagnostics, Inc., Princeton, NJ.

View larger version (9K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1 —Bar graph shows results for detection of malignant and benign breast lesions on breast MRI with gadobenate dimeglumine (gray bars) and gadopentetate dimeglumine (white bars) relative to histopathology findings (black bars). Detection of malignant breast lesions was significantly better with gadobenate dimeglumine (p = 0.0009; McNemar exact test).

View larger version (103K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —42-year-old woman with two histologically confirmed invasive carcinoma lesions in inferior outer quadrant of right breast. Nonsubtracted (A), subtracted (B), and maximum-intensity-projection (MIP) reconstruction of subtracted image (C) of enhanced T1-weighted gradient-echo images (TR/TE, 8.1/4; flip angle, 30°) after 0.1 mmol/kg of gadopentetate dimeglumine clearly show suspicious lesion (arrow, B).

View larger version (94K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —42-year-old woman with two histologically confirmed invasive carcinoma lesions in inferior outer quadrant of right breast. Nonsubtracted (A), subtracted (B), and maximum-intensity-projection (MIP) reconstruction of subtracted image (C) of enhanced T1-weighted gradient-echo images (TR/TE, 8.1/4; flip angle, 30°) after 0.1 mmol/kg of gadopentetate dimeglumine clearly show suspicious lesion (arrow, B).

View larger version (108K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2C —42-year-old woman with two histologically confirmed invasive carcinoma lesions in inferior outer quadrant of right breast. Nonsubtracted (A), subtracted (B), and maximum-intensity-projection (MIP) reconstruction of subtracted image (C) of enhanced T1-weighted gradient-echo images (TR/TE, 8.1/4; flip angle, 30°) after 0.1 mmol/kg of gadopentetate dimeglumine clearly show suspicious lesion (arrow, B).

View larger version (89K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2D —42-year-old woman with two histologically confirmed invasive carcinoma lesions in inferior outer quadrant of right breast. Lesion is more conspicuous and more strongly enhanced on subtracted (D) and MIP reconstruction of subtracted images (E and F) after 0.1 mmol/kg of gadobenate dimeglumine (arrow, D). Additional small histologically confirmed lesion (circle, E and F) that is not seen on gradient-echo images after gadopentetate dimeglumine administration is clearly visible in MIP reconstruction and subtracted image after gadobenate dimeglumine administration. Signal intensity–time curves (not shown) of two lesions after gadobenate dimeglumine revealed similar washout behavior indicative of malignancy.

View larger version (112K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2E —42-year-old woman with two histologically confirmed invasive carcinoma lesions in inferior outer quadrant of right breast. Lesion is more conspicuous and more strongly enhanced on subtracted (D) and MIP reconstruction of subtracted images (E and F) after 0.1 mmol/kg of gadobenate dimeglumine (arrow, D). Additional small histologically confirmed lesion (circle, E and F) that is not seen on gradient-echo images after gadopentetate dimeglumine administration is clearly visible in MIP reconstruction and subtracted image after gadobenate dimeglumine administration. Signal intensity–time curves (not shown) of two lesions after gadobenate dimeglumine revealed similar washout behavior indicative of malignancy.

View larger version (112K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2F —42-year-old woman with two histologically confirmed invasive carcinoma lesions in inferior outer quadrant of right breast. Lesion is more conspicuous and more strongly enhanced on subtracted (D) and MIP reconstruction of subtracted images (E and F) after 0.1 mmol/kg of gadobenate dimeglumine (arrow, D). Additional small histologically confirmed lesion (circle, E and F) that is not seen on gradient-echo images after gadopentetate dimeglumine administration is clearly visible in MIP reconstruction and subtracted image after gadobenate dimeglumine administration. Signal intensity–time curves (not shown) of two lesions after gadobenate dimeglumine revealed similar washout behavior indicative of malignancy.

View larger version (106K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —47-year-old woman with two histologically confirmed invasive lobular carcinoma lesions in left breast. Suspicious contrast-enhancing lesion (arrow) with correspondingly suspicious signal intensity–time curve is clearly visible on subtracted T1-weighted gradientecho images after administration of 0.1 mmol/kg of gadopentetate dimeglumine (A) and of 0.1 mmol/kg of gadobenate dimeglumine (B). Both degree of enhancement and lesion conspicuity are greater after gadobenate dimeglumine. Signal intensity–time curves for gadopentetate dimeglumine (A) and gadobenate dimeglumine (B) show similar washout behavior, which is characteristic for malignant lesion.

View larger version (120K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —47-year-old woman with two histologically confirmed invasive lobular carcinoma lesions in left breast. Suspicious contrast-enhancing lesion (arrow) with correspondingly suspicious signal intensity–time curve is clearly visible on subtracted T1-weighted gradientecho images after administration of 0.1 mmol/kg of gadopentetate dimeglumine (A) and of 0.1 mmol/kg of gadobenate dimeglumine (B). Both degree of enhancement and lesion conspicuity are greater after gadobenate dimeglumine. Signal intensity–time curves for gadopentetate dimeglumine (A) and gadobenate dimeglumine (B) show similar washout behavior, which is characteristic for malignant lesion.

View larger version (123K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3C —47-year-old woman with two histologically confirmed invasive lobular carcinoma lesions in left breast. Additional small histologically confirmed invasive lobular carcinoma lesion (arrow) that is not seen on gradient-echo images after gadopentetate dimeglumine is clearly visible on subtracted image after gadobenate dimeglumine.

View larger version (38K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3D —47-year-old woman with two histologically confirmed invasive lobular carcinoma lesions in left breast. Maximum-intensity-projection reconstruction (MIP) of subtracted images after gadopentetate dimeglumine reveals just one lesion (arrow).

View larger version (19K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3E —47-year-old woman with two histologically confirmed invasive lobular carcinoma lesions in left breast. Lesion shown in D(lower arrow) and additional small lesion (upper arrow) are clearly visible on subtracted MIP reconstruction after gadobenate dimeglumine.

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