Digital subtraction in Gd-DTPA enhanced imaging of the breast.

PURPOSE: This study examines the role of digital subtraction magnetic resonance imaging (MRI) of the breast in the interpretation of the morphology and characteristics of breast disease.

METHODS

Thirty-one patients with an abnormal mammogram or clinically palpable abnormality underwent MRI of the breast prior to surgical excision of the lesion. FLASH 3-D images of the breast were acquired before and after IV contrast injection of Gd-DTPA. Digital subtraction was performed on selected images. The images were independently assessed by two radiologists experienced in both mammography and MRI.

RESULTS

Accurate diagnosis was possible in 29 out of 31 patients using the subtraction technique compared to 23 cases using the pre-subtraction images alone. The actual extent of disease and multicentricity were also better appreciated on the subtracted image. Subtraction also provided better identification of tumour recurrence in the post-operative and post-radiotherapy breast. Chest wall and lymph node involvement were more easily appreciated on the subtraction images.

CONCLUSION

Digital subtraction is a simple, effective and relatively cheap technique which can aid in the interpretation of magnetic resonance imaging of the breast.