Digital subtraction in Gd-DTPA enhanced imaging of the breast

Abstract

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.