Breast MR Imaging in the Diagnostic Setting

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MR imaging diagnosis of primary breast cancer

Although the results of early clinical investigation of MR imaging of the breast suggested that the presence of signal enhancement after contrast injection would be a sensitive and specific sign for malignancy [9], it became clear that enhancement alone was not specific for cancer [10], [11]. Harms and colleagues [11] performed careful correlation between breast MR imaging and mastectomy specimens in a population of women undergoing mastectomy for breast cancer. They observed an overall

Multicenter results from the International Breast MR Imaging Consortium

The generalized diagnostic performance of breast MR imaging can be best assessed by the results of the multi-institutional trial conducted by the International Breast MR Imaging Consortium (IBMC). The IBMC study included 1004 women across 14 institutions with suspicious mammograms or clinical findings. This study found that the overall diagnostic performance of MR imaging as it is implemented and interpreted in most clinical centers was not sufficient to avoid biopsy in a cohort of all women

Practical implementation of MR imaging in the diagnostic setting

In any practical implementation of MR imaging in the diagnostic setting, the first rule of thumb is that the value of MR imaging in the setting of isolated mammogram microcalcifications is minimal. As tempting as it might be to use MR imaging to reduce concern over marginally suspicious calcification, clinical research experience does not support the use of MR imaging in this clinical setting. The decision to perform a biopsy of microcalcifications rests with mammography. The lesions that

Summary

The role of MR imaging as an adjunct in the diagnostic evaluation of findings on mammography or clinical examination continues to evolve. Clearly, the use of MR imaging to evaluate all suspicious screening findings is not reasonable or effective. In particular, the role of MR imaging in the setting of mammographic microcalcifications is limited. MR imaging may be used in cases of one or more mammographically detected masses or asymmetric density in an effort to avoid biopsy. Optimized MR

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