Accuracy of axillary MR imaging in treated breast cancer for distinguishing between recurrent tumour and treatment effects: does intravenous Gd-DTPA enhancement help in cases of diagnostic dilemma?

2.50
Hdl Handle:
http://hdl.handle.net/10541/86443
Title:
Accuracy of axillary MR imaging in treated breast cancer for distinguishing between recurrent tumour and treatment effects: does intravenous Gd-DTPA enhancement help in cases of diagnostic dilemma?
Authors:
Bradley, Alison J; Carrington, Bernadette M; Hammond, Claire L; Swindell, Ric; Magee, Brian
Abstract:
AIM: To evaluate the sensitivity and specificity of axillary magnetic resonance imaging (MRI) in symptomatic patients, who had previously been treated for breast cancer, compared with clinical outcome after a minimum of 1 year.METHODS: One hundred and five patients underwent axillary MRI examinations and were diagnosed as axillary tumour, metastatic tumour, treatment effect or normal. RESULTS: At MRI, 48 patients had axillary tumour, 51 had metastatic tumour (37 had both), 27 had treatment effect and 22 were normal. At outcome (median follow-up, 484 days), 54 patients were positive for axillary tumour, 59 for metastatic disease (40 had both), 21 had treatment effect alone and 18 were clear. Magnetic resonance imaging showed 89% sensitivity, 100% specificity and 94% accuracy for recurrent axillary tumour, and 85% sensitivity, 98% specificity and 90% accuracy for metastatic tumour. Soft tissue plaques were the commonest axillary disease pattern seen (37). Small volume soft tissue plaques gave the most diagnostic difficulty. Non-dynamic enhancement with intravenous Gadopentetate dimeglumine (Gd-DTPA) in a subset of 34 patients improved sensitivity for axillary tumour from 40 to 74%, and improved diagnostic confidence in 11 patients (32%). Magnetic resonance imaging had a positive management impact leading to treatment alteration in 45 patients, 43 of whom had recurrent axillary and/or metastatic tumour.CONCLUSIONS: Tumour plaques were the commonest pattern of recurrent axillary disease. Forty-eight percent of the patients had metastatic deposits identified by MRI. Magnetic resonance imaging had excellent specificity (100%) and good sensitivity (89%) for recurrent axillary tumour compared with outcome at 1 year, which was improved by non-dynamic administration of Gd-DTPA in 32% of the subset who received it.
Affiliation:
Department of Diagnostic Radiology, Christie Hospital NHS Trust, England, UK. Alison@radiologist.net
Citation:
Accuracy of axillary MR imaging in treated breast cancer for distinguishing between recurrent tumour and treatment effects: does intravenous Gd-DTPA enhancement help in cases of diagnostic dilemma? 2000, 55 (12):921-8 Clin Radiol
Journal:
Clinical Radiology
Issue Date:
Dec-2000
URI:
http://hdl.handle.net/10541/86443
DOI:
10.1053/crad.2000.0553
PubMed ID:
11124071
Type:
Article
Language:
en
ISSN:
0009-9260
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorBradley, Alison Jen
dc.contributor.authorCarrington, Bernadette Men
dc.contributor.authorHammond, Claire Len
dc.contributor.authorSwindell, Ricen
dc.contributor.authorMagee, Brianen
dc.date.accessioned2009-11-19T10:15:32Z-
dc.date.available2009-11-19T10:15:32Z-
dc.date.issued2000-12-
dc.identifier.citationAccuracy of axillary MR imaging in treated breast cancer for distinguishing between recurrent tumour and treatment effects: does intravenous Gd-DTPA enhancement help in cases of diagnostic dilemma? 2000, 55 (12):921-8 Clin Radiolen
dc.identifier.issn0009-9260-
dc.identifier.pmid11124071-
dc.identifier.doi10.1053/crad.2000.0553-
dc.identifier.urihttp://hdl.handle.net/10541/86443-
dc.description.abstractAIM: To evaluate the sensitivity and specificity of axillary magnetic resonance imaging (MRI) in symptomatic patients, who had previously been treated for breast cancer, compared with clinical outcome after a minimum of 1 year.METHODS: One hundred and five patients underwent axillary MRI examinations and were diagnosed as axillary tumour, metastatic tumour, treatment effect or normal. RESULTS: At MRI, 48 patients had axillary tumour, 51 had metastatic tumour (37 had both), 27 had treatment effect and 22 were normal. At outcome (median follow-up, 484 days), 54 patients were positive for axillary tumour, 59 for metastatic disease (40 had both), 21 had treatment effect alone and 18 were clear. Magnetic resonance imaging showed 89% sensitivity, 100% specificity and 94% accuracy for recurrent axillary tumour, and 85% sensitivity, 98% specificity and 90% accuracy for metastatic tumour. Soft tissue plaques were the commonest axillary disease pattern seen (37). Small volume soft tissue plaques gave the most diagnostic difficulty. Non-dynamic enhancement with intravenous Gadopentetate dimeglumine (Gd-DTPA) in a subset of 34 patients improved sensitivity for axillary tumour from 40 to 74%, and improved diagnostic confidence in 11 patients (32%). Magnetic resonance imaging had a positive management impact leading to treatment alteration in 45 patients, 43 of whom had recurrent axillary and/or metastatic tumour.CONCLUSIONS: Tumour plaques were the commonest pattern of recurrent axillary disease. Forty-eight percent of the patients had metastatic deposits identified by MRI. Magnetic resonance imaging had excellent specificity (100%) and good sensitivity (89%) for recurrent axillary tumour compared with outcome at 1 year, which was improved by non-dynamic administration of Gd-DTPA in 32% of the subset who received it.en
dc.language.isoenen
dc.subjectBreast Canceren
dc.subjectCancer Metastasisen
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshAxilla-
dc.subject.meshBreast Neoplasms-
dc.subject.meshContrast Media-
dc.subject.meshDiagnosis, Differential-
dc.subject.meshFemale-
dc.subject.meshFollow-Up Studies-
dc.subject.meshGadolinium DTPA-
dc.subject.meshHumans-
dc.subject.meshLymphatic Metastasis-
dc.subject.meshMagnetic Resonance Imaging-
dc.subject.meshMiddle Aged-
dc.subject.meshNeoplasm Metastasis-
dc.subject.meshRadiation Injuries-
dc.subject.meshSensitivity and Specificity-
dc.titleAccuracy of axillary MR imaging in treated breast cancer for distinguishing between recurrent tumour and treatment effects: does intravenous Gd-DTPA enhancement help in cases of diagnostic dilemma?en
dc.typeArticleen
dc.contributor.departmentDepartment of Diagnostic Radiology, Christie Hospital NHS Trust, England, UK. Alison@radiologist.neten
dc.identifier.journalClinical Radiologyen

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