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?
AffiliationDepartment of Diagnostic Radiology, Christie Hospital NHS Trust, England, UK. Alison@radiologist.net
MetadataShow full item record
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.
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 Radiol
- Value of the dynamic and delayed MR sequence with Gd-DTPA in the T-staging of stomach cancer: correlation with the histopathology.
- Authors: Kang BC, Kim JH, Kim KW, Lee DY, Baek SY, Lee SW, Jung WH
- Issue date: 2000 Jan-Feb
- Magnetic resonance imaging for axillary staging in patients with breast cancer.
- Authors: Mortellaro VE, Marshall J, Singer L, Hochwald SN, Chang M, Copeland EM, Grobmyer SR
- Issue date: 2009 Aug
- Magnetic resonance contrast enhancement with gadolinium-DTPA in patients with angina and angiographically normal coronary arteries: effect of chronic beta-blockade.
- Authors: Rossetti E, Fragasso G, Mellone R, Vanzulli A, Del Maschio A, Chierchia SL
- Issue date: 1999 Jul
- Low-dose gadobenate dimeglumine versus standard dose gadopentetate dimeglumine for contrast-enhanced magnetic resonance imaging of the liver: an intra-individual crossover comparison.
- Authors: Schneider G, Maas R, Schultze Kool L, Rummeny E, Gehl HB, Lodemann KP, Kirchin MA
- Issue date: 2003 Feb
- Utility of 18F-fluoro-deoxyglucose emission tomography/computed tomography fusion imaging (18F-FDG PET/CT) in combination with ultrasonography for axillary staging in primary breast cancer.
- Authors: Ueda S, Tsuda H, Asakawa H, Omata J, Fukatsu K, Kondo N, Kondo T, Hama Y, Tamura K, Ishida J, Abe Y, Mochizuki H
- Issue date: 2008 Jun 9