DYNAMIC MAGNETIC-RESONANCE MAMMOGRAPHY OF BOTH BREASTS FOLLOWING LOCAL EXCISION AND RADIOTHERAPY FOR BREAST-CARCINOMA

The purpose of this study was to evaluate a dynamic gadolinium-diethyl ene-triaminepentacetate (Gd-DTPA) enhanced magnetic resonance mammogra phy (MRM) protocol. incorporating image subtraction and using a dedica ted doable breast coil, in patients wit-h treated breast cancer. 36 pa tients who had undergone breast conserving surgery and radiotherapy, w ith clinical or mammographic suspicion of locally recurrent breast car cinoma, were examined. 3D rapid volume imaging of both breasts was per formed before and repeated three times, at 1, 2 and 3 min, following G d-DTPA enhancement. Image subtraction allowed identification of enhanc ing lesions and quantitative analysis of these was performed. Five pat ients had six lesions demonstrating rapid enhancement in the first min ute, all of which were histologically confirmed recurrent or second pr imary tumours, Slower enhancement was seen in six benign lesions and d iffuse enhancement was seen in one patient within 6 months of treatmen t. The dynamic protocol used allowed sufficient temporal resolution fo r distinguishing malignant from benign lesions al the site of previous surgery and ensured that both breasts were imaged in their entirety, thus enabling the diagnosis of multifocal and second primary tumours.