The optimal use of MR-Mammography (MRM) under consideration of economical aspects

With the introduction of the contrast agent gadolinum DTPA there were hopes that "MRM" would prove to be the investigatory technique that would largel y solve the problems of breast diagnostics. However, after the early years of acceptance, the new method of investigation became a subject of controve rsy. Nonetheless, MRM today occupies a recognized place in diagnostics for certain indications. It is still true, however, that reliable use of this p rocedure requires a great deal of experience, since there is a relatively l arge area of overlap between benign and malignant tumors. Further, the cost s are significantly higher than those for conventional methods of investiga tion. New studies that have been conducted at the Charite, Campus Virchow M edical Center in Berlin, suggest that, if one takes the relevant indication s into account, MRM can be economic and contribute significantly to cost re duction. Application of a newly developed software package has shown that t he good discrimination in a suspect area resulting from contrast agent enha ncement makes possible a reliable differentiation between malignant and ben ign tissue changes. A further result was that, when certain boundary condit ions are satisfied, a contrast agent bolus of 0.1 mmol/kg BW is sufficient, making a double dose (0.2mmol/kg BW) unnecessary.