Characterization of breast lesion morphology with delayed 3DSSMT: An adjunct to dynamic breast MRI

lThe purpose of the study was to determine the sensitivity and specificity of various morphologic criteria in distinguishing malignant from benign bre ast lesions using a new sequence (3DSSMT) performed immediately after dynam ic breast MRI, 3DSSMT combines a water-selective spectral-spatial excitatio n and an on-resonance magnetization transfer pulse with three-dimensional s poiled gradient-echo imaging, Morphologic features of 87 pathologically con firmed lesions were analyzed. The presence of either skin thickening, or a combination of a spiculated or microlobulated border, with a rim, ductal, l inear, or clumped enhancement pattern was 94% specific and 54% sensitive fo r malignancy. Conversely, the presence of either a perfectly smooth border, a well-defined margin, non-enhancing internal septations, or a macrolobula ted border was 97% specific and 35% sensitive for a benign diagnosis, In co nclusion, delayed 3DSSMT discriminates a significant number of benign and m alignant breast lesions; it has the potential to improve the diagnostic acc uracy of dynamic breast MRI. (C) 2000 Wiley-Liss, Inc.