MR imaging of the breast for the detection, diagnosis, and staging of breast cancer

With the introduction of contrast agents, advances in surface coil technolo gy, and development of new imaging protocols, contrast agent-enhanced magne tic resonance (MR) imaging has emerged as a promising modality for detectio n, diagnosis, and staging of breast cancer. The reported sensitivity of MR imaging for the visualization of invasive cancer has approached 100%. There are many examples in the literature of MR imaging-demonstrated mammographi cally, sonographically, and clinically occult breast cancer. Often, breast cancer detected on MR images has resulted in a change in patient care. Desp ite these results, there are many unresolved issues, including no defined s tandard technique for contrast-enhanced breast MR imaging, no standard inte rpretation criteria for evaluating such studies, no consensus on what const itutes clinically important enhancement, and no clearly defined clinical in dications for the use of MR imaging. Furthermore, this technology remains c ostly, and issues of cost-effectiveness and cost competition from percutane ous biopsy have yet to be fully addressed. These factors along with the lac k of commercially available MR imaging-guided localization and biopsy syste ms have slowed the transfer of this imaging technology from research center s to clinical breast imaging practices. Technical requirements, potential c linical applications, and potential pitfalls and limitations of contrast-en hanced MR imaging as a method to help detect, diagnose, and stage breast ca ncer will be described.