A Prospective Evaluation of T2-Weighted First-Pass Perfusion MR Imaging In Diagnosing Breast Neoplasms

OBJECTIVE To compare the results from breast cancer patients who undergo T2-weighted first-pass perfusion imaging after dynamic contrast-enhanced T1-weighted imaging during the same examination, and to evaluate if T2-weighted imaging can provide additional diagnostic information over that obtained with T1-weighted imaging.

METHODS Twenty-nine patients with breast lesions verified by pathology (benign 12, malignant 17) underwent MR imaging with dynamic contrast-enhanced T1-weighted imaging of the entire breasts, immediately followed by 6-sections of T2-weighted first-pass perfusion imaging of the lesions. The diagnostic indices were acquired by individual 3D T1-weighted enhancement rate criterion and the T2 signal-intensity loss rate criterion. The sensitivity and specificity were calculated and the 2 methods were compared.

RESULTS With the dynamic. contrast-enhanced T1-weighted imaging, there was a significant differences between the benign and malignant breast lesions (t=2.563, P=0.016). However we found a considerable overlap between the signal intensity increase in the carcinomas and that in the benign lesions, for a sensitivity of 94% and a specificity of 25%. With T2-weighted first-pass perfusion imaging, there was a very significant difference between the benign and malignant breast lesions(t = 4.777, P<0.001), and the overlap between the signal intensity decrease in the carcinomas and that of the benign lesions on the T2-weighted images was less pronounced than the overlap in the T1-weighted images. for a sensitivity of 88% and a specificity of 75%.

CONCLUSION T2-weighted first-pass perfusion imaging may help differentiate between benign and malignant breast lesions with a higher level of specificity. The combination of T1-weighted and T2-weighted imaging is feasible in a single patient examination and may improve breast MR imaging.