Diagnosis of ductal carcinoma in situ using contrast-enhanced magnetic resonance mammography compared with conventional mammography. 2008

Tibor Vag, and Pascal A T Baltzer, and Diane M Renz, and Stefan O R Pfleiderer, and Mieczyslaw Gajda, and Oumar Camara, and Werner A Kaiser
Institute of Diagnostic and Interventional Radiology, Friedrich Schiller University Jena, Erlanger Allee 101, 07747 Jena, Germany. tibor.vag@med.uni-jena.de

OBJECTIVE The objective of this study is to compare mammography with magnetic resonance mammography (MRM) in the diagnosis of histopathologically verified subtypes of ductal carcinoma in situ (DCIS). METHODS All patients with verified pure DCIS lesions (no signs of invasion or microinvasion) after surgery were identified between 2004 and 2006. Selection criteria were performed mammography and MRM at our institute prior to surgery resulting in a cohort of 33 patients (mean patient age, 60 years; mean lesion size, 15 mm). RESULTS Magnetic resonance mammography enabled identification of DCIS in 29 of 33 patients with histopathologically verified pure DCIS (7 G1, 13 G2, and 9 G3 subtypes), giving an overall sensitivity of 87.9% for this patient cohort. Four DCIS lesions (two G1 and two G2) up to 5 mm diameter or smaller were not detected by MRM. In mammography, 21 of the 33 patients revealed suspicious outcome (including all lesions not detected by MRM), demonstrating an overall sensitivity of 63.6%. The remaining 12 mammographically occult DCIS lesions (three G1 subtypes, four G2 subtypes, five G3 subtypes) were all identified in MRM. CONCLUSIONS Magnetic resonance mammography can diagnose mammographically visible and also occult DCIS lesions without microcalcifications. Only small DCIS foci with microcalcifications could additionally be verified by mammography supposing MRM as a diagnostic approach.

UI MeSH Term Description Entries
D007089 Image Enhancement Improvement of the quality of a picture by various techniques, including computer processing, digital filtering, echocardiographic techniques, light and ultrastructural MICROSCOPY, fluorescence spectrometry and microscopy, scintigraphy, and in vitro image processing at the molecular level. Image Quality Enhancement,Enhancement, Image,Enhancement, Image Quality,Enhancements, Image,Enhancements, Image Quality,Image Enhancements,Image Quality Enhancements,Quality Enhancement, Image,Quality Enhancements, Image
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D008327 Mammography Radiographic examination of the breast. 3D-Mammography,Digital Breast Tomosynthesis,Digital Mammography,X-ray Breast Tomosynthesis,3D Mammography,3D-Mammographies,Breast Tomosyntheses, Digital,Breast Tomosyntheses, X-ray,Breast Tomosynthesis, Digital,Breast Tomosynthesis, X-ray,Digital Breast Tomosyntheses,Digital Mammographies,Mammographies,Mammographies, Digital,Mammography, Digital,X ray Breast Tomosynthesis,X-ray Breast Tomosyntheses
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D003287 Contrast Media Substances used to allow enhanced visualization of tissues. Radiopaque Media,Contrast Agent,Contrast Agents,Contrast Material,Contrast Materials,Radiocontrast Agent,Radiocontrast Agents,Radiocontrast Media,Agent, Contrast,Agent, Radiocontrast,Agents, Contrast,Agents, Radiocontrast,Material, Contrast,Materials, Contrast,Media, Contrast,Media, Radiocontrast,Media, Radiopaque
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D012680 Sensitivity and Specificity Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed) Specificity,Sensitivity,Specificity and Sensitivity

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