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Comparison of gadobenate dimeglumine-enhanced breast MRI and gadopentetate dimeglumine-enhanced breast MRI with mammography and ultrasound for the detection of breast cancer.

AbstractPURPOSE:
To compare gadobenate dimeglumine-enhanced magnetic resonance imaging (MRI) with gadopentetate dimeglumine-enhanced MRI, mammography, and ultrasound for breast cancer detection across different malignant lesion types and across different densities of breast tissue.
MATERIALS AND METHODS:
In all, 153 women with Breast Imaging Reporting and Data System (BI-RADS) 3–5 findings on mammography and/or ultrasound underwent identical breast MRI exams at 1.5T with gadobenate dimeglumine and gadopentetate dimeglumine. Images were evaluated by three independent blinded radiologists. Mammography, ultrasound, and combined mammography and/or ultrasound findings were available for 108, 109, and 131 women. Imaging findings were matched with histology data by a fourth, independent, blinded radiologist. Malignant lesion detection rates and diagnostic performance were compared.
RESULTS:
In all, 120, 120, and 140 confirmed malignant lesions were present in patients undergoing MRI+mammography, MRI+ultrasound, and MRI+mammography and/or ultrasound, respectively. Significantly greater cancer detection rates were noted by all three readers for comparisons of gadobenate dimeglumine-enhanced MRI with mammography (Δ15.8–17.5%; P < 0.0001), ultrasound (Δ18.3–20.0%; P < 0.0001), and mammography and/or ultrasound (Δ8.6–10.7%; P ≤ 0.0105) but not for comparisons of gadopentetate dimeglumine-enhanced MRI with conventional techniques (P > 0.05). The false-positive detection rates were lower on gadobenate dimeglumine-enhanced MRI than on conventional imaging (4.0–5.5% vs. 11.1% at mammography; 6.3–8.4% vs. 15.5% at ultrasound). Significantly improved cancer detection on MRI was noted in heterogeneously dense breast (91.2–97.3% on gadobenate dimeglumine-enhanced MRI vs. 77.2–84.9% on gadopentetate dimeglumine-enhanced MRI vs. 71.9-84.9% with conventional techniques) and for invasive cancers (93.2–96.2% for invasive ductal carcinoma [IDC] on gadobenate dimeglumine-enhanced MRI vs. 79.7–88.5% on gadopentetate dimeglumine-enhanced MRI vs. 77.0–84.4% with conventional techniques). Overall diagnostic performance for the detection of cancer was superior on gadobenate dimeglumine-enhanced MRI than on conventional imaging or gadopentetate dimeglumine-enhanced MRI.
CONCLUSION:
Gadobenate dimeglumine-enhanced MRI significantly improves cancer detection compared to gadopentetate dimeglumine-enhanced MRI, mammography, and ultrasound in a selected group of patients undergoing breast MRI for preoperative staging or because of inconclusive findings at conventional imaging.
AuthorsFiona J Gilbert, Harrie C M van den Bosch, Antonella Petrillo, Katja Siegmann, Johannes T Heverhagen, Pietro Panizza, Hans-Björn Gehl, Federica Pediconi, Felix Diekmann, Wei-Jun Peng, Lin Ma, Francesco Sardanelli, Paolo Belli, Stefano Corcione, Christian M Zechmann, Matthieu Faivre-Pierret, Laura Martincich
JournalJournal of magnetic resonance imaging : JMRI (J Magn Reson Imaging) Vol. 39 Issue 5 Pg. 1272-86 (May 2014) ISSN: 1522-2586 [Electronic] United States
PMID25006633 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
Chemical References
  • Contrast Media
  • Organometallic Compounds
  • gadobenic acid
  • Meglumine
  • Gadolinium DTPA
Topics
  • Breast Neoplasms (diagnosis)
  • Contrast Media
  • Female
  • Gadolinium DTPA
  • Humans
  • Image Enhancement (methods)
  • Magnetic Resonance Imaging (methods)
  • Meglumine (analogs & derivatives)
  • Middle Aged
  • Organometallic Compounds
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Ultrasonography, Mammary (methods)

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