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Abstract
Breast conserving therapy has become an accepted treatment modality for breast cancer, by combining radiotherapy with local excision. However, recurrence remains a problem, and patients should be reviewed periodically. During follow up, differentiation between scar tissue and recurrence by mammography and ultrasound may be helpful, however in many cases remains indeterminate.
This study demonstrates the value of MRI in detection or exclusion of recurrence in the post operative breast. Three-Dimensional dynamic sequences following injection of 0.1-0.16 mmol/kg, Gd-DTPA, are found effective in differentiating benign from malignant tissue. A 3-minute imaging time should be optimal for both detection and diagnosis of breast malignancy as about 50% of fast enhancing malignancies reach their peak intensity during the first minute after injection, while other fast enhancing malignancies reach it during the 3rd minute after injection.
Evaluation of the enhancement could be done by using time intensity curves by selection of ROI, calculation of degree of enhancement, and by morphology of enhancement.
Contrast enhanced MRI of breast may contribute valuable additional information, being interpreted with mammography and ultrasound, 6 months after surgery, 10 months after therapy in some cases and 18 months after therapy is most cases. Also, contrast enhanced MRI could obtain highly significant results in evaluating the breast tissue around dense silicone Implants close to the chest wall.