DIGITAL SUBTRACTION IN GD-DTPA ENHANCED IMAGING OF THE BREAST

Purpose: This study examines the role of digital subtraction magnetic resonance imaging (MRI) of the breast in the interpretation of the morphology and characteristics of breast disease. Methods: Thirty-one patients with an abnormal mammogram or clinically palpable abnormality underwent MRI of the breast prior to surgical excision of the lesion. FLASH 3-D images of the breast were acquired before and after IV contrast injection of Gd-DTPA, Digital subtraction was performed on selected images, The images were independently assessed by two radiologists experienced in both mammography and MRI. Results: Accurate diagnosis was possible in 29 out of 31 patients using the subtraction technique compared to 23 cases using the pre-subtraction images alone. The actual extent of disease and multicentricity were also better appreciated on the subtracted image, Subtraction also provided better identification of tumour recurrence in the post-operative and post-radiotherapy breast, Chest wall and lymph node involvement were more easily appreciated on the subtraction images. Conclusion: Digital subtraction is a simple, effective and relatively cheap technique which can aid in the interpretation of magnetic resonance imaging of the breast.