Resonancia magnética dinámica de mama: estudio comparativo de gadobutrol y Gd-DTPA / Dynamic magnetic resonance imaging of the breast: comparison of gadobutrol vs. Gd-DTPA

Objetivo. Evaluar el perfil farmacocinético del gadobutrol en comparación con el Gd-DTPA, en resonancia magnética de mama con contraste (RM-DC). El objetivo secundario es valorar la eficacia diagnóstica en la detección de lesiones adicionales tumorales en RM-DC, y el perfil de seguridad de ambos contrastes. Material y métodos. Estudio retrospectivo y observacional que incluyó 400 pacientes con diagnóstico histológico de cáncer mamario. A 200 pacientes se les realizó RM-DC con contraste Gd-DTPA (Magnevist®) y a las otras 200 con gadobutrol (Gadovist®). Se analizaron los parámetros farmacocinéticos y la intensidad de señal mediante una ROI (region of interest) en el área intralesional con mayor intensidad de señal en las secuencias poscontraste. Se compararon las variables farmacocinéticas (Ktrans, Kep y Ve) y las curvas de intensidad de señal-tiempo de ambos grupos, así como el número de lesiones adicionales tumorales detectadas con ambos contrastes. Resultados. El realce relativo de intensidad de señal es más alto con gadobutrol que con Gd-DTPA. El gadobutrol muestra significativamente menos lavado (46%) que el Gd-DTPA (58,29%) (p=0,0323). Se observan valores más altos de Ktrans, Kep y Ve para el gadobutrol, siendo la diferencia estadísticamente significativa para los dos primeros parámetros (p=0,001). No se encuentran diferencias en el número de lesiones adicionales malignas confirmadas histológicamente (p=0,387). Conclusiones. El gadobutrol tiene valores más altos de realce, mientras que el Gd-DTPA muestra un lavado más marcado. El gadobutrol no es inferior en cuanto a número de lesiones adicionales malignas detectadas. Ambos contrastes son seguros (AU)

Objective. To compare the pharmacokinetic profile of gadobutrol versus Gd-DTPA in dynamic contrast-enhanced MRI (DCE-MRI) in patients with breast cancer. Secondary objectives included comparing the safety profiles and diagnostic efficacy of the two contrast agents for detecting additional malignant lesions. Material and methods. This retrospective observational study included 400 patients with histologically confirmed breast cancer; 200 underwent DCE-MRI with Gd-DTPA (Magnevist®) and 200 underwent DCE-MRI with gadobutrol (Gadovist®). Pharmacokinetic parameters and signal intensity were analyzed in a region of interest placed in the area within the lesion that had greatest signal intensity in postcontrast sequences. We compared the two groups on pharmacokinetic variables (Ktrans, Kep, and Ve), time-signal intensity curves, and the number of additional malignant lesions detected. Results. The relative signal intensity (enhancement) was higher with gadobutrol than with Gd-DTPA. Washout was lower with gadobutrol than with Gd-DTPA (46% vs. 58,29%, respectively; p=0,0323). Values for Ktrans and Kep were higher for gadobutrol (p=0,001). There were no differences in the number of histologically confirmed additional malignant lesions detected (p=0,387). Conclusions. Relative enhancement is greater with gadobutrol, but washout is more pronounced with Gd-DTPA. The number of additional malignant lesions detected did not differ between the two contrast agents. Both contrasts are safe (AU)

Dynamic magnetic resonance imaging of the breast: Comparison of gadobutrol vs. Gd-DTPA. / Resonancia magnética dinámica de mama: estudio comparativo de gadobutrol y Gd-DTPA.

OBJECTIVE: To compare the pharmacokinetic profile of gadobutrol versus Gd-DTPA in dynamic contrast-enhanced MRI (DCE-MRI) in patients with breast cancer. Secondary objectives included comparing the safety profiles and diagnostic efficacy of the two contrast agents for detecting additional malignant lesions. MATERIAL AND METHODS: This retrospective observational study included 400 patients with histologically confirmed breast cancer; 200 underwent DCE-MRI with Gd-DTPA (Magnevist®) and 200 underwent DCE-MRI with gadobutrol (Gadovist®). Pharmacokinetic parameters and signal intensity were analyzed in a region of interest placed in the area within the lesion that had greatest signal intensity in postcontrast sequences. We compared the two groups on pharmacokinetic variables (Ktrans, Kep, and Ve), time-signal intensity curves, and the number of additional malignant lesions detected. RESULTS: The relative signal intensity (enhancement) was higher with gadobutrol than with Gd-DTPA. Washout was lower with gadobutrol than with Gd-DTPA (46% vs. 58,29%, respectively; p=0,0323). Values for Ktrans and Kep were higher for gadobutrol (p=0,001). There were no differences in the number of histologically confirmed additional malignant lesions detected (p=0,387). CONCLUSIONS: Relative enhancement is greater with gadobutrol, but washout is more pronounced with Gd-DTPA. The number of additional malignant lesions detected did not differ between the two contrast agents. Both contrasts are safe.

Artefactos y pitfalls en la interpretación de la resonancia magnética de mama / Artifacts and pitfalls in the interpretation of breast magnetic resonance imaging

Junto con la mamografía y la ecografía, la RM de mama se ha establecido como una técnica de imagen necesaria para manejar la afección mamaria. Para realizar un diagnóstico correcto y preciso, la RM debe ser interpretada teniendo en cuenta los artefactos y posibles errores de interpretación (en inglés «pitfalls») secundarios a diferentes factores (técnicos, anatómicos y fisiológicos, por la afección, operador-dependientes). De esta manera, y trabajando en un contexto de multimodalidad, se pueden minimizar los falsos positivos y falsos negativos para incrementar la sensibilidad y la especificidad de la prueba. En este artículo se describe la técnica básica de la RM de mama y los diferentes artefactos y posibles errores que pueden dificultar la interpretación (AU)

Together with mammography and ultrasonography, MRI has become a necessary technique for the management of breast disease. To reach a correct and precise diagnosis when interpreting breast MRI studies, it is essential to take into account artifacts and pitfalls due to technical, anatomic, physiological, disease-related, and operator-dependent factors. A multimodal approach taking into account the limitations of each technique can help minimize false positives and false negatives and thus increase the sensitivity and specificity of each test. In this article, we describe the basic technique for breast MRI and the different artifacts and pitfalls that can hinder its interpretation (AU)

[Artifacts and pitfalls in the interpretation of breast magnetic resonance imaging]. / Artefactos y pitfalls en la interpretación de la resonancia magnética de mama.

Together with mammography and ultrasonography, MRI has become a necessary technique for the management of breast disease. To reach a correct and precise diagnosis when interpreting breast MRI studies, it is essential to take into account artifacts and pitfalls due to technical, anatomic, physiological, disease-related, and operator-dependent factors. A multimodal approach taking into account the limitations of each technique can help minimize false positives and false negatives and thus increase the sensitivity and specificity of each test. In this article, we describe the basic technique for breast MRI and the different artifacts and pitfalls that can hinder its interpretation.

Primary lymphoma of the breast: MR imaging features. A case report.

Primary non-Hodgkin's lymphoma (NHL) of the breast are rare and represent less than 0.6% of all mammary malignancies. Secondary involvement of the breast in patients with diffuse disease occurs more frequently. The radiologic features of breast lymphoma are nonspecific, and the diagnosis is based on histologic criteria. We present the MR-imaging features of a case of primary NHL of the breast.