Highlights
- •Concerns on gadolinium brain deposition/retention prompted dose reduction research.
- •Preoperative breast MRI must allow for accurate tumor sizing.
- •No study evaluated MRI tumor sizing accuracy at 1.5-T with a reduced gadobutrol dose.
- •1.5-T breast MRI with a 0.08 mmol/kg gadobutrol dose maintains high sizing accuracy.
- •Tumor sizing with 0.08 mmol/kg gadobutrol retains acceptable interreader agreement.
Abstract
Background
Evidence on gadolinium brain accumulation after contrast-enhanced MRI prompted research
in dose reduction.
Purpose
To estimate accuracy and inter-reader reproducibility of tumor size measurement in
breast MRI using 0.08 mmol/kg of gadobutrol.
Methods
We retrospectively analyzed all women who underwent 1.5-T breast MRI for cancer staging
at our department with 0.08 mmol/kg of gadobutrol. Two readers (R1 and R2, 12 and
3 years-experience) measured the largest lesion diameter. Accuracy was estimated both
as correlation with pathology and rate of absolute (>5 mm) overestimation and underestimation,
inter-reader reproducibility using the Bland–Altman method. Data are given as median
and interquartile range.
Results
Thirty-six patients were analyzed (median age 56 years, 49–66) for a total of 38 lesions,
24 (63%) mass enhancement, 14 (37%) non-mass enhancement. Histopathological median
size (mm) of all lesions was 15 (9–25): 13 (9–19) for mass lesions, 19 (11–39) for
non-mass lesions. On MRI, R1 measured (mm) 14 (10−22) for all lesions, 13 (10–19)
for mass lesions, 19 (11–49) for non-mass lesions. MRI-pathology correlation was very
high for all lesion categories (ρ ≥ 0.766). On MRI, R1 overestimated lesion size in
6 cases (16%), and underestimated in 3 (8%); R2, overestimated 7 cases (18%) and underestimated
3 cases (8%). At inter-reader reproducibility analysis (mm): bias 0.9, coefficient
of reproducibility 13 for all lesions; −0.1 and 6 for mass lesions; 2.5 and 20 for
non-mass lesions.
Conclusions
Breast MRI may be performed using 0.08 mmol/kg of gadobutrol with high accuracy and
acceptable inter-reader agreement.
Keywords
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Article info
Publication history
Published online: November 09, 2020
Accepted:
November 8,
2020
Received in revised form:
October 13,
2020
Received:
June 27,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
