Contrast-enhanced MRI of ductal carcinoma in situ: Characteristics of a new intensity-modulated parametric mapping technique correlated with histopathologic findings

Purpose To identify morphologic and dynamic enhancement magnetic resonance imaging (MRI) features of pure ductal carcinoma in situ (DCIS) by using a new intensity‐modulated parametric mapping technique, and to correlate the MRI features with histopathologic findings. Materials and Methods Fourteen patients with pure DCIS on pathology underwent conventional mammography and contrast‐enhanced (CE) MRI using the intensity‐modulated parametric mapping technique. The MR images were reviewed and the lesions were categorized according to morphologic and kinetic criteria from the ACR BI‐RADS‐MRI Lexicon, with BI‐RADS 4 and 5 lesions classified as suspicious. Results With the use of a kinetic curve shape analysis, MRI classified seven of 14 lesions (50%) as suspicious, including four with initial‐rapid/late‐washout and three with initial‐rapid/late‐plateau. Using morphologic criteria, MRI classified 10/14 (71%) as suspicious, with the most prominent morphologic feature being a regional enhancement pattern. Using the intensity modulated parametric mapping technique, MRI classified 12/14 cases (86%) as suspicious. Parametric mapping identified all intermediate‐ and high‐grade DCIS lesions. Conclusion The intensity‐modulated parametric mapping technique for breast MRI resulted in the highest detectionrate for the DCIS cases. Furthermore, the parametric mapping technique identified all intermediate‐ and high‐grade DCIS lesions, suggesting that a negative MRI using the parametric mapping technique may exclude intermediate‐ and high‐grade DCIS. This finding has potential clinical implications. J. Magn. Reson. Imaging 2005. © 2005 Wiley‐Liss, Inc.