• Federico D Pineda, Milica Medved, Shiyang Wang, Xiaobing Fan, David V Schacht, Charlene Sennett, Aytekin Oto, Gillian M Newstead, Hiroyuki Abe, and Gregory S Karczmar.
• Department of Radiology, University of Chicago, 5841 S. Maryland Ave. MC 2026, Chicago, IL, 60637.
• Acad Radiol. 2016 Sep 1; 23 (9): 1137-44.

Rationale And ObjectivesThe study aimed to evaluate the feasibility and advantages of a combined high temporal and high spatial resolution protocol for dynamic contrast-enhanced magnetic resonance imaging of the breast.Materials And MethodsTwenty-three patients with enhancing lesions were imaged at 3T. The acquisition protocol consisted of a series of bilateral, fat-suppressed "ultrafast" acquisitions, with 6.9- to 9.9-second temporal resolution for the first minute following contrast injection, followed by four high spatial resolution acquisitions with 60- to 79.5-second temporal resolution. All images were acquired with standard uniform Fourier sampling. A filtering method was developed to reduce noise and detect significant enhancement in the high temporal resolution images. Time of arrival (TOA) was defined as the time at which each voxel first satisfied all the filter conditions, relative to the time of initial arterial enhancement.ResultsUltrafast images improved visualization of the vasculature feeding and draining lesions. A small percentage of the entire field of view (<6%) enhanced significantly in the 30 seconds following contrast injection. Lesion conspicuity was highest in early ultrafast images, especially in cases with marked parenchymal enhancement. Although the sample size was relatively small, the average TOA for malignant lesions was significantly shorter than the TOA for benign lesions. Significant differences were also measured in other parameters descriptive of early contrast media uptake kinetics (P < 0.05).ConclusionsUltrafast imaging in the first minute of dynamic contrast-enhanced magnetic resonance imaging of the breast has the potential to add valuable information on early contrast dynamics. Ultrafast imaging could allow radiologists to confidently identify lesions in the presence of marked background parenchymal enhancement.Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

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