Improved visualization of breast lesions with gadolinium-enhanced magnetization transfer MR imaging

A pulse sequence with magnetization transfer as the main contrast mechanism (MT-FLASH) was developed for improved imaging of breast lesions that requires neither fat suppression nor postprocessing. After optimization of the sequence in phantom and volunteer studies, a clinical pilot study with 14 patients was performed. In carcinomas the relative signal increase after Gd-DTPA administration was on average 34% in MT-FLASH images compared with 169% in conventional T₁-weighted (T1W) three-dimensional FLASH images. In MT-FLASH images, all lesions demonstrated a signal intensity higher than that of fat; in T1W images, all lesions have a lower signal intensity. The average postcontrast carcinoma-to-fat contrast-to-noise ratios were +11.6 and -14.2, respectively. The conspicuity of 12 of 13 carcinomas was improved in postcontrast MT-FLASH images compared with postcontrast T1w images. Thus, MT- FLASH imaging enables excellent visualization of Gd-DTPA-enhancing breast lesions.