MR imaging of the breast: indications, established technique, and new directions

A detailed list of clinical indications for dynamic breast MR imaging is given, and an interpretation score system provided. The performance of the MR examination in terms of sensitivity and specificity for lesion detection and characterization is discussed in detail, as are the pharmacokinetics and safety of the two-compartment Gd-based contrast agents. The effects of stressing temporal and spatial resolution are also discussed. Finally, intriguing new directions in breast MR imaging are presented in terms of the potential for Gd-chelates with high T1-relaxivity, blood-pool contrast agents, and proton MR spectroscopy. (orig.)