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A method of coil localization for breast lesions seen only on MRI

R Warren, MD, FRCP 1 and P Kessar, PhD, FRCR 2

1Department of Diagnostic Radiology, Box 97 Addenbrooke's Hospital, Cambridge CB2 2QQ and 2Magnetic Resonance Research Unit, The Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK



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  		Figure 1. A 51-year-old woman (case 1 in text) with screen-detected ductal carcinoma in situ (DCIS) on the right side for pre-operative staging of the extent of DCIS. These images are from the contralateral (left) side to the screen-detected DCIS. The additional lesions have dynamic contrast medium uptake features similar to the histologically proven DCIS and suspicious of contralateral disease. (a) Sagittal reconstruction of three-dimensional (3D) dynamic T1 sequence at 90 s after gadolinium injection showing one of the suspect contrast enhancing areas (arrow). (b) Lateral mammogram marked to show both sites of contrast enhancement (arrows). (c) Sagittal 3D FSPGR sequence showing the coil at the site of lesion 1 (arrow). The susceptibility artefact is clearly seen, but the vessels show contrast enhancement and it is possible to undertake dynamic analysis of any lesion. (d). Axial reconstruction showing the position of lesion 1 at 90 s after gadolinium injection (arrow). (e) Craniocaudal mammogram showing pencil marks corresponding to the two lesions (arrows). (f) Craniocaudal mammogram showing coils in place and localizing wires inserted for surgery (arrows). Histology showed benign fibrocystic disease. NB Lesions 1 and 2 cannot be seen on the same tomographic slice of the MR image. They are of course both visible after marking with the coils on a mammogram. Images a–c are all sagittal/lateral views; (d–f) are all axial/craniocaudal views.

 




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