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Dynamic contrast enhanced MRI of the axilla in women with breast cancer: comparison with pathology of excised nodes

A D Murray, FRCR, FRCP1, R T Staff, PhD2, T W Redpath, PhD2, F J Gilbert, FRCR, FRCP1, A K Ah-See, FRCS3, J A Brookes, PhD2, I D Miller, FRCPath4 and S Payne, FRCPath4

Departments of 1 Radiology, 2 Biomedical Physics, 3 Surgery and 4 Pathology, University of Aberdeen and Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB25 2ZN, UK



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  		Figure 1. (a) Oblique sagittal T1 weighted fast low angle shot (T1W FLASH) image of an axilla containing several metastatic lymph nodes (arrows) before gadopentetate dimeglumine (Gd). (b) Oblique sagittal T1W FLASH image in the same position as (a) after Gd, showing enhancement in several enlarged lymph nodes (arrows). Regions of interest have been drawn around an enhancing node and an adjacent area of fat (arrowheads).

 


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  		Figure 2. (a) Oblique sagittal T1 weighted fast low angle shot (T1W FLASH) image of a normal axilla before gadopentetate dimeglumine (Gd). (b) Oblique sagittal T1W FLASH image in the same position as (a) after Gd. There are two small lymph nodes (arrows) which were normal histopathologically.

 


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  		Figure 3. A plot of maximal nodal enhancement ratio En for each patient.

 


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  		Figure 4. A plot of maximal node/fat ratio Ef for each patient.

 


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  		Figure 5. A plot of the largest node area A (cm2) for each patient.

 


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  		Figure 6. Receiver operating characteristic (ROC) curves for the various diagnostic approaches. The dotted line is the ROC curve for nodal area A<0.4 cm2; the grey line is the ROC curve for maximal node/fat ratio Ef<21%; and the upper bold line is the ROC curve for A<0.4 cm2 and Ef<21% combined. AUC, area under curve.

 




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