MR Imaging of Ductal Carcinoma in Situ: Morphological Appearances, Kinetic Features, and Choline Quantification with Pathological Correlation

J-H. Chen, H. J. YU, H-M. Baik, M-Y. Su, O. Nalcioglu Tu &Yuen Center for Functional Onco-Imaging, University of California, Irvine, Irvine, CA 92697, United States, Department of Radiology, China Medical University Hospital, Taichung, Taiwan Purpose Ductal carcinoma in situ (DCIS) accounts for 80% of noninvasive breast carcinomas. Laboratory and patient data suggest that DCIS is a precursor lesion for invasive cancer. Although MR imaging has been shown to be a sensitive imaging tool for invasive breast cancers, its role in diagnosis of DCIS is still a current topic of research interest. Two types of angiogenic patterns are associated with DCIS, the peri-ductal vessels and the stromal vessels. Since contrast enhanced MRI is based on angiogenesis, the presentation of DCIS on MRI may be different from that of invasive cancer, both in morphology and enhancement kinetics. MR spectroscopy has been shown useful for diagnosis of invasive cancer, but its role on diagnosis of DCIS has not been established. It has been reported that choline was not elevated in DCIS [Yeung DK, et al. Radiology 2002, 225(1): 190-7]. In this study, we applied the ACR BI-RADS breast MRI lexicon to describe morphological appearances and kinetic features of DCIS, and correlated results with the pathological tumor grading. MR spectroscopy study was also performed in selected patients to measure quantitative choline concentration. The results were compared between DCIS of high, intermediate, and low grades.