Vignesh Arasu1, Ryan Cheng-Ying Chen1, David Caryl Newitt1, Belinda Chang1, Hilda Tso1, Nola M. Hylton1, Bonnie Nancy Joe1
1Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
Breast MRI, although sensitive for identifying cancer extent, has been criticized for its poor specificity in staging preoperative patients, leading to unnecessary biopsies and changes in surgical management. Signal enhancement ratio (SER) of contrast-enhanced breast MRI lesions characterizes neoangiogenesis in cancer, with high values predicting malignancy. We investigated if SER also predicts malignancy in new lesions found secondary to the known primary cancer when staging preoperative patients. Our results show that high total tumor SER volume, washout SER volume, and high peak SER significantly predict secondary malignant lesions. These results potentially improve the efficacy of preoperative MRI for surgical management.