We selected 18 consecutive women (mean age 46 ± 10yrs.) who performed a high-field MRI scan (1,5T, Sola, Siemens – Erlangen, Germany) at our institution for the detection and characterization of breast abnormalities. These patients were previously investigated with standard full-field digital mammography (FFDM) projections, including digital breast tomosynthesis (DBT) and ultrasound (US) imaging. 50% of the patients were also submitted to US-guided core biopsy using a 14G tru-cut needle.

Patients were placed inside the magnet in the prone position, with both breasts hanging into a dedicated 18-channel phased-array breast coil.

Breast MRI consisted of the following sequences: a 3 mm short-tau inversion recovery (STIR) in the coronal plane; an axial dynamic gradient-echo (GRE) 3D T1-weighted fat-sat acquisition, one before and five after the intravenous administration of 0,5 mmol/kg gadopiclenol (Vueway, Bracco – Milan, Italy); a GRE 3D T1-weighted fat-sat sequence in the coronal plane. The contrast agent was injected in a cubital vein through a 20G needle, using an automatic injector (Accutron MR, Medtron AG – Saarbrücken, Germany) at 4 ml/s, followed by a saline flush.

Contrast intensity/time curves were calculated by manually placing a region of interest (ROI) in the portion of each detectable breast lesion with maximum enhancement on the post-contrast subtracted images of the dynamic acquisition, and the maximum enhancement value was registered for each lesion.

In our cohort of patients, benign nodules (11.1%), intraductal cancers (16.7%), suspected multifocal invasive ductal or lobular cancers (22.2%), and anomalous post-surgical scars (5.6%) have been found. We also had some MRI scans without any suspect alteration, consisting of surveillance of women with high genetic risk for developing breast cancer (16.7%), oncologic follow-up of patients at high risk for recurrence (11.1%), ruling of other previously unexplained abnormalities at US or FFDM (16.7%).

After performing breast MRI, some patients who previously didn’t receive any biopsy underwent US-guided tru-cut biopsy (67%), surgery (56%), clinical and imaging follow-up (44.4%) with US, FFDM, or MRI.

Standard informed consent was obtained from all the patients.