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BACKGROUND: Screening breast MRI has been shown to preferentially detect high grade ductal carcinoma in situ (DCIS) and invasive carcinoma, likely due to increased angiogenesis resulting in early initial uptake of contrast. As interest grows in abbreviated screening breast MRI (AB-MRI), markers of early contrast wash-in that can predict tumor grade and potential aggressiveness are of clinical interest. PURPOSE: To evaluate the feasibility of using the initial enhancement ratio (IER) as a surrogate marker for tumor grade, hormone receptor status, and prognostic markers, as an initial step to being incorporated into AB-MRI. STUDY TYPE: Retrospective. SUBJECTS: 162 women (mean 55.0 years, range 32.8–87.7 years) with 187 malignancies imaged January 2012–November 2015. FIELD STRENGTH/SEQUENCE: Images were acquired at 3.0T with a T1-weighted gradient echo fat suppressed volume interpolated breath-hold sequence. ASSESSMENT: Subjects underwent dynamic contrast-enhanced breast MRI with a 7-channel breast coil. IER (% signal increase over baseline at the first post-contrast acquisition) was assessed and correlated with background parenchymal enhancement, washout curves, stage and final pathology. STATISTICAL TESTS: Chi-square test, Spearman rank correlation, Mann-Whitney U tests, Bland-Altman analysis and receiver operating characteristic curve analysis. RESULTS: IER was higher for invasive cancer than for DCIS (R1/R2, p

To compare a novel multicoil compressed sensing technique with flexible temporal resolution, golden-angle radial sparse parallel (GRASP), to conventional fat-suppressed spoiled three-dimensional (3D) gradient-echo (volumetric interpolated breath-hold examination, VIBE) MRI in evaluating the conspicuity of benign and malignant breast lesions.Between March and August 2015, 121 women (24-84 years; mean, 49.7 years) with 180 biopsy-proven benign and malignant lesions were imaged consecutively at 3.0 Tesla in a dynamic contrast-enhanced (DCE) MRI exam using sagittal T1-weighted fat-suppressed 3D VIBE in this Health Insurance Portability and Accountability Act-compliant, retrospective study. Subjects underwent MRI-guided breast biopsy (mean, 13 days [1-95 days]) using GRASP DCE-MRI, a fat-suppressed radial "stack-of-stars" 3D FLASH sequence with golden-angle ordering. Three readers independently evaluated breast lesions on both sequences. Statistical analysis included mixed models with generalized estimating equations, kappa-weighted coefficients and Fisher's exact test.All lesions demonstrated good conspicuity on VIBE and GRASP sequences (4.28 ± 0.81 versus 3.65 ± 1.22), with no significant difference in lesion detection (P = 0.248). VIBE had slightly higher lesion conspicuity than GRASP for all lesions, with VIBE 12.6% (0.63/5.0) more conspicuous (P 0.001). Masses and nonmass enhancement (NME) were more conspicuous on VIBE (P 0.001), with a larger difference for NME (14.2% versus 9.4% more conspicuous). Malignant lesions were more conspicuous than benign lesions (P 0.001) on both sequences.GRASP DCE-MRI, a multicoil compressed sensing technique with high spatial resolution and flexible temporal resolution, has near-comparable performance to conventional VIBE imaging for breast lesion evaluation.3 Technical Efficacy: Stage 3 J. MAGN. RESON. IMAGING 2017;45:1746-1752.