Fig. 2

Standardised reading setup for comprehensive diagnostic and predictive/prognostic breast magnetic resonance imaging (MRI) at one-stop shop. A female patient with suspicious amorphous segmental calcifications on the right breast at mammography, breast imaging reporting and data system (BI-RADS) 4 diagnostic category (not shown). MRI was performed also for preoperative staging due to suspicion of extended ductal carcinoma in situ. Diagnostic MRI shows an extensive heterogeneous segmental non-mass enhancement predominantly with plateau dynamic pattern. A noncircumscribed mass with washout and heterogeneous internal enhancement (BI-RADS 5 diagnostic category) is located centrally within the non-mass lesions. Relevant prognostic findings are here washout, skin thickening, invasion of the nipple, and diffuse ipsilateral oedema (see also Figs. 5 and 6). Semantic criteria correspond to the MRI phenotype of an aggressive invasive breast cancer. P2-MRI results were confirmed by postoperative pathological examination (invasive cancer NOS, G3, Ki-67+++, triple negative, node positive). Apparent diffusion coefficient map (A); unenhanced T1-weighted gradient echo with colour overlap of the dynamic curve on a pixel-by-pixel basis (green/yellow/red = persistent/plateau/washout) (B); first (C) and last (D) contrast-enhanced T1 GRE; diffusion-weighted imaging obtained with b = 800 s/mm² (E); T2-weighted turbo spin-echo (F); first (G) and last (H) contrast-enhanced subtractions. Diffusion-weighted imaging findings are highlighted in Fig. 7