Shogo Nakano, Presenter: Nothing to Disclose

Kimihito Fujii, Abstract Co-Author: Nothing to Disclose

Kyoko Yorozuya, Abstract Co-Author: Nothing to Disclose

Miwa Yoshida, Abstract Co-Author: Nothing to Disclose

Takashi Fukutomi, Abstract Co-Author: Nothing to Disclose

Tsuneo Ishiguchi MD, Abstract Co-Author: Nothing to Disclose

Incidental enhancing lesions (IELs) are detectable by breast dynamic contrast-enhanced MR imaging (DCE-MRI) in 48% maximum. When morphologic and dynamic pattern suggest malignancy, some attempts have been made to re-identify IELs on second look US in order to assess lesions. We recently developed a real-time virtual sonography (RVS), applying the position tracking system with a magnetic sensor. This system can synchronize an US image and the DCE-MRI cutaway images of the same site to be displayed in real time. The aim of this study was to verify the utility of RVS at second look US.

 Between April 2006 and March 2009, 152 women underwent breast MRI at our hospital. Of these 105 patients, 58 underwent DCE-MRI for staging of known breast cancer, and the remaining 47 underwent DCE-MRI for problem solving, including abnormal findings at physical examination or on conventional images. All patients were examined using mammography, US, DCE-MRI and RVS. DCE-MRI was obtained on a 1.5-T imager using a flexible body surface coil, with the patient in the supine position.

 A total of 119 lesions were evaluated with RVS at diagnosis and before surgery. Overall sensitivity for detecting primary breast cancer was 74% (43/58) for mammography, 93% (54/58) for US, 97% (56/58) for DCE-MRI, and 97% (56/58) for RVS. IELs were found in 61 lesions which were not expected from the previous conventional techniques. Of these, 48% (29/61) of IELs could be identified only on repeated US, but 90% (55/61) of SL could be identified easily using the RVS (p<0.001). The RVS was able to project enhanced DCE-MRI information onto a body surface correctly while checking US form images without the use of large-scale equipment.

The present results suggest that RVS appears to be not time consuming technique which can identify a large part of DCE-MRI findings, and can accurately select the cases in which MRI-guide biopsy are required.

 RVS is able to project enhanced DCE-MRI information onto a body surface correctly while checking US form images without the use of large-scale equipment.

Nakano, S, Fujii, K, Yorozuya, K, Yoshida, M, Fukutomi, T, Ishiguchi, T, Real-time Virtual Sonography (RVS) Improves Localization of Incidental Enhancing Lesions on Breast DCE-MRI at Second Look US.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8005001.html