Alfonso Fausto MD, Presenter: Research Consultant, Bracco Group

Luca Gaburro BA, MS, Abstract Co-Author: Employee, General Electric Company

Alessandro Preziosa BS, MS, Abstract Co-Author: Employee, General Electric Company

Roberta Chersevani MD, Abstract Co-Author: Nothing to Disclose

Laura Taroni MS, BS, Abstract Co-Author: Employee, General Electric Company

Giorgio Rizzatto MD, Abstract Co-Author: Research Consultant, General Electric Company

To investigate the value of second look breast US with and without MR volume navigation and fusion imaging for MR-detected lesions.

Seven patients (53±14 years, range 35-75) with additional MR-detected lesions underwent bilateral contrast-enhanced (.1 mmol/Kgbw Gd-BOPTA, Multihance, Bracco) breast MR in supine position (1.5T, Achieva, Philips Healthcare) using T1w THRIVE sequence with flexible surface body coil. Three vitamin E pills and the corresponding drawing pen signs were used as skin reference for final alignment. Breast US and MR synchronization was manually obtained and maintained by means of a dual electromagnetic systems consisting of a magnetic transmitter positioned close to the patient and two small magnetic receivers positioned on a linear probe’s bracket (LOGIQ E9, GE Healthcare). Second look US with and without MR volume navigation and fusion imaging was performed by two independent experienced radiologists. Pathologic examination was standard of reference. McNemar and Sign test was used.

All eight additional lesions were detected both on prone and supine position breast MR. Pathologic examination showed one IDC, one ILC, one relapse of breast lymphoma, one DCIS, one benign gland tissue, one fibrocystic changes and two sclerosing adenosis. Additional lesions mean and SD were .6±.2 mm in diameter. A 87% (7/8) detection rate was found using second look US with MR volume navigation and fusion imaging and only 25% (2/8) without (p=0.018). Second look US with and without MR volume navigation and fusion imaging sensitivity was 75% (3/4) and 50% (2/4) without; specificity 50% (1/2) and 60% (3/5), respectively (p=ns). Both radiologists missed a DCIS of 9 millimeter in diameter pathologically proved with MR-guided biopsy.

Second look US with MR volume navigation and fusion imaging seems to show a significant higher detection rate for MR lesions. The small number of the sample does not allow to find differences in diagnostic values.

Second look US with MR volume navigation and fusion imaging could increase US-guided biopsy or follow-up accuracy of MR-detected lesions.

Fausto, A, Gaburro, L, Preziosa, A, Chersevani, R, Taroni, L, Rizzatto, G, Value of Second Look Breast Ultrasound with and without Volume Navigation and Fusion Imaging Using Contrast-enhanced Magnetic Resonance as Reference: A Pilot Study.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8013901.html