Abhishek Mahajan MD, Abstract Co-Author: Nothing to Disclose

Meenakshi Haresh Thakur MD, Presenter: Nothing to Disclose

  To examine the correlation of imaging findings on breast Multifunctional MRI (MFMRI) with pathologic data to determine the utility in evaluation of suspected recurrence. Correlate the utility of the additional MFMRI sequences in predicting recurrence/residual disease/post op changes.

  We prospectively reviewed our database of breast MRI after BCT for evaluating suspected recurrence by either by clinical examination, mammography or ultrasound. 24women with suspicion of post BCT recurrence underwent a breast MRI. Conventional MRI with MFMRI which included: DWI, perfusion, Spectroscopy, SWI and IDEAL sequences. The results of MFMRI were analyzed in recurrent/residual/post op changes. Few of the cases also underwent BOLD hypoxia imaging sequence. Cytohistologic examinations of suspected local recurrence were carried out.

Mean age was 48years. 12biopsies were performed and 8recurrences were confirmed histologically. MFMRI in these patients showed findings which added significant information for characterizing the lesion. Recurrent lesions showed high perfusion with type III kinetic curve, restricted diffusion, raised Choline peak, foci of hypointensity on SWI images and WATER images showed hyperintensity in recurrent cases. The post op scars and seromas showed features of benignity on MFMRI. The statistical analysis of the findings showed that MFMRI findings showed statistical significance for differentiation of post-treatment changes from recurrence and for guiding the histological confirmation. BOLD sequences showed hypoxia changes in few cases.  

Conventional-MRI sequences are as sensitive as MFMRI of the breast for the detection of locoregional recurrence, but MFMRI is associated with a far greater specificity. Therefore, dedicated MFMRI should be used when there is suspicion of recurrence to confirm or refute its presence.Under defined conditions and indications MFMRI is the best method to complement Conventional-MRI with the highest specificity for the diagnosis of local recurrences. 

MRI may be considered after BCT in three instances: 1.evaluation of residual disease after positive tumor margins, 2.evaluation of suspected recurrence, 3. as a screening tool in post BCT cases.

Mahajan, A, Thakur, M, The Efficacy of Multifunctional Breast MRI in Predicting Recurrence after Breast Conservation Therapy: Correlation of DWI, Perfusion, Spectroscopy, SWI and Ideal Sequence Findings.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9003367.html