Ji Eun Park, Presenter: Nothing to Disclose

Eun Suk Cha, Abstract Co-Author: Nothing to Disclose

Jee Eun Lee MD, Abstract Co-Author: Nothing to Disclose

Ji-Young Hwang MD, Abstract Co-Author: Nothing to Disclose

Seung Yon Baek MD, Abstract Co-Author: Nothing to Disclose

To evaluate the usefulness of an alternative dynamic imaging protocol in 3.0T MRI that combines 1st, 2nd and 4-6th axial imaging and 3rd and 7th sagittal imaging of the lesion site on a single study in patients with breast cancer and to determine if an alternative imaging can overcome B1 inhomogeneity in 3.0T system and provide additional diagnostic information to that obtained only with axial imaging.

From April 2010 to August 2010, total 103 patients (age range, 24-81 years; mean, 46.65 years) with biopsy confirmed malignancy underwent dynamic MRI for preoperative staging. All examinations were performed on a 3.0T scanner using a 7-channel dedicated breast array coil. Imaging study for dynamic sequence was performed with 1st, 2nd and 4-6th axial and 3rd and 7th sagittal sequence of lesion site of breast cancer. Assessment of MR images were based on lesion morphologic characteristics and postcontrast enhancement patterns using a three-point visual scale.

Spicules were only identified with an alternative imaging protocol in 11 (8.3 %) of 132 malignant lesions, whereas only irregular or smooth boarders were identified with the axial sequence. Regarding the visual assessment scale, only two lesions scored higher in axial sequence, while 35 lesions scored higher in the combined axial and sagittal sequence in margin characterization. Ductal enhancement were more clearly identified in 35 (53.8 %) of 65 nonmass like enhancement, whereas ductal enhancement was not suspected with the axial sequence. There was a strong correlation between the visual score on the alternative sequence with the invasive ductal component on histopathologic examination (r= 0.304, p< .001).  

The new trial with an alternative sequence using combination of axial and sagittal planes in dynamic study of breast cancer patients seems to be a reliable imaging protocol, provides a relatively homogenous magnetic field and gives confidence in diagnosis of ductal enhancement and marginal characteristics using mid-phase sagittal sequence, without loss of kinetic information of early wash-in and late wash-out patterns using axial sequences.

The alternative dynamic MR imaging protocol can overcome the inhomogeneous B1 field issue and helps to determine exact surgical extent and is recommended as preoperative imaging for breast cancer.

Park, J, Cha, E, Lee, J, Hwang, J, Baek, S, Imaging Protocols for Dynamic Contrast Enhancement in 3.0 T Breast MRI Using Alternative Axial and Sagittal Sequences: Is It Useful?.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11003737.html