Preoperative axillary lymph node evaluation in breast cancer patients by breast magnetic resonance imaging (MRI): Can breast MRI exclude advanced nodal disease?

Purpose We investigated whether an abbreviated protocol (AP), consisting of only one pre- and one postcontrast acquisition and their derived images (first postcontrast subtracted [FAST] and maximum-intensity projection [MIP] images), was suitable for breast magnetic resonance imaging (MRI) screening. Methods We conducted a prospective observational reader study in 443 women at mildly to moderately increased risk who underwent 606 screening MRIs. Eligible women had normal or benign digital mammograms and, for those with heterogeneously dense or extremely dense breasts (n = 427), normal or benign ultrasounds. Expert radiologists reviewed the MIP image first to search for significant enhancement and then reviewed the complete AP (consisting of MIP and FAST images and optionally their nonsubtracted source images) to characterize enhancement and establish a diagnosis. Only thereafter was the regular full diagnostic protocol (FDP) analyzed. Results MRI acquisition time for FDP was 17 minutes, versus 3 minutes for the AP. Average time to read the single MIP and complete AP was 2.8 and 28 seconds, respectively. Eleven breast cancers (four ductal carcinomas in situ and seven invasive cancers; all T1N0 intermediate or high grade) were diagnosed, for an additional cancer yield of 18.2 per 1,000. MIP readings were positive in 10 (90.9%) of 11 cancers and allowed establishment of the absence of breast cancer, with a negative predictive value (NPV) of 99.8% (418 of 419). Interpretation of the complete AP, as with the FDP, allowed diagnosis of all cancers (11 [100%] of 11). Specificity and positive predictive value (PPV) of AP versus FDP were equivalent (94.3% v 93.9% and 24.4% v 23.4%, respectively). Conclusion An MRI acquisition time of 3 minutes and an expert radiologist MIP image reading time of 3 seconds are sufficient to establish the absence of breast cancer, with an NPV of 99.8%. With a reading time < 30 seconds for the complete AP, diagnostic accuracy was equivalent to that of the FDP and resulted in an additional cancer yield of 18.2 per 1,000.

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Segmentation of elongated structures processed on breast MRI for the detection of vessels

tm - Technisches Messen ◽

10.1515/teme-2021-0017 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Marco Gierlinger ◽

Dinah M. Brandner ◽

Bernhard G. Zagar

Keyword(s):

Breast Magnetic Resonance Imaging ◽

Breast Mri ◽

Region Growing ◽

Seed Region ◽

Resonance Imaging ◽

Mr Images ◽

Pixel Intensity ◽

Breast Magnetic Resonance ◽

Magnetic Resonance Imaging Mri ◽

Diagnosis Of Diseases

Abstract The multi-seed region growing (MSRG) algorithm from previous work is extended to extract elongated segments from breast Magnetic Resonance Imaging (MRI) stacks. A model is created to adjust the MSRG parameters such that the elongated segments may reveal vessels that can support clinicians in their diagnosis of diseases or provide them with useful information before surgery during e. g. a neoadjuvant therapy. The model is a pipeline of tasks and contains user-defined parameters that influence the segmentation result. A crucial task of the model relies on a skeletonization-like algorithm that collects useful information about the segments’ thickness, length, etc. Length, thickness, and gradient information of the pixel intensity along the segment helps to determine whether the extracted segments have a tubular structure, which is assumed to be the case for vessels. In this work, we show how the results are derived and that the MSRG algorithm is capable of extracting vessel-like segments even from noisy MR images.

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Indications for breast magnetic resonance imaging at a referral center for the diagnosis and treatment of breast cancer in Brazil

Radiologia Brasileira ◽

10.1590/0100-3984.2019.0114 ◽

2021 ◽

Vol 54 (2) ◽

pp. 83-86

Author(s):

Samuel Silva Ferreira ◽

Adriene Moraes Campos ◽

Patrícia Lima Fernandes ◽

Izabela Machado Pereira ◽

Flavia Maria Rodrigues ◽

...

Keyword(s):

Breast Cancer ◽

Magnetic Resonance Imaging ◽

High Risk ◽

Magnetic Resonance ◽

Breast Magnetic Resonance Imaging ◽

Breast Mri ◽

Diagnosis And Treatment ◽

Resonance Imaging ◽

Referral Center ◽

Breast Magnetic Resonance

Abstract Objective: To describe the indications for breast magnetic resonance imaging (MRI) at a referral center for breast cancer in Brazil. Materials and Methods: This was a retrospective study in which we reviewed the clinical records, including physician requests and patient questionnaires, of women who underwent breast MRI between 2014 and 2018 at a referral center for the diagnosis and treatment of breast cancer in the city of Belo Horizonte, Brazil. Results: The most common indication for breast MRI was as a complement to mammography/ultrasonography (in 43.6% of cases), followed by breast cancer staging (in 25.1%), the screening of patients at high risk (in 17.4%), the evaluation of breast implants (in 10.1%), and the evaluation of the response to neoadjuvant chemotherapy (in 3.8%). Conclusion: Although there is strong evidence supporting the use of breast MRI, mainly for the screening of high-risk patients, the imaging method is underutilized in Brazil.

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Breast Magnetic Resonance Imaging of Multicentric, Multifocal and Bilateral Cancer — A Case-based Review

European Oncology & Haematology ◽

10.17925/eoh.2011.07.01.24 ◽

2011 ◽

Vol 07 (01) ◽

pp. 24

Author(s):

Virginia Pérez Dueñas ◽

María Ruíz de Gopegui Andreu ◽

Sara Morón Hodge ◽

Asunción Suárez Manrique ◽

◽

...

Keyword(s):

Breast Cancer ◽

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

False Positive ◽

Breast Magnetic Resonance Imaging ◽

Breast Mri ◽

Resonance Imaging ◽

Mri Findings ◽

Mri Features ◽

Breast Magnetic Resonance

Multifocal or multicentric breast cancer can be difficult to detect on mammography or ultrasound, particularly in patients with dense breast tissue. A multimodality approach that includes breast magnetic resonance imaging (MRI) is indicated, particularly when conservative surgery is being considered as it is the most sensitive technique for identifying additional sites of disease. However, its influence on recurrence and survival rates has yet not been clearly established, and false-positive cases may lead to more aggressive management and treatment. Radiologists should therefore be aware of relevant breast MRI findings. Infiltrating carcinomas, contralateral unsuspected carcinomas, occult carcinomas, false-positive cases and post-chemotherapy changes. Several cases of multiple-site breast carcinomas and their corresponding mammographic, ultrasound and MRI features have been reviewed for this article, in which the definition and differences between multifocal, multicentric and contralateral breast carcinoma are explained and the most relevant imaging findings on MRI are illustrated and correlated with mammogram and ultrasound findings. Finally, the role of breast MRI in the pre-operative assessment of breast cancer is discussed.

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Efficacy of Screening Breast MRI for High-Risk Women

10.1093/med/9780190223700.003.0039 ◽

2016 ◽

Author(s):

Christoph I. Lee

Keyword(s):

High Risk ◽

Breast Magnetic Resonance Imaging ◽

Breast Mri ◽

Resonance Imaging ◽

Additional Information ◽

High Risk Women ◽

Study Methodology ◽

Breast Magnetic Resonance ◽

Magnetic Resonance Imaging Mri ◽

Higher Sensitivity

This chapter, found in the cancer screening and management section of the book, provides a succinct synopsis of a key study examining the efficacy of screening breast magnetic resonance imaging (MRI) for high-risk women. This summary outlines the study methodology and design, major results, limitations and criticisms, related studies and additional information, and clinical implications. Breast MRI screening has higher sensitivity than mammography for high-risk women, but both the specificity and positive predictive value are lower than for mammography screening. In addition to outlining the most salient features of the study, a clinical vignette and imaging example are included in order to provide relevant clinical context.

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The impact of preoperative breast magnetic resonance imaging (MRI) on surgical decision-making in young patients with breast cancer.

10.1158/0008-5472.sabcs-4012 ◽

2009 ◽

Author(s):

SD Mukherjee ◽

N Hodgson ◽

L Peter ◽

C Shelley ◽

S Jonathan ◽

...

Keyword(s):

Breast Cancer ◽

Magnetic Resonance Imaging ◽

Breast Magnetic Resonance Imaging ◽

Young Patients ◽

Resonance Imaging ◽

Surgical Decision ◽

Breast Magnetic Resonance ◽

Magnetic Resonance Imaging Mri ◽

The Impact ◽

Surgical Decision Making

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The Role of Preoperative Bilateral Breast Magnetic Resonance Imaging in Patient Selection for Partial Breast Irradiation in Ductal CarcinomaIn Situ

International Journal of Surgical Oncology ◽

10.1155/2012/206342 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6

Author(s):

Kristin V. Kowalchik ◽

Laura A. Vallow ◽

Michelle McDonough ◽

Colleen S. Thomas ◽

Michael G. Heckman ◽

...

Keyword(s):

Breast Cancer ◽

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Breast Magnetic Resonance Imaging ◽

Breast Mri ◽

Partial Breast Irradiation ◽

Breast Irradiation ◽

Resonance Imaging ◽

Ipsilateral Breast ◽

Breast Magnetic Resonance

Purpose. Women with ductal carcinomain situ(DCIS) are often candidates for breast-conserving therapy, and one option for radiation treatment is partial breast irradiation (PBI). This study evaluates the use of preoperative breast magnetic resonance imaging (MRI) for PBI selection in DCIS patients.Methods. Between 2002 and 2009, 136 women with newly diagnosed DCIS underwent a preoperative bilateral breast MRI at Mayo Clinic in Florida. One hundred seventeen women were deemed eligible for PBI by the NSABP B-39 (National Surgical Adjuvant Breast and Bowel Project, Protocol B-39) inclusion criteria using physical examination, mammogram, and/or ultrasound. MRIs were reviewed for their impact on patient eligibility, and findings were pathologically confirmed.Results. Of the 117 patients, 23 (20%) were found ineligible because of pathologically proven MRI findings. MRI detected additional ipsilateral breast cancer in 21 (18%) patients. Of these women, 15 (13%) had more extensive disease than originally noted before MRI, and 6 (5%) had multicentric disease in the ipsilateral breast. In addition, contralateral breast cancer was detected in 4 (4%).Conclusions. Preoperative breast MRI altered the PBI recommendations for 20% of women. Bilateral breast MRI should be an integral part of the preoperative evaluation of all patients with DCIS being considered for PBI.

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Establishing a Comprehensive Breast Magnetic Resonance Imaging Service in a Community Hospital

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2010.11.002 ◽

2011 ◽

Vol 62 (1) ◽

pp. 22-30 ◽

Cited By ~ 1

Author(s):

Neety Panu ◽

Elizabeth Morris

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Breast Magnetic Resonance Imaging ◽

Breast Mri ◽

Resonance Imaging ◽

Team Members ◽

Assessment Centre ◽

Imaging Service ◽

Breast Magnetic Resonance ◽

Magnetic Resonance Imaging Mri

Advances made since the first application of breast magnetic resonance imaging (MRI) in the late 1980s have made it an integral complement to a comprehensive breast assessment centre. Incorporating breast MRI into an existing practice can appear daunting, but a structured and organized approach allows for a smoother transition. With a well thought out plan that engages all team members and experience in interpretation and performing of interventional procedures, breast MRI will serve to add valuable information in patient management.

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Anatomical Breast Imaging Derived Parameters Do Not Provide Incremental Information In Prediction of Nonvisualization of Sentinel Lymph Nodes On Lymphoscintigraphy

10.21203/rs.3.rs-1187890/v1 ◽

2022 ◽

Author(s):

Youssef Chahid ◽

Hein J. Verberne ◽

Edwin Poel ◽

N. Harry Hendrikse ◽

Jan Booij

Keyword(s):

Breast Cancer ◽

Retrospective Study ◽

Cancer Patients ◽

Breast Imaging ◽

Multivariable Analysis ◽

Breast Mri ◽

Breast Cancer Patients ◽

Incremental Information ◽

Breast Magnetic Resonance ◽

Magnetic Resonance Imaging Mri

Abstract Background: Accurate sentinel lymph node (SLN) staging is essential for both prognosis and treatment in patients with breast cancer. However, the preoperative lymphoscintigraphy may fail to visualize the SLN. The aim of this retrospective study was to investigate whether parameters derived from anatomical breast imaging can predict SLN nonvisualization on lymphoscintigraphy. For this single-center retrospective study all data of mammography, breast magnetic resonance imaging (MRI), and lymphoscintigraphy of SLN procedures from January 2016 to April 2021 were collected and reviewed from the Amsterdam UMC electronic health records database.Results: A total of 758 breast cancer patients were included in this study. The SLN nonvisualization rate was 29.7% on lymphoscintigraphy. Multivariable analysis showed that age ≥ 70 years (P = 0.019; OR: 1.82; 95% CI: 1.10–3.01), BMI ≥ 30 kg/m2 (P = 0.031; OR: 1.59; 95% CI: 1.04–2.43), and nonpalpable tumors (P = 0.034; OR: 1.54; 95% CI: 1.03–2.04) were independent predictors of SLN nonvisualization. Differences in tumor size, Breast Imaging-Reporting and Data System (BI-RADS) classification, or breast density were not significantly associated with SLN nonvisualization.Conclusions: This study shows that, by using a multivariable analysis, risk factors for SLN nonvisualization in breast cancer patients during preoperative lymphoscintigraphy are age ≥70 years, BMI ≥30 kg/m2, and nonpalpable tumors. Parameters derived from mammography or breast MRI, however, are not useful to predict SLN nonvisualization on lymphoscintigraphy.

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