No abstract

This study was undertaken to assess the utility of whole‐body turbo short tau inversion recovery (STIR) magnetic resonance imaging (MRI) to detect metastases to liver, brain, and bone as a single examination in women with breast cancer. Seventeen patients with biopsy‐proven breast cancer and suspected metastatic disease attending over a 12‐month period referred for both conventional imaging and whole‐body MRI were included in the study. Three patients were found to be free of metastases at both conventional and MR imaging. Appendicular or axial skeletal metastases were identified in 11 of 17 patients, with correlation between findings at whole‐body MRI and scintigraphy in 15 of the 17 patients. Five patients had evidence of hepatic metastases on whole‐body MRI, of which metastases were identified in only three patients at CT despite contrast enhancement. Four patients had brain abnormalities (metastases in three patients, meningioma in one patient) detected on both whole‐body and dedicated brain MRI. Preliminary clinical experience suggests that turbo STIR whole‐body MRI may represent a convenient and cost‐effective method of total body screening for metastases in patients with breast carcinoma. J. Magn. Reson. Imaging 2000;11:343–350. © 2000 Wiley‐Liss, Inc.

Our evaluation of discrepancy rates was unusual in that we included interpretations of sonograms, on which residents and the attending radiologist had a higher rate of agreement (99.5%). Because of the high agreement in the interpretation of sonograms, the overall discrepancy rate was 3.8%. However, if only body CT scan interpretations were evaluated, our results were closer to the rates reported in previously published studies. Major discrepancies led to a change in patient treatment but did not lead to any increase in patient morbidity or to any quantifiable increase in the length of the hospital stay.

Despite expert reader analyses, subjective evaluations of liver lesion signal characteristics are prone to inaccuracy and lack certainty and consistency when intermediate TEs (50/160 ms) are used. Quantitative measurements of T2 relaxation times should be performed to accurately and confidently differentiate benign from malignant liver lesions. Use of a higher T2 threshold than previously recommended is required to avoid misclassification of malignancies.