Breast MRI: guidelines from the European Society of Breast Imaging

Mann, Ritse M.; Kuhl, Christiane K.; Kinkel, Karen; Boetes, C.

doi:10.1007/s00330-008-0863-7

Cited by 677 publications

(470 citation statements)

References 124 publications

(98 reference statements)

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“…Axillae, supraclavicular fossae, chest wall, and anterior mediastinum can be assessed by breast MRI (e.g. to search for enlarged lymph nodes) but their evaluation could be omitted as there is no evidence of its diagnostic value (17).…”

Section: Breast Segmentationmentioning

confidence: 99%

“…Because enhancing lesions may become isointense to adjacent fatty tissue after contrast material injection, fat-saturation has been introduced to enhance the contrast between lesion and surrounding tissue and to overcome the limitations due to subtraction artifacts (7). However, fat-sat sequences introduce additional challenges for lesion segmentation, such as artifacts from inhomogeneous signal saturation and a lower contrast-to-noise-ratio between enhanced lesions and surrounding parenchyma (17).…”

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confidence: 99%

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Performance of a fully automatic lesion detection system for breast DCE‐MRI

Vignati

Giannini

Luca

et al. 2011

Magnetic Resonance Imaging

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Purpose: To describe and test a new fully automatic lesion detection system for breast DCE-MRI.Materials and Methods: Studies were collected from two institutions adopting different DCE-MRI sequences, one with and the other one without fat-saturation. The detection pipeline consists of (i) breast segmentation, to identify breast size and location; (ii) registration, to correct for patient movements; (iii) lesion detection, to extract contrast-enhanced regions using a new normalization technique based on the contrast-uptake of mammary vessels; (iv) false positive (FP) reduction, to exclude contrastenhanced regions other than lesions. Detection rate (number of system-detected malignant and benign lesions over the total number of lesions) and sensitivity (systemdetected malignant lesions over the total number of malignant lesions) were assessed. The number of FPs was also assessed.Results: Forty-eight studies with 12 benign and 53 malignant lesions were evaluated. Median lesion diameter was 6 mm (range, 5-15 mm) for benign and 26 mm (range, 5-75 mm) for malignant lesions. Detection rate was 58/65 (89%; 95% confidence interval [CI] 79%-95%) and sensitivity was 52/53 (98%; 95% CI 90%-99%). Mammary median FPs per breast was 4 (1st-3rd quartiles 3-7.25). Conclusion:The system showed promising results on MR datasets obtained from different scanners producing fatsat or non-fat-sat images with variable temporal and spatial resolution and could potentially be used for early diagnosis and staging of breast cancer to reduce reading time and to improve lesion detection. Further evaluation is needed before it may be used in clinical practice.

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Section: Breast Segmentationmentioning

confidence: 99%

mentioning

confidence: 99%

Performance of a fully automatic lesion detection system for breast DCE‐MRI

Vignati

Giannini

Luca

et al. 2011

Magnetic Resonance Imaging

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“…The guidelines from the European Society of Breast Imaging recommend the use of MRI halfway in the treatment regime to evaluate tumor response, as this is superior to clinical examination, mammography or ultrasound (5). However, no definite criteria for early evaluation have been defined.…”

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confidence: 99%

Diffusion‐weighted and dynamic contrast‐enhanced MRI in evaluation of early treatment effects during neoadjuvant chemotherapy in breast cancer patients

Jensen¹,

Garzón²,

Heldahl³

et al. 2011

Magnetic Resonance Imaging

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Purpose: To use dynamic contrast-enhanced (DCE) and diffusion-weighted (DW) MRI at 3 Tesla (T) for early evaluation of treatment effects in breast cancer patients undergoing neoadjuvant chemotherapy (NAC), and assess the reliability of DW-MRI.Materials and Methods: DW-and DCE-MRI acquisitions of 15 breast cancer patients were performed before and after one cycle of NAC. MRI tumor diameter and volume, apparent diffusion coefficient (ADC) and kinetic parameters (K trans , v e ) were derived. The reliability of ADC before NAC was assessed. Changes in MRI parameters after NAC were analyzed, and logistic regression analysis was used to find the best predictors for pathologic response. Results:The reliability for ADC values was high, with intraclass correlation coefficient of 0.84 (P ¼ 0.001). After one cycle of NAC, MRI tumor diameter (8%, P ¼ 0.005) and tumor volume (30%, P ¼ 0.008) was reduced for all patients, while ADC mean values increased (0.12 mm 2 /s, P ¼ 0.008). The best predictor for treatment response was a change in MRI tumor diameter with mean error rate of 0.167 (13% for responders, 5% for nonresponders, P ¼ 0.291).Conclusion: Changes in MRI derived tumor diameter and ADC after only one cycle of NAC could provide a valuable tool for early evaluation of treatment effects in breast cancer patients.

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“…The American College of Radiologists (ACR) and the European Society of Breast Imaging (EUSOBI) combine a woman's hereditary risk with age at diagnosis in the family in their screening advice although in different ways. 14,15 The ACR advises screening for all three risk-groups from 30 or 10 years of age earlier than the age at diagnosis of the youngest affected relative, whichever is later. 14 The EUSOBI advises screening from 30 years of age, and 5 years younger than the youngest relative.…”

Section: Early Detection and Diagnosismentioning

confidence: 99%

“…Most guidelines advise either starting at a fixed age depending only on risk group (e.g., 25 or 30 years in BRCA1 or BRCA2 carriers), [11][12][13] or take into account the age of the youngest affected relative. 14,15 Aside from financial burden, risk reduction strategies have documented side effects, such as false-positive screening results and anxiety. 16 Also, more than 50% of BRCA1 and BRCA2 mutation carriers who opt for preventive mastectomy at 25-30 years of age would not have developed breast cancer before the age of 50 years.…”

mentioning

confidence: 99%

Optimal age to start preventive measures in women with BRCA1/2 mutations or high familial breast cancer risk

Tilanus-Linthorst

Lingsma

Evans

et al. 2013

Intl Journal of Cancer

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Women from high-risk families consider preventive measures for breast cancer including screening. Guidelines on screening differ considerably regarding starting age. We investigated whether age at diagnosis in affected relatives is predictive for age at diagnosis. We analyzed the age of breast cancer detection of 1,304 first-and second-degree relatives of 314 BRCA1, 164 BRCA2 and 244 highrisk participants of the Dutch MRI-SCreening study. The within-and between-family variance in the relative's age at diagnosis was analyzed with a random effect linear regression model. We compared the starting age of screening based on risk-group (25 years for BRCA1, 30 years for BRCA2 and 35 years for familial risk), on family history, and on the model, which combines both. The findings were validated in 63 families from the UK-MARIBS study. Mean age at diagnosis in the relatives varied between families; 95% range of mean family ages was 35-55 in BRCA1-, 41-57 in BRCA2-and 44-60 in high-risk families. In all, 14% of the variance in age at diagnosis, in BRCA1 even 23%, was explained by family history, 7% by risk group. Determining start of screening based on the model and on risk-group gave similar results in terms of cancers missed and years of screening. The approach based on familial history only, missed more cancers and required more screening years in both the Dutch and the United Kingdom data sets. Age at breast cancer diagnosis is partly dependent on family history which may assist planning starting age for preventive measures.The average risk of detecting breast cancer between 50 and 70 years of age is 5-6% for women in the United States and Europe. A woman's risk of developing breast cancer increases when a first-degree relative has had breast cancer progressively with decreasing age at onset in the relative 1 and with an increasing number of family members with breast and/or ovarian cancer. 1-3 Very high risk and young age at onset are seen in women with a BRCA1 or BRCA2 mutation, who have a cumulative lifetime risk of 45-80%. [2][3][4][5] Screening with MRI or other preventive measures such as preventive mastectomy are considered appropriate in these groups from 25 to 30 years onward. However, in about 80% of families that meet the criteria for BRCA testing no causative gene mutation can be detected currently. 6 These women are considered as having an increased familial risk.Screening and preventive surgery should ideally be tailored to the expected age of breast cancer onset. The estimated risk at a given age differs considerably between studies, both for BRCA1/2 mutation carriers and for women

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Breast MRI: guidelines from the European Society of Breast Imaging

Cited by 677 publications

References 124 publications

Performance of a fully automatic lesion detection system for breast DCE‐MRI

Performance of a fully automatic lesion detection system for breast DCE‐MRI

Diffusion‐weighted and dynamic contrast‐enhanced MRI in evaluation of early treatment effects during neoadjuvant chemotherapy in breast cancer patients

Optimal age to start preventive measures in women with BRCA1/2 mutations or high familial breast cancer risk

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