Breast MRI: State of the Art

Vandermeer, Fauzia Q.; Bluemke, David A.

doi:10.1080/07357900701360013

Cited by 15 publications

(11 citation statements)

References 74 publications

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“…Breast magnetic resonance imaging (MRI) has attracted much attention recently because its ability to detect breast lesions sufficient to allow the accurate visualization of intraductal lesions around main tumors [7,8]. However, although MRI offers the advantage of sensitivity, it tends to overestimate tumor size and is limited by a relatively high false-positive rate, and thus, requires additional biopsies and increases patient anxiety, time, and costs [9-11]. In addition, MRI cannot be performed in patients with claustrophobia and is usually performed in the prone position, whereas surgery is performed with the patient supine.…”

Section: Discussionmentioning

confidence: 99%

The value of chest CT for prediction of breast tumor size: comparison with pathology measurement

Ahn

Kim

et al. 2013

World J Surg Onc

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BackgroundLittle information is available on the use of chest computed tomography (CT) to predict breast tumor size in breast cancer, despite the fact that chest CT examinations are being increasingly used. The purpose of this study was to evaluate the value of chest CT for predicting breast tumor size using pathology measurements as reference standards.MethodsTumor sizes (defined as greatest diameter) were retrospectively measured on the preoperative chest CT images of 285 patients with surgically proven unifocal, invasive breast carcinoma. Greatest tumor diameters as determined by chest CT and pathologic examinations were compared by linear regression and Spearman’s rho correlation analysis. Concordance between CT and pathology results was defined as a diameter difference of <5 mm. Subgroup analyses were also performed with respect to tumor size (<20 mm or ≥20 mm) and histological subtype (invasive ductal carcinoma(IDC) or non-IDC).ResultsCT and pathology measured diameters were found to be linearly related (size at pathology = 1.086 × CT determined tumor size - 1.141; Spearman’s rho correlation coefficient = 0.84, P<0.001). Most tumors (n = 228, 80.0%) were concordant by chest CT and pathology, but 36 tumors (12.7%) were underestimated by CT (average underestimation, 11 mm; range, 6–36 mm) and 21 tumors (7.4%) were overestimated (average overestimation by CT, 10 mm; range, 6–19 mm). The concordance rate between the two sets of measurements was greater for tumor of <20 mm and for IDC (P<0.001 and P = 0.011, respectively).ConclusionsTumor size by chest CT is well correlated with pathology determined tumor size in breast cancer patients, and the diameters of the majority of tumors by chest CT and pathology differed by <5 mm. In addition, the concordance rate was higher for breast tumors of <20 mm and for tumors of the IDC histologic subtype.

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Section: Discussionmentioning

confidence: 99%

The value of chest CT for prediction of breast tumor size: comparison with pathology measurement

Ahn

Kim

et al. 2013

World J Surg Onc

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“…Staging of metastatic disease is currently performed using fluorodeoxyglucose-PET. Breast MRI is useful in detecting axillary metastases from breast cancer (25). For specific localization and extent of disease, fat-suppressed (STIR) T 2 and T 1 are used (25).…”

Section: Cancer Diagnosis and Stagingmentioning

confidence: 99%

“…Mammography and ultrasound are still the most relevant imaging modalities for this purpose. Screening high-risk populations, evaluation of suspicious breast lesions, staging and treatment planning, assessment of residual disease after lumpectomy, assessment of breast cancer recurrence and evaluation of treatment response, postoperative tissue reconstruction, axillary adenopathy of unknown etiology, and evaluation of the augmented breast are some of the areas where MRI/MRS can be used to advantage compared with other imaging modalities (25). In addition, MRS of total choline as a biomarker for malignant breast tissue, and MRI detection of the uptake of ultrasmall superparamagnetic iron oxide (SPIO) particles for detecting lymph node involvement are also emerging as valuable techniques for breast cancer diagnosis and prognosis.…”

Section: Introductionmentioning

confidence: 99%

Molecular and functional imaging of breast cancer

et al. 2008

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Despite several major advances in breast cancer diagnosis and treatment, the American Cancer Society has estimated that in the US alone 43300 women and 400 men will die from breast cancer in 2007. Breast cancer typically is a multi-focal, multi-faceted disease, with the major cause of mortality being complications due to metastasis. Whereas a decade ago genetic alterations were the primary focus in cancer research, it is now apparent that the physiological tumor microenvironment, interactions between cancer cells and stromal cells such as endothelial cells, fibroblasts and macrophages, the extracellular matrix, and a multitude of secreted factors and cytokines influence progression, aggressiveness, and response of the disease to treatment. Prevention, early diagnosis, and treatment are the three broad challenges for MR molecular and functional imaging in reducing mortality from this disease. Multi-parametric molecular and functional MRI provides unprecedented opportunities for identifying novel targets for imaging and therapy at the bench, as well as for accurate diagnosis and monitoring response to therapy at the bedside. Here we provide an overview of the current status of molecular and functional MRI of breast cancer, outlining some key developments, as well as identifying some of the important challenges facing this field in the future.

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“…Many indications for clinical breast MRI are recognized. These include resolving mammography findings, staging of breast cancer when multiple or bilateral disease is suspected, and detecting the occult primary breast cancer presenting with malignant axillary lymphadenopathy [7, 8]. …”

Section: Introductionmentioning

confidence: 99%

Differentiation of benign and malignant breast lesions by mechanical imaging

Egorov

Kearney

Pollak

et al. 2009

Breast Cancer Res Treat

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Mechanical imaging yields tissue elasticity map and provides quantitative characterization of a detected pathology. The changes in the surface stress patterns as a function of applied load provide information about the elastic composition and geometry of the underlying tissue structures. The objective of this study is the clinical evaluation of breast mechanical imager for breast lesion characterization and differentiation between benign and malignant lesions. The breast mechanical imager includes a probe with pressure sensor array, an electronic unit providing data acquisition from the pressure sensors and communication with a touch-screen laptop computer. We have developed an examination procedure and algorithms to provide assessment of breast lesion features such as hardness related parameters, mobility, and shape. A statistical Bayesian classifier was constructed to distinguish between benign and malignant lesions by utilizing all the listed features as the input. Clinical results for 179 cases, collected at four different clinical sites, have demonstrated that the breast mechanical imager provides a reliable image formation of breast tissue abnormalities and calculation of lesion features. Malignant breast lesions (histologically confirmed) demonstrated increased hardness and strain hardening as well as decreased mobility and longer boundary length in comparison with benign lesions. Statistical analysis of differentiation capability for 147 benign and 32 malignant lesions revealed an average sensitivity of 91.4% and specificity of 86.8% with a standard deviation of ±6.1%. The area under the receiver operating characteristic curve characterizing benign and malignant lesion discrimination is 86.1% with the confidence interval ranging from 80.3 to 90.9%, with a significance level of P = 0.0001 (area = 50%). The multisite clinical study demonstrated the capability of mechanical imaging for characterization and differentiation of benign and malignant breast lesions. We hypothesize that the breast mechanical imager has the potential to be used as a cost effective device for cancer diagnostics that could reduce the benign biopsy rate, serve as an adjunct to mammography and to be utilized as a screening device for breast cancer detection.

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Breast MRI: State of the Art

Cited by 15 publications

References 74 publications

The value of chest CT for prediction of breast tumor size: comparison with pathology measurement

The value of chest CT for prediction of breast tumor size: comparison with pathology measurement

Molecular and functional imaging of breast cancer

Differentiation of benign and malignant breast lesions by mechanical imaging

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