Dynamic contrast-enhanced breast MRI at 7T and 3T: an intra-individual comparison study

Abstract

The aim of this study is to compare the current state of lesion identification, the BI-RADS classification and the contrast-enhancement behavior at 7T and 3T breast MRI in the same patient group. Twenty-seven patients with thirty suspicious lesions were selected for this prospective study and underwent both 7T and 3T MRI. All examinations were rated by two radiologists (R1 and R2) independently on image quality, lesion identification and BI-RADS classification. We assessed sensitivity, specificity, NPV and PPV, observer agreement, lesion sizes, and contrast-enhancement-to-noise ratios (CENRs) of mass lesions. Fifteen of seventeen histopathological proven malignant lesions were detected at both field strengths. Image quality of the dynamic series was good at 7T, and excellent at 3T (P = 0.001 for R1 and P = 0.88 for R2). R1 found higher rates of specificity, NPV and PPV at 7T when compared to 3T, while R2 found the same results for sensitivity, specificity, NPV and PPV for both field strengths. The observers showed excellent agreement for BI-RADS categories at 7T (κ = 0.86) and 3T (κ = 0.93). CENRs were higher at 7T (P = 0.015). Lesion sizes were bigger at 7T according to R2 (P = 0.039). Our comparison study shows that 7T MRI allows BI-RADS conform analysis. Technical improvements, such as acquisition of T2w sequences and adjustment of B1+ field inhomogeneity, are still necessary to allow clinical use of 7T breast MRI.

Multiparametric MRI of the breast: A review

“…A recent study by Menezes et al that lesion identification, assigned BI‐RADS classification, and the contrast‐enhancement behavior at 7T and 3T breast MRI in the same patient group, had similar results. They authors concluded that 7T MRI of the breast allows BI‐RADS conform analysis yet technical improvements, such as acquisition of T 2 ‐weighted sequences and adjustment of B 1 + field inhomogeneity, are still necessary . A recent study by Bogner et al showed that B 0 images derived with DWI can be used to provide T 2 ‐weighted images and thus this limitation of clinical breast MRI at 7T has been overcome.…”

“…They authors concluded that 7T MRI of the breast allows BI-RADS conform analysis yet technical improvements, such as acquisition of T 2 -weighted sequences and adjustment of B 1 1 field inhomogeneity, are still necessary. 42 A recent study by Bogner et al 43 showed that B 0 images derived with DWI can be used to provide T 2 -weighted images and thus this limitation of clinical breast MRI at 7T has been overcome. Nevertheless, there are still challenges and due to the limited availability of ultrahigh-field scanners worldwide, the current use of MRI of the breast at 7T in clinical practice is still limited.…”

Are We Heading to the Future of Musculoskeletal Tumor Imaging with Ultra-High Field 7T MRI?

“…In terms of diagnosis and tumor detection, 7-Tesla MRI has been described as a safe procedure in breast cancer [51]. 3D chemicalexchange saturation transfer imaging (CEST) showed that magnetization transfer asymmetry values were positively correlated with tumor proliferation and that this index might become a biomarker of high interest in breast tumor characterization [52].…”

Magnetic Resonance Spectroscopy and its Clinical Applications: A Review

“…This information was applied for cancer detection and checking the tumour response to treatment. Although breast MRS started from phosphorus atoms, today because of the higher sensitivity of 1H-MRS in comparison with 31P-MRS, there is increasing interest in breast cancer research by means of hydrogen 1H-MRS. Several studies have shown that the signal of tCho can be observed in malignant lesions; however, it is not visible in normal tissues or benign tumours [186][187][188][189][190].…”