MRI Breast: Current Imaging Trends, Clinical Applications, and Future Research Directions

Abstract

Magnetic Resonance Imaging (MRI) is the most sensitive and advanced imaging technique in diagnosing breast cancer and is essential in improving cancer detection, lesion characterization, and determining therapy response. In addition to the dynamic contrast-enhanced (DCE) technique, functional techniques such as magnetic resonance spectroscopy (MRS), diffusion-weighted imaging (DWI), diffusion kurtosis imaging (DKI), and intravoxel incoherent motion (IVIM) further characterise and differentiate benign and malignant lesions thus, improving diagnostic accuracy. There is now an increasing clinical usage of MRI breast, including screening in high risk and supplementary screening tool in average-risk patients. MRI is becoming imperative in assisting breast surgeons in planning breast-conserving surgery for preoperative local staging and evaluation of neoadjuvant chemotherapy response. Other clinical applications for MRI breast include occult breast cancer detection, investigation of nipple discharge, and breast implant assessment. There is now an abundance of research publications on MRI Breast with several areas that still remain to be explored. This review gives a comprehensive overview of the clinical trends of MRI breast with emphasis on imaging features and interpretation using conventional and advanced techniques. In addition, future research areas in MRI breast include developing techniques to make MRI more accessible and cost-effective for screening. The key advances in MRI Breast include the abbreviated MRI breast protocol and area of focused research in the augmentation of radiologists’ work artificial intelligence are high impact for the future.

Avoiding unnecessary sentinel lymph node biopsy with the use of superparamagnetic iron oxide mapping agents (Magtrace®) in breast surgery

“…19 This is important to consider with the increasing use of MRI scan in breast cancer surveillance. 20 Further challenges to the implementation of the use of SPIO for D-SLNB include the need for the SPIO tracer, the magnetometer and associated non-metallic devices needed at time of operation, and the associated cost of this equipment. 21 Metallic instruments used in theatre lead to interference of the magnetic signal, and the magnetometer needs to be frequently recalibrated by holding the probe at least half a meter away from any metallic or magnetic objects, or whilst the probe is in contact with the body and repressing the balance button.…”

“…Furthermore, residual SPIO, such as in patients who underwent BCS after SPIO injection can lead to the presence on artefact on post‐operative MRI and impair the diagnostic valve of the scan 19 . This is important to consider with the increasing use of MRI scan in breast cancer surveillance 20 …”

History of Mammography: Analysis of Breast Imaging Diagnostic Achievements over the Last Century

“…Today, breast MRI is indispensable in the management of patients with breast lesions. Among the leading applications whose usefulness is established, we find the proper assessment of the extent of lesions to evaluate conservative surgery, evaluation of response to neoadjuvant therapy, study in patients with axillary adenopathy without finding mammographically evident breast lesions, and study of previous surgery scars and prosthetic integrity evaluation [83]. However, one of the most exciting roles to be discussed is the potential of MRI to be used as an additional screening method in high-risk patients.…”