Role of Magnetic Resonance Imaging in Evaluating the Extent of Disease

Gavenonis, Sara C.; Roth, Susan Orel

doi:10.1016/j.mric.2010.02.002

Cited by 15 publications

(10 citation statements)

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“…Breast MRI can be a helpful tool in evaluating patients with benign or malignant breast diseases. It has continued to gain popularity in screening high‐risk individuals, assessing extent of disease, and quantifying the response of neo‐adjuvant chemotherapy . Breast MRI is an essential resource in the treatment of patients with breast diseases; however, it is important to recognize some of its limitations.…”

Section: Discussioncontrasting

confidence: 70%

“…Breast magnetic resonance imaging (MRI) has gained popularity over the last decade in radiographically evaluating breast diseases. Breast MRI has been suggested to be a helpful tool in screening high‐risk patients, evaluating the extent of disease in newly diagnosed patients, determining the location of otherwise occult breast primary tumors, and assessing tumor response after neo‐adjuvant treatment in breast cancer patients . Because of these advantages, the use of breast MRI has continued to increase .…”

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confidence: 99%

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False-positive Extra-Mammary Findings in Breast MRI: Another Cause for Concern

et al. 2015

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Breast magnetic resonance imaging (MRI) has been repeatedly shown to have a high false-positive rate for additional findings in the breast resulting in additional breast imaging and biopsies. We hypothesize that breast MRI is also associated with a high rate of false-positive findings outside of the breast requiring additional evaluation, interventions, and delays in treatment. We performed a retrospective review of all breast MRIs performed on breast cancer patients in 2010 at a single institution. MRI reports were analyzed for extra-mammary findings. The timing and yield of the additional procedures was also analyzed. Three hundred and twenty-seven breast cancer patients (average age = 53.53 ± 11.08 years) had a breast MRI. Incidental, extra-mammary findings were reported in 35/327 patients (10.7%) with a total of 38 incidental findings. The extra-mammary findings were located in the liver (n = 21, 60.0%), thoracic cavity (n = 12, 34.3%), kidneys (n = 1, 2.9%), musculoskeletal system (n = 3, 8.6%), and neck (n = 1, 2.9%). Eighteen of the 35 patients (51.4%) received additional radiographic imaging, 3 (8.6%) received additional laboratory testing, 2 (5.7%) received additional physician referrals and 2 (5.7%) received a biopsy of the finding. The average time to additional procedures in these patients was 14.5 days. None of the incidental, extra-mammary findings were associated with breast cancer or other malignancy. Breast MRI was associated with a high rate (10.7%) of extra-mammary findings, which led to costly additional imaging studies, referrals, and tests. These findings were not associated with breast cancer or other malignancies. Extra-mammary findings highlight an unrecognized adverse consequence of breast MRI.

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Section: Discussioncontrasting

confidence: 70%

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confidence: 99%

False-positive Extra-Mammary Findings in Breast MRI: Another Cause for Concern

et al. 2015

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“…Technologic advances have offered an array of new-generation, highly sensitive breast imaging modalities that allow clinicians to detect and preoperatively characterize the extent of disease (46–48). As part of standard clinical care, several prognostic factors are also assessed on the resected cancer, such as tumor histopathology, immunohistochemistry (49), and gene expression profiling (28,50).…”

Section: Discussionmentioning

confidence: 99%

Identification of Intrinsic Imaging Phenotypes for Breast Cancer Tumors: Preliminary Associations with Gene Expression Profiles

Ashraf¹,

Daye²,

Gavenonis³

et al. 2014

Radiology

142

147

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Purpose To present a method for identifying intrinsic imaging phenotypes in breast cancer tumors and to investigate their association with prognostic gene expression profiles. Materials and Methods The authors retrospectively analyzed dynamic contrast material–enhanced (DCE) magnetic resonance (MR) images of the breast in 56 women (mean age, 55.6 years; age range, 37–74 years) diagnosed with estrogen receptor–positive breast cancer between 2005 and 2010. The study was approved by the institutional review board and compliant with HIPAA. The requirement to obtain informed consent was waived. Primary tumors were assayed with a validated gene expression assay that provides a score for the likelihood of recurrence. A multiparametric imaging phenotype vector was extracted for each tumor by using quantitative morphologic, kinetic, and spatial heterogeneity features. Multivariate linear regression was performed to test associations between DCE MR imaging features and recurrence likelihood. To identify intrinsic imaging phenotypes, hierarchical clustering was performed on the extracted feature vectors. Multivariate logistic regression was used to classify tumors at high versus low or medium risk of recurrence. To determine the additional value of intrinsic phenotypes, the phenotype category was tested as an additional variable. Receiver operating characteristic analysis and the area under the receiver operating characteristic curve (Az) were used to assess classification performance. Results There was a moderate correlation (r = 0.71, R2 = 0.50, P < .001) between DCE MR imaging features and the recurrence score. DCE MR imaging features were predictive of recurrence risk as determined by the surrogate assay, with an Az of 0.77 (P < .01). Four dominant imaging phenotypes were detected, with two including only low- and medium-risk tumors. When the phenotype category was used as an additional variable, the Az increased to 0.82 (P < .01). Conclusion Intrinsic imaging phenotypes exist for breast cancer tumors and correlate with recurrence likelihood as determined with gene expression profiling. These imaging biomarkers could ultimately help guide treatment decisions.

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“…MRI is an established tool for breast cancer diagnosis and staging [12][13][14][15][16][17]. As the clinical application of breast MRI becomes more widespread, a parallel increase in the number of incidental extramammary findings is reasonably expected.…”

Section: Discussionmentioning

confidence: 99%