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The Basics of Breast MRI

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Abstract

Magnetic resonance imaging of the breast has been well established as a supplemental imaging modality with proven benefit in breast cancer screening and diagnosis. Dynamic contrast-enhanced MRI of the breast has been shown to be the most sensitive imaging modality in the detection of breast carcinoma. A review of the currently accepted as well as some additional less commonly used indications that have not been rigorously validated is presented. The protocols, techniques of examination, and the artifacts encountered in a breast MRI examination are discussed. The role of MRI in the assessment of breast implants is briefly described. The BI-RADS terminology for breast MRI is presented. Breast MRI in the staging and diagnosis of breast cancer is discussed in a separate chapter.

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References

  1. DeMartini W, Lehman C. A review of current evidence-based clinical applications for breast magnetic resonance imaging. Top Magn Reson Imaging. 2008;19(3):143–50.

    Article  PubMed  Google Scholar 

  2. Saslow D, et al. American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin. 2007;57(2):75–89.

    Article  PubMed  Google Scholar 

  3. Boetes C. Update on screening breast MRI in high-risk women. Obstet Gynecol Clin North Am. 2011;38(1):149–58.

    Article  PubMed  CAS  Google Scholar 

  4. Kriege M, Brekelmans CT, Boetes C, et al. Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition. N Engl J Med. 2004;351(5):427–37.

    Article  PubMed  CAS  Google Scholar 

  5. Sardanelli F, et al. Magnetic resonance imaging of the breast: recommendations from the EUSOMA working group. Eur J Cancer. 2010;46(8):1296–316.

    Article  PubMed  Google Scholar 

  6. Leach MO, Boggis CR, Dixon AK, et al. Screening with magnetic resonance imaging and mammography of a UK population at high familial risk of breast cancer: a prospective multicentre cohort study (MARIBS). Lancet. 2005;365(9473):1769–78.

    Article  PubMed  CAS  Google Scholar 

  7. Warner E, Plewes DB, Hill KA, et al. Surveillance of BRCA1 and BRCA2 mutation carriers with magnetic resonance imaging, ultrasound, mammography, and clinical breast examination. JAMA. 2004;292(11):1317–25.

    Article  PubMed  CAS  Google Scholar 

  8. Sardanelli F, Podo F, D’Agnolo G, et al. Multicenter comparative multimodality surveillance of women at genetic-familial high risk for breast cancer (HIBCRIT study): interim results. Radiology. 2007;242(3):698–715.

    Article  PubMed  Google Scholar 

  9. Weinstein SP, Localio AR, Conant EF, et al. Multimodality screening of high-risk women: a prospective cohort study. J Clin Oncol. 2009;27(36):6124–8.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Podo F, Sardanelli F, Canese R, et al. The Italian multi-centre project on evaluation of MRI and other imaging modalities in early detection of breast cancer in subjects at high genetic risk. J Exp Clin Cancer Res. 2002;21:115–24.

    PubMed  CAS  Google Scholar 

  11. Morris EA, Liberman L, Ballon DJ, et al. MRI of occult breast carcinoma in a high-risk population. AJR Am J Roentgenol. 2003;181:619–26.

    Article  PubMed  Google Scholar 

  12. Lehman CD, Isaacs C, Schnall MD, et al. Cancer yield of mammography, MRI, and ultrasound in high risk women: prospective multi-institution breast cancer screening study. Radiology. 2007;244:381–8.

    Article  PubMed  Google Scholar 

  13. Sutcliffe 3rd JB, Otto PM. Controversies in breast MRI. Curr Probl Diagn Radiol. 2013;42(4):149–63.

    Article  PubMed  Google Scholar 

  14. Warner E, et al. Systematic review: using magnetic resonance imaging to screen women at high risk for breast cancer. Ann Intern Med. 2008;148(9):671–9.

    Article  PubMed  Google Scholar 

  15. Berg WA. Detection of breast cancer with addition of annual screening ultrasound or a single screening MRI to mammography in women with elevated breast cancer risk. JAMA. 2012;307(13):1394–404.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  16. Middleton MS, McNamara Jr MP. Breasts implant classification with MR imaging correlation. Radiographics. 2000;20(3):1–72.

    Article  Google Scholar 

  17. DeAngelis GA, de Lange EE, Miller LR, Morgan RF. MR imaging of breast implants. Radiographics. 1994;14(4):783–94.

    Article  PubMed  CAS  Google Scholar 

  18. Bondurant S, Ernster V, Herdman R, editors. Safety of silicone breast implants. Report produced by the Committee on the Safety of Silicone Breast Implants, Institute of Medicine, National Academy of Sciences; 1999.

    Google Scholar 

  19. Steinbach BG, Hardt NS, Abbitt PL, Lanier L, Caffee HH. Breast implants, common complications and concurrent breast disease. Radiographics. 1993;13(1):95–118.

    Article  PubMed  CAS  Google Scholar 

  20. Berg WA, et al. Diagnosing breast implant rupture with MR imaging, US, and mammography. Radiographics. 1993;13(6):1323–36.

    Article  PubMed  CAS  Google Scholar 

  21. Piccoli CW, Greer JG, Mitchell DG. Breast MR imaging for cancer detection and implant evaluation: potential pitfalls. Radiographics. 1996;16(1):63–75.

    Article  PubMed  CAS  Google Scholar 

  22. Hölmich LR, Vejborg I, Conrad C, Sletting S, McLaughlin JK. The diagnosis of breast implant rupture: MRI findings compared with findings at explantation. Eur J Radiol. 2005;53(2):213–25.

    Article  PubMed  Google Scholar 

  23. Vestito A, Mangieri FF, Ancona A, Minervini C, Perchinunno V, Rinaldi S. Study of breast implant rupture: MRI versus surgical findings. Radiol Med. 2012;117(6):1004–18.

    Article  PubMed  CAS  Google Scholar 

  24. Moy L, et al. Is breast MRI helpful in the evaluation of inconclusive mammographic findings? AJR Am J Roentgenol. 2009;193(4):986–93.

    Article  PubMed  Google Scholar 

  25. Dorrius MD, Pijnappel RM, Jansen-van der Weide MC, Oudkerk M. Breast magnetic resonance imaging as a problem-solving modality in mammographic BI-RADS 3 lesions. Cancer Imaging. 2010;10(Spec no A):S54–8.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Benndorf M, Baltzer PA, Vag T, Gajda M, Runnebaum IB, Kaiser WA. Breast MRI as an adjunct to mammography: does it really suffer from low specificity? A retrospective analysis stratified by mammographic BI-RADS classes. Acta Radiol. 2010;51(7):715–21.

    Article  PubMed  Google Scholar 

  27. Bluemke DA, Gatsonis CA, Chen MH, et al. Magnetic resonance imaging of the breast prior to biopsy. JAMA. 2004;292:2735–42.

    Article  PubMed  CAS  Google Scholar 

  28. ACR practice guideline for the performance of contrast-enhanced magnetic resonance imaging (MRI) of the breast. American College of Radiology. Revised 2008 (Resolution 25). Section II, 1, a. Available from: http://www.acr.org/SecondaryMainMenuCategories/quality_safety/guidelines/breast/mri_breast.aspx.

  29. Ikeda DM, Hylton NM, Kuhl CK, et al. BI-RADS: magnetic resonance imaging. In: D’Orsi CJ, Mendelson EB, Ikeda DM, editors. Breast imaging reporting and data system: ACR BI-RADS – breast imaging atlas. 1st ed. Reston: American College of Radiology; 2003.

    Google Scholar 

  30. Ikeda DM. Updated breast MRI Lexicon. Eur J Radiol. 2012;81 Suppl 1:S63.

    Article  PubMed  Google Scholar 

  31. Erguvan-Dogan B, Whitman GJ, Kushwaha AC, Phelps MJ, Dempsey PJ. BI-RADS-MRI: a primer. AJR Am J Roentgenol. 2006;187(2):W152–60.

    Article  PubMed  Google Scholar 

  32. Agrawal G, Su MY, Nalcioglu O, Feig SA, Chen JH. Significance of breast lesion descriptors in the ACR BI-RADS MRI lexicon. Cancer. 2009;115(7):1363–80.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Baltzer PA, Dietzel M, Burmeister HP, et al. Application of MR mammography beyond local staging: Is there a potential to accurately assess axillary lymph nodes? Evaluation of an extended protocol in an initial prospective study. AJR Am J Roentgenol. 2011;196:W641–7.

    Article  PubMed  Google Scholar 

  34. Rahbar H, Partridge SC, Javid SH, Lehman CD. Imaging axillary lymph nodes in patients with newly diagnosed breast cancer. Curr Probl Diagn Radiol. 2012;41(5):149–58.

    Article  PubMed  Google Scholar 

  35. Macura KJ, Ouwerkerk R, Jacobs MA, Bluemke DA. Patterns of enhancement on breast MR images: interpretation and imaging pitfalls. Radiographics. 2006;26(6):1719–34.

    Article  PubMed  Google Scholar 

  36. Kelcz F. It is not all in the CAD or BI-RADS. Eur J Radiol. 2012;81 Suppl 1:S76–7.

    Article  PubMed  Google Scholar 

  37. Santamaría G, et al. Radiologic and pathologic findings in breast tumors with high signal intensity on T2-weighted MR images. Radiographics. 2010;30(2):533–48.

    Article  PubMed  Google Scholar 

  38. Mahoney MC, Gatsonis C, Hanna L, DeMartini WB, Lehman C. Positive predictive value of BI-RADS MR imaging. Radiology. 2012;264(1):51–8.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Wang LC, DeMartini WB, Partridge SC, Peacock S, Lehman CD. MRI-detected suspicious breast lesions: predictive values of kinetic features measured by computer-aided evaluation. AJR Am J Roentgenol. 2009;193(3):826–31.

    Article  PubMed  Google Scholar 

  40. Liberman L, Mason G, Morris EA, Dershaw DD. Does size matter? Positive predictive value of MRI-detected breast lesions as a function of lesion size. AJR Am J Roentgenol. 2006;186:426–30.

    Article  PubMed  Google Scholar 

  41. Weinstein SP, et al. Frequency of malignancy seen in probably benign lesions at contrast-enhanced breast MR imaging: findings from ACRIN 6667. Radiology. 2010;255(3):731–7.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Eby PR, et al. Cancer yield of probably benign breast MR examinations. J Magn Reson Imaging. 2007;26(4):950–5.

    Article  PubMed  Google Scholar 

  43. Eby PR, DeMartini WB, Gutierrez RL, Saini MH, Peacock S, Lehman CD. Characteristics of probably benign breast MRI lesions. AJR Am J Roentgenol. 2009;193(3):861–7.

    Article  PubMed  Google Scholar 

  44. Hauth E, Umutlu L, Kümmel S, Kimmig R, Forsting M. Follow-up of probably benign lesions (BI-RADS 3 category) in breast MR imaging. Breast J. 2010;16(3):297–304.

    Article  PubMed  Google Scholar 

  45. Rausch DR, Hendrick RE. How to optimize clinical breast MR imaging practices and techniques on Your 1.5-T system. Radiographics. 2006;26(5):1469–84.

    Article  PubMed  Google Scholar 

  46. Millet I, Pages E, Hoa D, Merigeaud S, Curros Doyon F, Prat X, Taourel P. Pearls and pitfalls in breast MRI. Br J Radiol. 2012;85(1011):197–207.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  47. Harvey JA. Breast MR, imaging artifacts: how to recognize and fix them. Radiographics. 2007;27 Suppl 1:S131–45.

    Article  PubMed  Google Scholar 

  48. Ojeda-Fournier H, Choe KA, Mahoney MC. Recognizing and interpreting artifacts and pitfalls in MR imaging of the breast. Radiographics. 2007;27:S147–64.

    Article  PubMed  Google Scholar 

  49. Friedman EP, Hall-Craggs MA, Mumtaz H, Schneidau A. Breast MR and the appearance of the normal and abnormal nipple. Clin Radiol. 1997;52:854–61.

    Article  PubMed  CAS  Google Scholar 

  50. Spillane AJ, Donnellan M, Matthews AR. Clinical significance of intramammary lymph nodes. Breast. 1999;8:143–6.

    Article  PubMed  CAS  Google Scholar 

  51. Obdeijn IM, Loo CE, Rijnsburger AJ, Wasser MN, Bergers E, Kok T, et al. Assessment of false-negative cases of breast MR imaging in women with a familial or genetic predisposition. Breast Cancer Res Treat. 2010;119:399–407.

    Article  PubMed  Google Scholar 

  52. Teifke A, Hlawatsch A, Beier T, Werner Vomweg T, Schadmand S, Schmidt M, et al. Undetected malignancies of the breast: dynamic contrast-enhanced MR imaging at 1.0 T. Radiology. 2002;224:881–8.

    Article  PubMed  Google Scholar 

  53. Kurz KD, Roy S, Modder U, Skaane P, Saleh A. Typical atypical findings on dynamic MRI of the breast. Eur J Radiol. 2010;76:195–210.

    Article  PubMed  Google Scholar 

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Correspondence to Mahesh K. Shetty MD, FRCR, FACR, FAIUM .

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© 2015 Springer Science+Business Media New York

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Shetty, M.K. (2015). The Basics of Breast MRI. In: Shetty, M. (eds) Breast Cancer Screening and Diagnosis. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1267-4_8

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  • DOI: https://doi.org/10.1007/978-1-4939-1267-4_8

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  • Online ISBN: 978-1-4939-1267-4

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