April 23, 2009 - 3T MRI can detect a significant number of lesions not found on mammography and sonography, according to a study performed at the University of Toledo Medical Center, Toledo, OH. The study included 434 women who underwent mammography, sonography and 3T MRI for the detection of malignant breast lesions-all women were at high risk. Results showed that 3T MRI detected 66/66 malignant lesions; mammography detected 54/66 malignant lesions; and sonography detected 57/66 malignant lesions. "3T MRI depicted a significantly higher number of malignant tumors of the breast than mammography and sonography," said Haitham Elsamaloty, M.D., lead author of the study. "Our study detected 'early' breast cancer (lesions as small as 4 mm) in size and also identified malignant lesions that were only detected by MRI and confirmed by MRI guided biopsy. These crucial findings led to a significant change in patient management in 18.2 percent of the cases in our study. "Our study suggests an important role for 3T MRI in such high risk groups for an early diagnosis of breast cancer and better accuracy in evaluating the extent of disease-a crucial factor in appropriate therapy planning," said Dr. Elsamaloty. "High field strength (3T) MRI systems are becoming increasingly available in the clinical setting and more of them are being used for the evaluation of breast malignancy. 3T MRI is an important addition to mammography and sonography," he said. Source: This study appears in the April issue of the American Journal of Roentgenology. For more information: www.ajronline.org
3T MRI Detects "Early" Breast Cancer Not Seen On Mammography, Ultrasound
Left to right: Subtraction right mediolateral oblique (MLO) CEM was non-diagnostic because of artifact, potentially due to motion misregistration from extended exposure time; subtraction right MLO implant displaced CEM image shows 5.8 cm enhancing mass (arrow); contrast-enhanced MRI sagittal subtraction image shows concordant mass (arrow).
A, Contrast-enhanced axial T1-weighted fat-saturated image from baseline MRI before initiation of neoadjuvant therapy shows irregular mass (arrow) in upper inner right breast corresponding to biopsy-proven carcinoma. B, Contrast-enhanced axial T1-weighted fat-saturated image from follow-up MRI performed 3 months after initiation of neoadjuvant therapy shows decrease in size of right breast cancer (arrow). C, Contrast-enhanced axial T1-weighted fat-saturated image 3 months after initiation of neoadjuvant therapy shows new mass (arrow) in upper outer left breast that was assessed as BI-RADS 4. Pathologic examination from MRI-guided core biopsy of new suspicious mass revealed benign usual ductal hyperplasia. No atypia or malignancy was identified. Image courtesy of American Roentgen Ray Society (ARRS), American Journal of Roentgenology (AJR)