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11 - Breast magnetic resonance imaging

Published online by Cambridge University Press:  06 July 2010

Michael J. Michell
Affiliation:
King's College Hospital, London
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Summary

Introduction

The first magnetic resonance imaging (MRI) of the whole body, achieved in 1980 was followed by rapid advances in this technology as scientists and manufacturers recognized the enormous potential of this new technique. The initial results from imaging the breast were disappointing as it was not possible to distinguish cancer from the surrounding parenchymal tissue. The introduction of intravenous paramagnetic contrast in the early eighties changed this and the first studies demonstrating the potential of this technology to detect breast cancer were published.

Precessing hydrogen protons in the body are lined up along the main axis of a powerful magnetic field. A radiofrequency pulse is used to flip these protons 90° or 180°. The image is created from the different times it takes for the protons to relax back to the main axis. The images can be given different contrast weightings depending on the timing and repetition of the radiofrequency pulse. Breast parenchymal tissue has a long relaxation time and cancerous tissue is very slightly longer than this. Paramagnetic contrast agent shortens the relaxation time considerably with the leaky vascular cancers taking up the contrast to a greater extent and more rapidly than the background tissue.

Magnetic resonance technique

In order to create high-quality images a dedicated bilateral breast coil is used in a high field (>1.5T) strength machine.

Type
Chapter
Information
Breast Cancer , pp. 191 - 217
Publisher: Cambridge University Press
Print publication year: 2010

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References

Smith, FW, Hutchison, JM, Mallard, JR, et al. Oesophageal carcinoma demonstrated by whole-body nuclear magnetic resonance imaging. Br Med J 1981; 282: 510–2.CrossRefGoogle ScholarPubMed
Heywang-Kobrunner, S, Hahn, D, Schmid, H, et al. MR Imaging of the breast using Gadolinium DTPA. J Comput Assist Tomogr 1986; 10: 199–204.CrossRefGoogle Scholar
Kaiser, WA, Zeitler, E. MR imaging of the breast: fast imaging sequences with and without Gd-DTPA. Preliminary observations. Radiology 1989; 170: 681–6.CrossRefGoogle ScholarPubMed
Heywang, S, Wolf, A, Pruss, E, et al. MR imaging of the breast with Gd-DTPA: Use and limitations. Radiology 1989; 171: 95–103.CrossRefGoogle ScholarPubMed
Collidge, TA, Thomson, PC, Mark, PB, et al. Gadolinium-enhanced MR imaging and nephrogenic systemic fibrosis: retrospective study of a renal replacement therapy cohort. Radiology 2007; 245: 168–75.CrossRefGoogle ScholarPubMed
Knopp, MV, Bourne, MW, Sardanelli, F, et al. Gadobenate dimeglumine-enhanced MRI of the breast: analysis of dose response and comparison with gadopentetate dimeglumine.[see comment]. Am J Roentgenol 2003; 181: 663–76.CrossRefGoogle ScholarPubMed
Delille, JP, Slanetz, PJ, Yeh, ED, et al. Physiologic changes in breast magnetic resonance imaging during the menstrual cycle: perfusion imaging, signal enhancement, and influence of the T1 relaxation time of breast tissue. Breast J 2005; 11: 236–41.CrossRefGoogle ScholarPubMed
Kuhl, CK, Bieling, HB, Giesekey, J, et al. Healthy premenopausal breast parenchyma in dynamic contrast-enhanced MR imaging of the breast: normal contrast medium enhancement and cyclical-phase dependency. Radiology 1997; 203: 137–44.CrossRefGoogle ScholarPubMed
Muller-Schimpfle, M, Ohmenhauser, K, Stoll, P, et al. Menstrual cycle and age: influence on parenchymal contrast medium enhancement in MR imaging of the breast. Radiology 1997; 203: 145–9.CrossRefGoogle ScholarPubMed
Reichenbach, JR, Przetak, C, Klinger, G, et al. Assessment of Breast Tissue Changes on Hormonal Replacement Therapy Using MRI: A Pilot Study. J comput assist tomogr 1999; 23: 407–13.CrossRefGoogle ScholarPubMed
Pfleiderer, SO, Sachse, S, Sauner, D, et al. Changes in magnetic resonance mammography due to hormone replacement therapy. Breast Cancer Res 2004; 6: R232–8.CrossRefGoogle ScholarPubMed
Nunes, LW, Schnall, MD, Orel, SG, et al. Correlation of lesion appearance and histologic findings for the nodes of a breast MR imaging interpretation model. Radiographics 1999; 19: 79–92.CrossRefGoogle ScholarPubMed
Matsubayashi, R, Matsuo, Y, Edakuni, G, et al. Breast masses with peripheral rim enhancement on dynamic contrast-enhanced MR images: correlation of MR findings with histologic features and expression of growth factors. Radiology 2000; 217: 841–8.CrossRefGoogle ScholarPubMed
Szabo, BK, Aspelin, P, Kristoffersen Wiberg, M, et al. Invasive breast cancer: correlation of dynamic MR features with prognostic factors. Eur Radiol 2003; 13: 2425–35.CrossRefGoogle ScholarPubMed
Nunes, LW, Schnall, MD, Orel, SG. Update of breast MR imaging architectural interpretation model. Radiology 2001; 219: 484–94.CrossRefGoogle ScholarPubMed
Kuhl, CK, Mielcareck, P, Klaschik, S, et al. Dynamic breast MR imaging: are signal intensity time course data useful for differential diagnosis of enhancing lesions? Radiology 1999; 211: 101–10.CrossRefGoogle ScholarPubMed
Kuhl, CK, Schild, HH, Morakkabati, N. Dynamic bilateral contrast-enhanced MR imaging of the breast: trade-off between spatial and temporal resolution. Radiology 2005; 236: 789–800.CrossRefGoogle ScholarPubMed
Goethem, M, Tjalma, W, Schelfout, K, et al. Magnetic resonance imaging in breast cancer. Eur J Surg Oncol 2006; 32: 901–10.CrossRefGoogle ScholarPubMed
Boetes, C, Mus, R, Holland, R, et al. Breast tumours: comparative accuracy of MR imaging relative to mammography and US for demonstrating extent. Radiology 1995; 197: 743–7.CrossRefGoogle ScholarPubMed
Mann, RM, Veltman, J, Barentsz, JO, et al. The value of MRI compared to mammography in the assessment of tumour extent in invasive lobular carcinoma of the breast. Eur J Surg Oncol 2008; 34: 135–42.CrossRefGoogle ScholarPubMed
Gilbert, FJ. MRI detection of DCIS. In: Evans, A, Pinder, S, Wilson, R, Ellis, I, eds. Breast Calcification A Diagnostic Manual. London: Greenwich Medical Media, 2002; 155.Google Scholar
Kuhl, CK, Schrading, S, Bieling, HB, et al. MRI for diagnosis of pure ductal carcinoma in situ: a prospective observational study. Lancet 2007; 370: 485–92.CrossRefGoogle ScholarPubMed
Soderstrom, C, Harms, S, Copit, D, et al. Three-dimensional RODEO breast MR imaging of lesions containing ductal carcinoma in situ. Radiology 1996; 201: 427–32.CrossRefGoogle ScholarPubMed
Satake, H, Shimamoto, K, Sawaki, A, et al. Role of ultrasonography in the detection of intraductal spread of breast cancer: correlation with pathologic findings, mammography and MR imaging. Eur Radiol 2000; 10: 1726–32.CrossRefGoogle ScholarPubMed
Viehweg, P, Lampe, D, Buchmann, J, et al. In situ and minimally invasive breast cancer: morphologic and kinetic features on contrast-enhanced MR imaging. MAGMA 2000; 11: 129–37.CrossRefGoogle ScholarPubMed
Amano, G, Ohuci, N, Ishibashi, T, et al. Correlation of three-dimensional magnetic resonance imaging with precise histopathological map concerning carcinoma extension in the breast. Breast Cancer Res Treat 2000; 60: 43–55.CrossRefGoogle ScholarPubMed
Radjenovic, A, Dall, BJ, Ridgway, JP, et al. Measurement of pharmacokinetic parameters in histologically graded invasive breast tumours using dynamic contrast-enhanced MRI. Br J Radiol 2008; 81: 120–8.CrossRefGoogle ScholarPubMed
Gilbert, FJ, Warren, RML, Kwan-Lim, G, et al. MRI and mammography features of screen detected cancers and prior examinations in BRCA1 and BRCA2 carriers and in women at high risk of breast cancer. Radiology 2009; 252: 358–68.CrossRefGoogle Scholar
,National Institute for Health and Clinical Excellence. Breast Cancer (Early & Locally Advanced): Diagnosis and Treatment. London: NICE 2009.Google Scholar
Saslow, D, Boetes, C, Burke, W, et al. American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin 2007; 57: 75–89.CrossRefGoogle ScholarPubMed
Mann, RM, Kuhl, CK, Kinkel, K, et al. Breast MRI: guidelines from the European Society of Breast Imaging. Eur Radiol 2008; 18: 1307–18.CrossRefGoogle ScholarPubMed
Hadden, WE. Recommendations for the surveillance of young women at increased risk for breast cancer. Australas Radiol 2007; 51: 1–11.CrossRefGoogle ScholarPubMed
Berg, WA, Gutierrez, L, NessAiver, MS, et al. Diagnostic accuracy of mammography, clinical examination, US, and MR imaging in preoperative assessment of breast cancer. Radiology 2004; 233: 830–49.CrossRefGoogle Scholar
Bedrosian, I, Mick, R, Orel, SG, et al. Changes in the surgical management of patients with breast carcinoma based on preoperative magnetic resonance imaging. Cancer 2003; 98: 468–73.CrossRefGoogle ScholarPubMed
Bilimoria, KY, Cambic, A, Hansen, NM, et al. Evaluating the impact of preoperative breast magnetic resonance imaging on the surgical management of newly diagnosed breast cancers. Arch Surg 2007; 142: 441–5; discussion 445–7.CrossRefGoogle ScholarPubMed
Del Frate, C, Borghese, L, Cedolini, C, et al. Role of pre-surgical breast MRI in the management of invasive breast carcinoma. Breast J 2007; 16: 469–81.CrossRefGoogle ScholarPubMed
Deurloo, EE, Klein Zeggelink, WF, Teertstra, HJ, et al. Contrast-enhanced MRI in breast cancer patients eligible for breast-conserving therapy: complementary value for subgroups of patients. Eur Radiol 2006; 16: 692–701.CrossRefGoogle ScholarPubMed
Liberman, L, Morris, EA, Dershaw, DD, et al. MR imaging of the ipsilateral breast in women with percutaneously proven breast cancer. Am J Roentgenol 2003; 180: 901–10.CrossRefGoogle ScholarPubMed
,Blue Cross and Blue Shield Association. Magnetic Resonance Imaging of the Breast for Preoperative Evaluation in Patients with Localized Breast Cancer. Chicago IL: BCBSA, 2004; 18(No.8).Google Scholar
Houssami, N, Ciatto, S, Macaskill, P, et al. Accuracy and surgical impact of magnetic resonance imaging in breast cancer staging: systematic review and meta-analysis in detection of multifocal and multicentric cancer. J Clin Oncol 2008; 26: 3248–58.CrossRefGoogle ScholarPubMed
Esserman, L, Hylton, N, Yassa, L, et al. Utility of magnetic resonance imaging in the management of breast cancer: Evidence for improved preoperative staging. J Clin Oncol 1999; 17: 110–9.CrossRefGoogle ScholarPubMed
Kneeshaw, PJ, Turnbull, LW, Smith, A, et al. Dynamic contrast enhanced magnetic resonance imaging aids the surgical management of invasive lobular breast cancer. Eur J Surg Oncol 2003; 29: 32–7.CrossRefGoogle ScholarPubMed
Mann, RM, Veltman, J, Barentsz, JO, et al. The value of MRI compared to mammography in the assessment of tumour extent in invasive lobular carcinoma of the breast. Eur J Surg Oncol 2008; 34: 135–42.CrossRefGoogle ScholarPubMed
Quan, ML, Sclafani, L, Heerdt, AS, et al. Magnetic resonance imaging detects unsuspected disease in patients with invasive lobular cancer. Ann Surg Oncol 2003; 10: 1048–53.CrossRefGoogle ScholarPubMed
Schelfout, K, Goethem, M, Kersschot, E, et al. Preoperative breast MRI in patients with invasive lobular breast cancer. Eur Radiol 2004; 14: 1209–16.CrossRefGoogle ScholarPubMed
Murray, AD, Staff, RT, Redpath, TW, et al. Dynamic contrast enhanced MRI of the axilla in women with breast cancer: comparison with pathology of excised nodes. Br J Radiol 2002; 75: 220–8.CrossRefGoogle ScholarPubMed
Stets, C, Brandt, S, Wallis, F, et al. Axillary lymph node metastases: A statistical analysis of various parameters in MRI with USPIO. J Magn Reson Imag 2002; 16: 60–8.CrossRefGoogle ScholarPubMed
Michel, SC, Keller, TM, Frohlich, JM, et al. Preoperative breast cancer staging: MR imaging of the axilla with ultrasmall superparamagnetic iron oxide enhancement. Radiology 2002; 225: 527–36.CrossRefGoogle ScholarPubMed
Murray, AD, Redpath, TW, Needham, G, et al. Dynamic magnetic resonance mammography of both breasts following local excision and radiotherapy for breast carcinoma. Br J Radiol 1996; 69: 594–600.CrossRefGoogle ScholarPubMed
Viehweg, P, Heinig, A, Lampe, D, et al. Retrospective analysis for evaluation of the value of contrast-enhanced MRI in patients treated with breast conservative therapy. MAGMA 1998; 7: 141–52.CrossRefGoogle ScholarPubMed
Drew, PJ, Kerin, MJ, Turnbull, LW, et al. Routine screening for local recurrence following breast-conserving therapy for cancer with dynamic contrast-enhanced magnetic resonance imaging of the breast. Ann Surg Oncol 1998; 5: 265–70.CrossRefGoogle ScholarPubMed
Kramer, S, Schulz-Wendtland, R, Hagedorn, K, et al. Magnetic resonance imaging and its role in the diagnosis of multicentric breast cancer. Anticancer Res 1998; 18: 2163–4.Google Scholar
Rieber, A, Merkle, E, Zeitler, H, et al. Value of MR mammography in the detection and exclusion of recurrent breast carcinoma. J Comput Assist Tomogr 1997; 21: 780–4.CrossRefGoogle ScholarPubMed
Mann, RM, Kuhl, CK, Kinkel, K, et al. Breast MRI: guidelines from the European Society of Breast Imaging. Eur Radiol 2008; 18: 1307–18.CrossRefGoogle ScholarPubMed
Londero, V, Bazzocchi, M, Del Frate, C, et al. Locally advanced breast cancer: comparison of mammography, sonography and MR imaging in evaluation of residual disease in women receiving neoadjuvant chemotherapy. Eur Radiol 2004; 14: 1371–9.CrossRefGoogle Scholar
Julius, T, Kemp, SE, Kneeshaw, PJ, et al. MRI and conservative treatment of locally advanced breast cancer. Eur J Surg Oncol 2005; 31: 1129–34.CrossRefGoogle ScholarPubMed
,Blue Cross and Blue Shield Association. Breast MRI for Management of Patients with Locally Advanced Breast Cancer Who are Being Referred for Neoadjuvant Chemotherapy. Chicago IL: BCBSA, 2004; 19(7).Google Scholar
Segara, D, Krop, IE, Garber, JE, et al. Does MRI predict pathologic tumor response in women with breast cancer undergoing preoperative chemotherapy? J Surg Oncol 2007; 96: 474–80.CrossRefGoogle ScholarPubMed
Chen, JH, Feig, B, Agrawal, G, et al. MRI evaluation of pathologically complete response and residual tumors in breast cancer after neoadjuvant chemotherapy. Cancer 2008; 112: 17–26.CrossRefGoogle ScholarPubMed
Garimella, V, Qutob, O, Fox, JN, et al. Recurrence rates after DCE-MRI image guided planning for breast-conserving surgery following neoadjuvant chemotherapy for locally advanced breast cancer patients. Eur J Surg Oncol 2007; 33: 157–61.CrossRefGoogle ScholarPubMed
Wasser, K, Sinn, HP, Fink, C, et al. Accuracy of tumor size measurement in breast cancer using MRI is influenced by histological regression induced by neoadjuvant chemotherapy. Eur Radiol 2003; 13: 1213–23.Google ScholarPubMed
Yu, HJ, Chen, JH, Mehta, RS, et al. MRI measurements of tumor size and pharmacokinetic parameters as early predictors of response in breast cancer patients undergoing neoadjuvant anthracycline chemotherapy. J Magn Reson Imag 2007; 26: 615–23.CrossRefGoogle ScholarPubMed
Padhani, AR, Hayes, C, Assersohn, L, et al. Prediction of clinicopathologic response of breast cancer to primary chemotherapy at contrast-enhanced MR imaging: initial clinical results. Radiology 2006; 239: 361–74.CrossRefGoogle ScholarPubMed
Cheung, YC, Chen, SC, Su, MY, et al. Monitoring the size and response of locally advanced breast cancers to neoadjuvant chemotherapy (weekly paclitaxel and epirubicin) with serial enhanced MRI. Breast Cancer Res Treat 2003; 78: 51–8.CrossRefGoogle ScholarPubMed
Orel, S, Weinstein, S, Schnall, M, et al. Breast MR imaging in patients with axillary lymph node metastase and unknown primary malignancy. Radiology 1999; 212: 543–9.CrossRefGoogle Scholar
Buchanan, CL, Morris, EA, Dorn, PL, et al. Utility of breast magnetic resonance imaging in patients with occult primary breast cancer. Ann Surg Oncol 2005; 12: 1045–53.CrossRefGoogle ScholarPubMed
,National Collaborating Centre for Primary Care. Familial breast cancer: the classification and care of women at risk of familial breast cancer in primary, secondary and tertiary care (partial update of CG14). London: National Collaborating Centre for Primary Care, 2006; 1–75.
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: 1769–78.Google Scholar
Tilanus-Linthorst, MM, Obdeijn, IM, Hop, WC, et al. BRCA1 mutation and young age predict fast breast cancer growth in the Dutch, United Kingdom, and Canadian magnetic resonance imaging screening trials. Clin Cancer Res 2007; 13: 7357–62.CrossRefGoogle Scholar
Veltman, J, Mann, R, Kok, T, et al. Breast tumor characteristics of BRCA1 and BRCA2 gene mutation carriers on MRI. Eur Radiol 2008; 18: 931–8.CrossRefGoogle ScholarPubMed
Metcalfe, K, Lynch, HT, Ghadirian, P, et al. Contralateral breast cancer in BRCA1 and BRCA2 mutation carriers. J Clin Oncol 2004; 22: 2328–35.CrossRefGoogle ScholarPubMed
Jagannathan, NR, Kumar, M, Seenu, V, et al. Evaluation of total choline from invivo volume localized proton MR spectroscopy and its response to neoadjuvant chemotherapy in locally advanced breast cancer. Br J Cancer 2001; 84: 1016–22.CrossRefGoogle Scholar
Kumar, M, Jagannathan, NR, Seenu, V, et al. Monitoring the therapeutic response of locally advanced breast cancer patients: sequential in vivo proton MR spectroscopy study. J Magn Reson Imag 2006; 24: 325–32.CrossRefGoogle ScholarPubMed
Meisamy, S, Bolan, PJ, Baker, EH, et al. Neoadjuvant chemotherapy of locally advanced breast cancer: predicting response with in vivo (1)H MR spectroscopy–a pilot study at 4 T. Radiology 2004; 233: 424–31.CrossRefGoogle ScholarPubMed
Connor, DW, Simple, SIK, Redpath, TW, et al. The assessment of MRI as a biomarker in monitoring neoadjuvant chemotherapy in breast cancer. RCR Breast Group Annual Scientific Meeting, London, 2008.
Esserman, L, Kaplan, E, Partridge, S, et al. MRI phenotype is associated with response to doxorubicin and cyclophosphamide neoadjuvant chemotherapy in stage III breast cancer. Ann Surg Oncol 2001; 8: 549–59.CrossRefGoogle ScholarPubMed
Wasser, K, Klein, SK, Fink, C, et al. Evaluation of neoadjuvant chemotherapeutic response of breast cancer using dynamic MRI with high temporal resolution. Eur Radiol 2003; 13: 80–7.Google ScholarPubMed
Partridge, SC, Gibbs, JE, Lu, Y, et al. MRI measurements of breast tumor volume predict response to neoadjuvant chemotherapy and recurrence-free survival. Am J Roentgenol 2005; 184: 1774–81.CrossRefGoogle ScholarPubMed
Pickles, MD, Lowry, M, Manton, DJ, et al. Role of dynamic contrast enhanced MRI in monitoring early response of locally advanced breast cancer to neoadjuvant chemotherapy. Breast Cancer Res Treat 2005; 91: 1–10.CrossRefGoogle ScholarPubMed
El Khoury, C, Servois, V, Thibault, F, et al. MR quantification of the washout changes in breast tumors under preoperative chemotherapy: feasibility and preliminary results. Am J Roentgenol 2005; 184: 1499–504.CrossRefGoogle ScholarPubMed
Martincich, L, Montemurro, F, Rosa, G, et al. Monitoring response to primary chemotherapy in breast cancer using dynamic contrast-enhanced magnetic resonance imaging. Breast Cancer Res Treat 2004; 83: 67–76.CrossRefGoogle ScholarPubMed
Rieber, A, Zeitler, H, Rosenthal, H, et al. MRI of breast cancer: influence of chemotherapy on sensitivity. Br J Radiol 1997; 70: 452–8.CrossRefGoogle ScholarPubMed
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: 1317–25.CrossRefGoogle ScholarPubMed
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. New Engl J Med 2004; 351: 427–37.CrossRefGoogle ScholarPubMed
Kuhl, CK, Schrading, S, Leutner, CC, et al. Mammography, breast ultrasound, and magnetic resonance imaging for surveillance of women at high familial risk for breast cancer. J Clin Oncol 2005; 23: 8469–76.CrossRefGoogle ScholarPubMed
Hagen, AI, Kvistad, KA, Maehle, L, et al. Sensitivity of MRI versus conventional screening in the diagnosis of BRCA-associated breast cancer in a national prospective series. Breast J 2007; 16: 367–74.CrossRefGoogle Scholar
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: 698–715.CrossRefGoogle ScholarPubMed
Riedl, CC, Ponhold, L, Flory, D, et al. Magnetic resonance imaging of the breast improves detection of invasive cancer, preinvasive cancer, and premalignant lesions during surveillance of women at high risk for breast cancer. Clin Cancer Res 2007; 13: 6144–52.CrossRefGoogle ScholarPubMed

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