High-quality breast MRI

Breast magnetic resonance imaging (MRI) demands the competing factors of high spatial resolution, good temporal resolution, high signal-to-noise ratios, and complete bilateral breast coverage. Achieving these competing factors requires modern MRI equipment with high magnetic field strength and homogeneity, high maximum gradient strength with short rise times, dedicated multichannel bilateral breast coils with prone patient positioning, and 3D (volume) gradient-echo MRI pulse sequences with short TR, short TE, high spatial resolution, and reasonably short acquisition times. This article discusses the equipment and pulse sequences needed to achieve high-quality breast MRI and summarizes requirements of the ACR Breast MRI Accreditation Program.

Consistency of breast density measured from the same women in four different MR scanners

PURPOSE

To compare the breast volume (BV), fibroglandular tissue volume (FV), and percent density (PD) measured from breast MRI of the same women using four different MR scanners.

METHODS

The study was performed in 34 healthy Asian volunteers using two 1.5T (GE and Siemens) and two 3T (GE and Philips) MR scanners. The BV, FV, and PD were measured on nonfat-suppressed T1-weighted images using a comprehensive computer algorithm-based segmentation method. The scanner-to-scanner measurement difference, and the coefficient of variation (CV) among the four scanners were calculated. The measurement variation between two density morphological patterns presenting as the central type and the intermingled type was separately analyzed and compared.

RESULTS

All four scanners provided satisfactory image quality allowing for successful completion of the segmentation processes. The measured parameters between each pair of MR scanners were highly correlated, with R(2) ≥ 0.95 for BV, R(2) ≥ 0.99 for FV, and R(2) ≥ 0.97 for PD in all comparisons. The mean percent differences between each pair of scanners were 5.9%-7.8% for BV, 5.3%-6.5% for FV, 4.3%-7.3% for PD; with the overall CV of 5.8% for BV, 4.8% for FV, and 4.9% for PD. The variation of FV was smaller in the central type than in the intermingled type (p = 0.04).

CONCLUSIONS

The results showed that the variation of FV and PD measured from four different MR scanners is around 5%, suggesting the parameters measured using different scanners can be used for a combined analysis in a multicenter study.

Optimizing 1.5-Tesla and 3-Tesla dynamic contrast-enhanced magnetic resonance imaging of the breasts

The technical requirements for magnetic resonance imaging (MRI) of the breasts are challenging because high temporal and high spatial resolution are necessary. This article describes the necessary equipment and pulse sequences for performing a high-quality study. Although imaging at 3-Tesla (T) has a higher signal-to-noise ratio, the protocol needs to be modified from the 1.5-T system to provide optimal imaging. The article presents the requirements for performing breast MRI and discusses techniques to ensure high-quality examinations on 1.5-T and 3-T systems.

Implementing a breast MR imaging program: all things considered

The role of magnetic resonance (MR) imaging in breast imaging and evaluation has increased rapidly. MR imaging now encompasses diagnostic evaluation as well as screening for breast cancer in high-risk groups, monitoring the extent of disease and the response to chemotherapy. It is expected that the utility of breast MR imaging will continue to increase, requiring additional facilities and expertise. Establishing a breast MR imaging program requires familiarity with several unique issues pertaining to the nature of this imaging modality. This article attempts to address some of these issues, including selection of a magnet based on needs of the particular practice and magnet field strength, selection of a dedicated breast coil, magnet location and siting, advantages and challenges of higher strength magnets such as 3 Tesla, establishing a referral base, scheduling of breast MR examinations, patient safety concerns, and examination interpretation and reporting.