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Current applications and future direction of MR mammography.

Kneeshaw PJ, Turnbull LW, Drew PJ - Br. J. Cancer (2003)

Bottom Line: Advances in both spatial and temporal resolutions, the imaging sequences employed, pharmacokinetic modelling of contrast uptake, the use of dedicated and now phased-array breast coils, and gadolinium-based contrast agents have all played their part in the advancement of this imaging technique.Despite the limitations of patient compliance, scan-time and cost, this review describes how MRM has become a valuable tool in breast disease, especially in cases of diagnostic uncertainty.However, MRM must make the transition from research institutions into routine clinical practice.

View Article: PubMed Central - PubMed

Affiliation: 1Academic Surgical Unit, Castle Hill Hospital, Castle Road, Cottingham HU 16 5JQ, UK.

ABSTRACT
Compared with triple assessment for symptomatic and occult breast disease, magnetic resonance mammography (MRM) offers higher sensitivity for the detection of multifocal cancer, which is important in selecting patients appropriately for breast-conserving surgery. It is an ideal tool for the screening of patients with a high risk of breast cancer or where there is axillary disease or nipple discharge and conventional imaging has not revealed the primary focus. Techniques are now available to biopsy lesions only apparent on MRM. MRM can differentiate scar tissue from tumour; therefore, it is useful in patients in which there is possible recurrent disease. Clinical and X-ray mammographic assessment of response to neoadjuvant chemotherapy may be unreliable because of replacement of the tumour with scar tissue. MRM can identify responders and nonresponders with more accuracy. It is the modality of choice for the assessment of breast implants for rupture with accuracy higher than X-ray mammography and ultrasound. Advances in both spatial and temporal resolutions, the imaging sequences employed, pharmacokinetic modelling of contrast uptake, the use of dedicated and now phased-array breast coils, and gadolinium-based contrast agents have all played their part in the advancement of this imaging technique. Despite the limitations of patient compliance, scan-time and cost, this review describes how MRM has become a valuable tool in breast disease, especially in cases of diagnostic uncertainty. However, MRM must make the transition from research institutions into routine clinical practice.

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Related in: MedlinePlus

A T1-weighted image of an invasive breast cancer (A) fat-saturated image after gadolinium contrast (B).
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fig1: A T1-weighted image of an invasive breast cancer (A) fat-saturated image after gadolinium contrast (B).

Mentions: MRM relies on the presence of well-established morphological features that help distinguish malignant from benign lesions. In addition, angiogenesis induced by cancers is demonstrated by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Areas of increased microvessel density are delineated following intravenous gadolinium–diethylenetriaminepentaacetic acid (Gd–DTPA). The enhancement in malignant tissue is thought to be because of increased permeability, vascularity and increased interstitial space (Vaupel, 1994) (Figure 1Figure 1


Current applications and future direction of MR mammography.

Kneeshaw PJ, Turnbull LW, Drew PJ - Br. J. Cancer (2003)

A T1-weighted image of an invasive breast cancer (A) fat-saturated image after gadolinium contrast (B).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2376788&req=5

fig1: A T1-weighted image of an invasive breast cancer (A) fat-saturated image after gadolinium contrast (B).
Mentions: MRM relies on the presence of well-established morphological features that help distinguish malignant from benign lesions. In addition, angiogenesis induced by cancers is demonstrated by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Areas of increased microvessel density are delineated following intravenous gadolinium–diethylenetriaminepentaacetic acid (Gd–DTPA). The enhancement in malignant tissue is thought to be because of increased permeability, vascularity and increased interstitial space (Vaupel, 1994) (Figure 1Figure 1

Bottom Line: Advances in both spatial and temporal resolutions, the imaging sequences employed, pharmacokinetic modelling of contrast uptake, the use of dedicated and now phased-array breast coils, and gadolinium-based contrast agents have all played their part in the advancement of this imaging technique.Despite the limitations of patient compliance, scan-time and cost, this review describes how MRM has become a valuable tool in breast disease, especially in cases of diagnostic uncertainty.However, MRM must make the transition from research institutions into routine clinical practice.

View Article: PubMed Central - PubMed

Affiliation: 1Academic Surgical Unit, Castle Hill Hospital, Castle Road, Cottingham HU 16 5JQ, UK.

ABSTRACT
Compared with triple assessment for symptomatic and occult breast disease, magnetic resonance mammography (MRM) offers higher sensitivity for the detection of multifocal cancer, which is important in selecting patients appropriately for breast-conserving surgery. It is an ideal tool for the screening of patients with a high risk of breast cancer or where there is axillary disease or nipple discharge and conventional imaging has not revealed the primary focus. Techniques are now available to biopsy lesions only apparent on MRM. MRM can differentiate scar tissue from tumour; therefore, it is useful in patients in which there is possible recurrent disease. Clinical and X-ray mammographic assessment of response to neoadjuvant chemotherapy may be unreliable because of replacement of the tumour with scar tissue. MRM can identify responders and nonresponders with more accuracy. It is the modality of choice for the assessment of breast implants for rupture with accuracy higher than X-ray mammography and ultrasound. Advances in both spatial and temporal resolutions, the imaging sequences employed, pharmacokinetic modelling of contrast uptake, the use of dedicated and now phased-array breast coils, and gadolinium-based contrast agents have all played their part in the advancement of this imaging technique. Despite the limitations of patient compliance, scan-time and cost, this review describes how MRM has become a valuable tool in breast disease, especially in cases of diagnostic uncertainty. However, MRM must make the transition from research institutions into routine clinical practice.

Show MeSH
Related in: MedlinePlus