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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

Monitoring the response to neo-adjuvant chemotherapy. Before treatment (A) and response after 3 months (B).
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fig4: Monitoring the response to neo-adjuvant chemotherapy. Before treatment (A) and response after 3 months (B).

Mentions: Patients with locally advanced disease at presentation are more commonly undergoing neoadjuvant chemotherapy followed by surgery. It is the aim of the treatment to shrink the tumour to allow subsequent mastectomy or breast-conserving surgery (Jacquillat et al, 1989). Evaluation of the response to chemotherapy by conventional imaging methodology is difficult. This is because of changes induced in the breast parenchyma, including the replacement of tumour with diffuse fibrosis. The fibrotic tissue may be confused with residual tumour on palpation. Breast MRI is more effective than X-ray mammography at determining the extent of residual disease following neoadjuvant chemotherapy (Esserman et al, 1999; Drew et al, 2001) (Figure 4Figure 4


Current applications and future direction of MR mammography.

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

Monitoring the response to neo-adjuvant chemotherapy. Before treatment (A) and response after 3 months (B).
© Copyright Policy
Related In: Results  -  Collection

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

fig4: Monitoring the response to neo-adjuvant chemotherapy. Before treatment (A) and response after 3 months (B).
Mentions: Patients with locally advanced disease at presentation are more commonly undergoing neoadjuvant chemotherapy followed by surgery. It is the aim of the treatment to shrink the tumour to allow subsequent mastectomy or breast-conserving surgery (Jacquillat et al, 1989). Evaluation of the response to chemotherapy by conventional imaging methodology is difficult. This is because of changes induced in the breast parenchyma, including the replacement of tumour with diffuse fibrosis. The fibrotic tissue may be confused with residual tumour on palpation. Breast MRI is more effective than X-ray mammography at determining the extent of residual disease following neoadjuvant chemotherapy (Esserman et al, 1999; Drew et al, 2001) (Figure 4Figure 4

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