Dynamic contrast-enhanced breast MRI at 7T and 3T: an intra-individual comparison study.

Gisela L G Menezes,Vincent O Boer,Floortje M Knuttel,Wouter B Veldhuis,Wybe J M Van Der Kemp,Peter R Luijten,Tijl A Van Der Velden,Bertine L Stehouwer,Maurice A A J Van Den Bosch,Dennis W J Klomp

doi:10.1186/s40064-015-1654-7

Gisela L G Menezes, Vincent O Boer + Show 8 more

Open Access

https://doi.org/10.1186/s40064-015-1654-7

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Journal: SpringerPlus	Publication Date: Jan 5, 2016
Citations: 26	License type: CC BY 4.0

Affiliation: University Medical Center Utrecht

Abstract

The aim of this study is to compare the current state of lesion identification, the BI-RADS classification and the contrast-enhancement behavior at 7T and 3T breast MRI in the same patient group. Twenty-seven patients with thirty suspicious lesions were selected for this prospective study and underwent both 7T and 3T MRI. All examinations were rated by two radiologists (R1 and R2) independently on image quality, lesion identification and BI-RADS classification. We assessed sensitivity, specificity, NPV and PPV, observer agreement, lesion sizes, and contrast-enhancement-to-noise ratios (CENRs) of mass lesions. Fifteen of seventeen histopathological proven malignant lesions were detected at both field strengths. Image quality of the dynamic series was good at 7T, and excellent at 3T (P = 0.001 for R1 and P = 0.88 for R2). R1 found higher rates of specificity, NPV and PPV at 7T when compared to 3T, while R2 found the same results for sensitivity, specificity, NPV and PPV for both field strengths. The observers showed excellent agreement for BI-RADS categories at 7T (κ = 0.86) and 3T (κ = 0.93). CENRs were higher at 7T (P = 0.015). Lesion sizes were bigger at 7T according to R2 (P = 0.039). Our comparison study shows that 7T MRI allows BI-RADS conform analysis. Technical improvements, such as acquisition of T2w sequences and adjustment of B1+ field inhomogeneity, are still necessary to allow clinical use of 7T breast MRI.

Highlights

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the breast has become a wellestablished imaging method for detection of breast carcinomas, and an increased use of 1.5 tesla (T) and 3T DCE-MRI systems has been observed over the past decades
Subsequent improvements in hardware and imaging strategies have led to an improved image quality and showed that 7T breast MRI is amenable to BI-RADS lexicon conform analysis (Stehouwer et al 2013a, b)
The aim of this study is to compare the current state of lesion identification and BI-RADS classification at DCEMRI at 7T and 3T in the same patient group

Summary

Introduction

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of the breast has become a wellestablished imaging method for detection of breast carcinomas, and an increased use of 1.5 tesla (T) and 3T DCE-MRI systems has been observed over the past decades. In literature the first attempt to perform DCE-MRI breast imaging at 7T was made by Umutu et al using a single loop coil, showing the complexity of ultra–high field breast MRI. Apart from the new contrast mechanisms available at 7T, such as chemical exchange saturation transfer (CEST) and 31phosphorous magnetic resonance spectroscopy (31P-MRS), the conventional breast MRI still needs to at least offer comparable imaging results to the current clinical standard of 3T imaging to maintain good medical care

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