Feasibility, Image Quality and Clinical Evaluation of Contrast-Enhanced Breast MRI Performed in a Supine Position Compared to the Standard Prone Position.

Alfonso Fausto,Maria Antonietta Mazzei,Raffaella Massafra,Annarita Fanizzi,Luca Volterrani,Daniele La Forgia,Donato Casella,Claudio Calabrese,Marco Marcasciano,Francesco Giuseppe Mazzei

doi:10.3390/cancers12092364

Abstract

Background: To assess the feasibility, image quality and diagnostic value of contrast-enhanced breast magnetic resonance imaging (MRI) performed in a supine compared to a prone position. Methods: One hundred and fifty-one patients who had undergone a breast MRI in both the standard prone and supine position were evaluated retrospectively. Two 1.5 T MR scanners were used with the same image resolution, sequences and contrast medium in all examinations. The image quality and the number and dimensions of lesions were assessed by two expert radiologists in an independent and randomized fashion. Two different classification systems were used. Histopathology was the standard of reference. Results: Two hundred and forty MRIs from 120 patients were compared. The analysis revealed 134 MRIs with monofocal (U), 68 with multifocal (M) and 38 with multicentric (C) lesions. There was no difference between the image quality and number of lesions in the prone and supine examinations. A significant difference in the lesion extension was observed between the prone and supine position. No significant differences emerged in the classification of the lesions detected in the prone compared to the supine position. Conclusions: It is possible to perform breast MRI in a supine position with the same image quality, resolution and diagnostic value as in a prone position. In the prone position, the lesion dimensions are overestimated with a higher wash-in peak than in the supine position.

Highlights

Many years have passed since the introduction of breast magnetic resonance imaging (MRI)in the diagnosis and monitoring of breast cancer [1,2]
In addition to reporting the multiple advantages of supine MRI, the purpose of this study is to demonstrate that it is possible to perform the dynamic sequence of breast MRI with the patient in the supine position with the same diagnostic accuracy as that of the prone position and using the same classification criteria
Examinations in the prone position, 240 breast MRIs were compared in 120 subjects

Summary

Introduction

Many years have passed since the introduction of breast magnetic resonance imaging (MRI)in the diagnosis and monitoring of breast cancer [1,2]. The guidelines prescribe the use of dedicated coils for breast MRI, with the patient in a prone position and the breasts lying within the coils. The purpose of these guidelines is to ensure an examination of good technical quality, and to provide improved diagnostic accuracy via multiparametric classification of the lesions [4]. Image quality and diagnostic value of contrast-enhanced breast magnetic resonance imaging (MRI) performed in a supine compared to a prone position. There was no difference between the image quality and number of lesions in the prone and supine examinations. No significant differences emerged in the classification of the lesions detected in the prone compared to the supine position

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Discussion

Conclusion