Abstract
Despite the development and implementation of several MRI techniques for breast density assessments, there is no consensus on the optimal protocol in this regard. This study aimed to determine the most appropriate MRI protocols for the quantitative assessment of breast density using a personalized 3D-printed breast model. The breast model was developed using silicone and peanut oils to simulate the MRI related-characteristics of fibroglandular and adipose breast tissues, and then scanned on a 3T MRI system using non-fat-suppressed and fat-suppressed sequences. Breast volume, fibroglandular tissue volume, and percentage of breast density from these imaging sequences were objectively assessed using Analyze 14.0 software. Finally, the repeated-measures analysis of variance (ANOVA) was performed to examine the differences between the quantitative measurements of breast volume, fibroglandular tissue volume, and percentage of breast density with respect to the corresponding sequences. The volume of fibroglandular tissue and the percentage of breast density were significantly higher in the fat-suppressed sequences than in the non-fat-suppressed sequences (p < 0.05); however, the difference in breast volume was not statistically significant (p = 0.529). Further, a fat-suppressed T2-weighted with turbo inversion recovery magnitude (TIRM) imaging sequence was superior to the non-fat- and fat-suppressed T1- and T2-weighted sequences for the quantitative measurement of breast density due to its ability to represent the exact breast tissue compositions. This study shows that the fat-suppressed sequences tended to be more useful than the non-fat-suppressed sequences for the quantitative measurements of the volume of fibroglandular tissue and the percentage of breast density.
Highlights
Breast density, a measure of dense fibroglandular tissue relative to non-dense fatty tissue, has been determined as an independent risk factor for developing breast cancer [1,2,3,4]
This combination of findings further supports the hypothesis that such a model could be used to examine different MR breast-imaging protocols in order to determine the optimum for the quantitative assessment of breast density
A possible explanation for this could be that these types of acquisitions are highly affected by inhomogeneity in the magnetic field, demonstrating inhomogeneous fat suppression in the fatty structures
Summary
A measure of dense fibroglandular tissue relative to non-dense fatty tissue, has been determined as an independent risk factor for developing breast cancer [1,2,3,4]. Recent developments in breast cancer screening have intensified the need for a standardized imaging protocol and/or measurement method for the evaluation of breast density predominantly for women at an elevated risk of developing breast cancer, such as those with high breast density [4,8,9,10]. There has been little consensus on the optimal MR breast-imaging protocol and measurement method for breast density screening and/or assessment, especially in the context of women with dense breast tissues
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