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Purpose:To compare conspicuity of liver hemangiomas on STIR, T1-weighted, and T2-weighted magnetic resonance (MR) images before and after administration of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) (hepatocellular contrast agent), using contrast-to-noise ratios (CNRs). Materials and Methods:Thirteen hemangiomas were imaged using breath-hold gradient echo (GRE) T1, fat-saturated turbo spin echo (TSE)-T2, and short tau inversion recovery (STIR) sequences. Background noise and signalto-noise ratios (SNRs) for liver and hemangioma, along with CNR for normal liver and hemangioma, were measured on each sequence before and after administration of Gd-EOB-DTPA. Hemangioma conspicuity was also evaluated qualitatively.Results: After Gd-EOB-DTPA administration, the quantitative liver SNR decreased 54% on STIR, increased 45% on T1-weighted images, and increased 14.5% on TSE-T2-weighted images. The CNR for liver and hemangioma increased 50% on STIR images (P Ͻ 0.0001), increased 46% on T1-weighted imaging (P ϭ 0.0033), and increased 22% on TSE-T2-weighted MR imaging (MRI) (P ϭ 0.0083). After contrast, the CNR for TSE-T2 images was greater than those for both the T1 and STIR images (P Ͻ 0.0001 for both). Qualitatively, signal change was visually apparent in the liver on T1 and STIR, but not on T2 images or in the hemangiomas on any sequence. Conclusion:Despite the statistically significant T1 and STIR increase in CNR, liver hemangiomas were most conspicuous on TSE-T2 images after Gd-EOB-DTPA. This pilot study with hemangiomas highlights the newly recognized potential benefit of TSE-T2 imaging with hepatocellular contrast.

Objective Given variability in how practices manage patients on antithrombotic medications, we undertook this study to understand the current practice of antithrombotic management for patients undergoing percutaneous breast and axillary procedures. Methods A 20-item survey with multiple-choice and write-in options was emailed to 2094 active North American members of the Society of Breast Imaging (SBI) in March 2021. Data were collected anonymously and analyzed quantitatively, with free-text responses categorized by themes. Results Three-hundred twenty-six of 2094 members (15.6%) completed the survey. Eighty-seven percent (274/313) reported having a policy for managing antithrombotic medications. Fifty-nine percent (185/312) reported routinely withholding medications before biopsy, more commonly in the Northeast and South (P = 0.08). Withholding of medications did not vary by lesion location (182/308, 59%, breast vs 181/308, 58.7%, axillary; P = 0.81). Respondents were statistically more likely to withhold medications if using a vacuum-assisted device for all classes of antithrombotic medications (P < 0.001). Up to 50.2% (100/199) on warfarin and 33.6% (66/196) on direct oral anticoagulants had medications withheld more stringently than guidelines. Conclusion Based on a survey of SBI members, breast imaging practices vary widely in antithrombotic management for image-guided breast and axillary procedures. Of the 60% who withhold antithrombotic medications, a minority comply with recommended withhold guidelines, placing at least some patients at potential risk for thrombotic events. Breast imaging radiologists should weigh the risks and benefits of withholding these medications, and if they elect to withhold should closely follow evidence-based guidelines to minimize the risks of this practice.

Pre-operative mammograms and exact information on the pathological-anatomical extent of the tumour were available in 198 patients with carcinoma of the breast. The tumour as seen on the mammogram was measured and compared with the histological information. Five of the 198 carcinomas (2 1/2%) could not be seen on the mammogram. In 69.7% of cases, mammography was suspicious of a carcinoma and in 27.8% a lesion was found that required further investigation. In 67.7%, the mammographic and pathological tumour extent agreed within 3 mm. In 18.2% the tumour appeared more than 3 mm greater, and in 9.6% more than 3 mm smaller than real size; the error was greater than 30 mm in only 3.2%.