3.0 Tesla vs 1.5 Tesla breast magnetic resonance imaging in newly diagnosed breast cancer patients

Abstract

AIM:To compare 3.0 Tesla (T) vs 1.5T magnetic resonance (MR) imaging systems in newly diagnosed breast cancer patients. METHODS:Upon Institutional Review Board approval, a Health Insurance Portability and Accountability Actcompliant retrospective review of 147 consecutive 3.0T MR examinations and 98 consecutive 1.5T MR examinations in patients with newly diagnosed breast cancer between 7/2009 and 5/2010 was performed. Eleven patients who underwent neoadjuvant chemotherapy in the 3.0T group were excluded. Mammographically occult suspicious lesions (BIRADS Code 4 and 5) additional to the index cancer in the ipsilateral and contralateral breast were identified. Lesion characteristics and pathologic diagnoses were recorded, and results achieved with both systems compared. Statistical significance was analyzed using Fisher's exact test. RESULTS:In the 3.0T group, 206 suspicious lesions were identified in 55% (75/136) of patients and 96% (198/206) of these lesions were biopsied. In the 1.5T group, 98 suspicious lesions were identified in 53% (52/98) of patients and 90% (88/98) of these lesions were biopsied. Biopsy results yielded additional malignancies in 24% of patients in the 3.0T group vs 14% of patients in the 1.5T group (33/136 vs 14/98, P = 0.07). Average size and histology of the additional cancers was comparable. Of patients who had a suspicious MR imaging study, additional cancers were found in 44% of patients in the 3.0T group vs 27% in the 1.5T group (33/75 vs 14/52, P = 0.06), yielding a higher positive predictive value (PPV) for biopsies performed with the 3.0T system. CONCLUSION: 3.0T MR imaging detected more additional malignancies in patients with newly diagnosed breast cancer and yielded a higher PPV for biopsies performed with the 3.0T system. © 2013 Baishideng. All rights reserved.Key words: Breast; Breast cancer; Cancer staging; Outcome; Magnetic resonance imaging; Breast magnetic resonance imaging; 3 Tesla; Technical Core tip: 3.0 Tesla (T) breast magnetic resonance (MR) imaging offers superior image quality through improved signal-to-noise ratio and resolution. In a comparison of two nearly identical patient populations of women with newly diagnosed breast cancer, a greater number of suspicious lesions and mammographically occult malignancies were detected using an optimized 3.0T system compared to a conventional 1.5T system. The positive predictive value of an abnormal MR imaging study was higher for 3.0T MR imaging compared to 1.5T imaging. These results attest to a clinical benefit and higher accuracy achievable with a 3.0T magnet.Butler RS, Chen C, Vashi R, Hooley RJ, Philpotts LE. 3.0 Tesla vs 1.5 Tesla breast magnetic resonance imaging in newly diagnosed breast cancer patients. World J Radiol 2013; 5(8): 285-294

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