MRI can accurately diagnose breast cancer during lactation

Nissan, Noam; Massasa, Efi Efraim Moss; Bauer, Ethan; Halshtok-Neiman, Osnat; Shalmon, Anat; Gotlieb, Michael; Faermann, Renata; Samoocha, David; Yagil, Yael; Ziv‐Baran, Tomer; Anaby, Debbie; Sklair‐Levy, Miri

doi:10.1007/s00330-022-09234-z

Cited by 10 publications

(1 citation statement)

References 44 publications

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“…Furthermore, in this study, the negative predictive value of mammogram in patients with a pacemaker was not assessed. For this purpose, a sufficient follow‐up period is required to ensure the lack of false negative cases 30 . In addition, the exact incidence of pacemakers in patients undergoing mammography is probably higher than our actual findings because the presence of pacemaker, as identified in our analysis, was missing from the radiological report in some cases, or to some extent, was not visible on any of view, due to patient body habitus and pacemaker location, pain around the site, and/or the thickness difference between the pacemaker and the remainder of the breast tissue.…”

Section: Discussionmentioning

confidence: 99%

Pacemaker in patients undergoing mammography: A limitation for breast cancer diagnosis?

et al. 2023

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SummaryIntroductionA pacemaker may affect the utility of a mammogram in several ways. The aim of this study is to summarize our institution's experience with mammograms among patients with a cardiac pacemaker, focusing on the diagnostic workup among patients with a newly diagnosed ipsilateral breast cancer.MethodsA retrospective search of all mammography reports between January 2011 and April 2021 was conducted for identifying cases of patients with a pacemaker. Demographic and clinical characteristics as well as mammography‐derived quality parameters and findings were categorized and statistically compared.ResultsThe incidence of pacemaker concurrence in mammographic examination, although apparently slightly under‐documented, accounted for 0.33% of cases. Population mean age was 71.7 years, and most patients (79%) had a left‐sided pacemaker. The pacemaker was much more likely to be projected on the medio‐lateral‐oblique (96%) than on the cranio‐caudal view (10%), on the axilla rather than the breast, and on the retro‐pectoral rather than the pre‐pectoral region (P < 0.001 for all). Compression force decreased by up to 23.0% (P < 0.001) and breast thickness increased by up to 9.5% (P < 0.001) for the ipsilateral vs. the contralateral side. Among 11 patients with newly diagnosed ipsilateral breast cancer, the pacemaker partially projected on the tumour region in two cases, and significantly obscured the tumour in another two.ConclusionAlthough rare, the coexistence of a pacemaker in patients undergoing mammography is associated with reduced image quality due to suboptimal breast visualization and reduced compression, and as a result, this may eventually lead to decreased diagnostic efficacy.

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Section: Discussionmentioning

confidence: 99%

Pacemaker in patients undergoing mammography: A limitation for breast cancer diagnosis?

et al. 2023

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Ultrafast DCE-MRI for discriminating pregnancy-associated breast cancer lesions from lactation related background parenchymal enhancement

Nissan,

Anaby,

Mahameed

et al. 2023

Eur Radiol

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Smart forecasting of artifacts in contrast-enhanced breast MRI before contrast agent administration

Liebert,

Das,

Kapsner

et al. 2023

Eur Radiol

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Objectives To evaluate whether artifacts on contrast-enhanced (CE) breast MRI maximum intensity projections (MIPs) might already be forecast before gadolinium-based contrast agent (GBCA) administration during an ongoing examination by analyzing the unenhanced T1-weighted images acquired before the GBCA injection. Materials and methods This IRB-approved retrospective analysis consisted of n = 2884 breast CE MRI examinations after intravenous administration of GBCA, acquired with n = 4 different MRI devices at different field strengths (1.5 T/3 T) during clinical routine. CE-derived subtraction MIPs were used to conduct a multi-class multi-reader evaluation of the presence and severity of artifacts with three independent readers. An ensemble classifier (EC) of five DenseNet models was used to predict artifacts for the post-contrast subtraction MIPs, giving as the input source only the pre-contrast T1-weighted sequence. Thus, the acquisition directly preceded the GBCA injection. The area under ROC (AuROC) and diagnostics accuracy scores were used to assess the performance of the neural network in an independent holdout test set (n = 285). Results After majority voting, potentially significant artifacts were detected in 53.6% (n = 1521) of all breast MRI examinations (age 49.6 ± 12.6 years). In the holdout test set (mean age 49.7 ± 11.8 years), at a specificity level of 89%, the EC could forecast around one-third of artifacts (sensitivity 31%) before GBCA administration, with an AuROC = 0.66. Conclusion This study demonstrates the capability of a neural network to forecast the occurrence of artifacts on CE subtraction data before the GBCA administration. If confirmed in larger studies, this might enable a workflow-blended approach to prevent breast MRI artifacts by implementing in-scan personalized predictive algorithms. Clinical relevance statement Some artifacts in contrast-enhanced breast MRI maximum intensity projections might be predictable before gadolinium-based contrast agent injection using a neural network. Key Points • Potentially significant artifacts can be observed in a relevant proportion of breast MRI subtraction sequences after gadolinium-based contrast agent administration (GBCA). • Forecasting the occurrence of such artifacts in subtraction maximum intensity projections before GBCA administration for individual patients was feasible at 89% specificity, which allowed correctly predicting one in three future artifacts. • Further research is necessary to investigate the clinical value of such smart personalized imaging approaches.

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MRI can accurately diagnose breast cancer during lactation

Cited by 10 publications

References 44 publications

Pacemaker in patients undergoing mammography: A limitation for breast cancer diagnosis?

Pacemaker in patients undergoing mammography: A limitation for breast cancer diagnosis?

Ultrafast DCE-MRI for discriminating pregnancy-associated breast cancer lesions from lactation related background parenchymal enhancement

Smart forecasting of artifacts in contrast-enhanced breast MRI before contrast agent administration

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