Failures In MRI Imaging -- Differentiation Failures
Failed MRI Differentiation In Breast Examination
Source
History of Breast MRI
N.Breiter, M.D., Department of Diagnostic Radiology I, University Hospital, Göttingen, FRG
Failed MRI Differentiation In Breast Examination
Damadian - in the early 70s - was the first who reported that in vitro proton relaxation times were longer in cancers than in normal tissues. Lauterbur - the inaugurator of the MR imaging technique - also noted in his initial report that a "possible application of considerable interest ... would be ... the in vivo study of malignant tumors". In vitro MR spectroscopy of breast cancer tissue by Fossel et al. revealed a T1 of cancer above a "malignant threshold" of 370 milliseconds whereas uninvolved tissue remained below 370 milliseconds. The first in vivo MR images of the breast using whole-body magnets, an ordinary body coil and spin-echo sequences were obtained by Mansfield et al. (1979), Ross et al. (1982) and El Yousef (1982) but failed to reach clinical value due to poor spatial resolution and low S/N ratio. The employment of surface coils by Axel and Fritschy et al. in 1984 improved spatial resolution but still no reliable criteria to differentiate between benign and malignant lesions could be established. The use of T1 - and T2-weighted gradient-echo sequences by Kaiser (1984), Stelling et al. (1985), Heywang et al. (1985) and Dash et al. (1986) improved image quality to a point that first criteria for benign and malignant breast lesions could be developed. The introduction of contrast enhanced imaging of the breast with Gd-DTPA by Heywang et al. (1986) substantially increased the information content of MR images and was the starting point of modern MR-mammography.
Take home points:
- The breast was an early target organ for MRI
- Tissue differentiation was unsuccessfull with non-contrast MRI
Copyright © May 20, 2008 6:24 AM by Karl Loren on behalf of Vibrant Life, ALL RIGHTS RESERVED. Permission is granted for non-commercial downloading, copying, distribution or redistribution on two conditions: One, that some form of copyright notice is included in every copy distributed or copied, showing the copyright belonging to Vibrant Life, Burbank, CA, at www.oralchelation.com . The second condition is that the material is not to be used for any purpose contrary to the purposes and objectives of this site. This permission does not extend to materials on this site which are copyrighted by others.
While breast MRI is an effective problem-solving technology, it has limitations as a screening tool for breast cancer. Breast MRI’s limited availability, expense, and frequent non-specificity (failure to distinguish between cancerous and non-cancerous abnormalities) have slowed its widespread acceptance. However, if research continues to show that MRI can be effective as screening women at high risk of breast cancer (particularly young women who have dense breast tissue that makes it difficult to detect cancer with mammography), it may one day play a larger role in breast cancer detection.
The following chart summarizes the benefits and limitations
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