A compact and easy to handle set-up for high quality MR Elastography of the breast

Abstract

Synopsis Distinction between benign and malignant breast lesions remains diတcult with conventional (dynamic) contrast-enhanced MRI. MR Elastography (MRE) can distinguish benign and malignant tissues based on their viscoelastic properties but breast MRE has not found widespread use in daily clinical practice, because of the complex equipment required and cumbersome data acquisition. Here we present a compact, easy to handle breast MRE setup that allows the acquisition of high quality, artefact-free MRE data. This setup was designed, built and tested at two diတerent institutions in volunteers and a patient. Target audience Clinicians, scientists interested in cancer research, breast imaging, and MR Elastography. Purpose Breast cancer is the second most common cancer and one in eight women is expected to develop this type of cancer during her life. Treatment options include (neo-adjuvant) chemotherapy, radiotherapy and surgery, with many women opting for breast-saving therapy: excision of the tumour while the breast remains in place. To reduce breast cancer-related mortality, screening programs have been implemented in many countries to detect early cancers. Population screening is done with X-ray mammography, often with follow-up by (dynamic) contrast-enhanced MRI. Although MRI has high sensitivity, its speciဠcity is only moderate due to overlap between benign and malignant lesions resulting in false-positive ဠndings and hence, relatively low positive predictive value. MR Elastography (MRE) has shown to be a promising technique for distinguishing between benign and malignant tissues based on their viscoelastic properties. However, breast MRE has not found widespread use in daily clinical practice, probably due to the relatively complex MRE actuator setups necessary to generate shear waves for MRE. Many proposed breast MRE actuator setups use a coil as engine (engine-coil) to generate the shear wave, which is closely placed to the breast. The B-ဠelds generated by these coils disturb the imaged FOV in close vicinity to the engine-coil, which often results in artefacts that reduce the valid image volume. In this study we present a compact clinically easy to handle breast MRE setup where the engine-coils are placed at a distance from the breast, resulting in high quality artefact-free MRE images.

Full text

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        
   
Radiology, Academic Medical Center, Amsterdam, Netherlands, Biomedical NMR, Eindhoven University of Technology, Eindhoven, Netherlands, Preclinical and
Translational MRI, Academic Medical Center, Amsterdam, Netherlands, Surgery, Academic Medical Center, Amsterdam, Netherlands, Biomedical Engineering, King's
College London, London, United Kingdom
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