Emerging MRI News and Research — October 2025

New magnetic resonance imaging (MRI) research in October ranged from multiple studies on the merits of preoperative breast MRI to emerging findings with ofatumumab for relapsing multiple sclerosis and a new iron-based contrast agent for visualization of malignant neoplasms on brain MRI.

With this in mind, let’s take a closer look at the most well-read MRI content from October.

Is DCE-MRI Sufficient Follow-Up Imaging for Suspicious Calcifications from Mammography Exams?

For suspicious calcifications identified on mammography, dynamic contrast-enhanced MRI (DCE-MRI) may help refine diagnosis and potentially limit unnecessary biopsies.

In a study analyzing 81 women with 86 calcifications, models integrating qualitative DCE-MRI features achieved an AUC for malignancy detection ranging from 71 percent to 76 percent in comparison to 57 percent observed with models based on mammography and clinical variables. DCE-MRI was also associated with up to a 30 percent higher detection rate for invasive breast cancer or high-grade ductal carcinoma in situ (DCIS).^1,2

The study authors maintained that the inclusion of diffusion-weighted imaging (DWI) or quantitative MRI features did not demonstrate clear added diagnostic value beyond standard qualitative DCE-MRI for differentiating these suspicious calcifications.^1,2

The utility of DCE-MRI in this setting is further supported by evidence suggesting it could reduce the need for biopsy. For patients with mammographic BI-RADS 4A and 4B calcifications, standard DCE-MRI could have potentially reduced the total number of unnecessary biopsies by 73.0 percent to 77.8 percent in the studied cohort, particularly when calcifications were non-enhancing and high-grade DCIS or invasive cancer was absent.^1,2

What Multiple Studies Show About the Impact of Pre-Op Breast MRI

Beyond diagnostic capabilities, new research affirms the impact of preoperative breast MRI on treatment outcomes for breast cancer, particularly in younger women.

Among patients aged 50 or younger who underwent surgery for newly diagnosed breast cancer, pre-op MRI was associated with a 51 percent reduction in the 5-year cumulative incidence of ipsilateral in-breast recurrence. For women with hormone receptor-negative tumors, researchers found that pre-op MRI use resulted in a 12.5 percent reduced 5-year recurrence risk (8.2 percent vs. 20.7 percent).^3,4

In a separate study, preoperative MRI was associated with a higher rate of mastectomy (49 percent vs. 31 percent) and revealed additional suspicious lesions in over 50 percent of women planning to have breast cancer surgery.^5,6

What Does a New Meta-Analysis Reveal About the PI-RADS v2.1 System for Prostate MRI?

In a large meta-analysis assessing the performance of the PI-RADS v2.1 system for prostate MRI interpretation, researchers reviewed data from 117 studies and over 25,000 patients.^7,8

The analysis reinforced the system's high patient-level sensitivity for detecting clinically significant prostate cancer (csPCa), reporting 96 percent sensitivity for PI-RADS category > 3 lesions and 88 percent for PI-RADS category > 4 assessments. Cancer detection rates (CDRs) correlated strongly with PI-RADS categorization, ranging from 3 percent for PI-RADS 1 to 83 percent for PI-RADS 5.^7,8

The meta-analysis authors advised caution, however, noting that nearly one-third (29 percent) of the reviewed studies demonstrated a high risk of bias or questionable applicability.^7,8

Emerging Developments in MRI Neuroimaging

In contrast agent news, the Food and Drug Administration (FDA) approved Ferabright™ (ferumoxytol injection), making it the first iron-based contrast agent for brain MRI indicated for adults with known or suspected malignant neoplasms.⁹

Ferabright offers a long half-life that facilitates flexible MRI protocols and may serve as an alternative contrast agent for patients who are contraindicated for or decline gadolinium, according to Azurity Pharmaceuticals, the manufacturer of Ferabright. The company noted the iron-based agent is processed via natural iron metabolism pathways, minimizing concerns regarding long-term contrast retention.⁹

In other MRI neuroimaging news, researchers found that switching patients with relapsing multiple sclerosis from oral therapies to monthly subcutaneous ofatumumab led to a significant reduction in inflammatory activity.^10,11

In a recent interview with Diagnostic Imaging, Riley Bove, M.D., noted that study findings of a 98.1 percent reduction in gadolinium-positive (Gd+) T1 lesions at 96 weeks reflected the marked efficacy of B-cell depleting therapies against new focal inflammatory activity in this patient population.^10,11

References

1. Park VY, Hippe DS, Kazerouni AS, et al. Multiparametric breast MRI to problem-solve mammographically detected suspicious calcifications. Eur J Radiol. 2025 Oct 11:104:112467. doi: 10.1016/j.ejrad.2025.112467.

2. Hall J. Assessing the utility of mpMRI for enhancing diagnostic clarity with suspicious calcifications from mammography exams. Diagc Imaging. Available at: https://www.diagnosticimaging.com/view/assessing-mpmri-enhancing-diagnostic-clarity-suspicious-calcifications-mammography-exams . Published October 14, 2025. Accessed October 27, 2025.

3. Yoen H, Skin HC, Yoon KH, et al. Preoperative breast MRI and survival outcomes in women 50 years or younger with breast cancer. Radiology. 2025 Oct;317(1):e250439. doi: 10.1148/radiol.250439.

4. Hall J. New research assesses the impact of pre-op MRI on breast cancer recurrence. Diagn Imaging. Available at: https://www.diagnosticimaging.com/view/new-research-impact-pre-op-mri-breast-cancer-recurrence . Published October 22, 2025. Accessed October 27, 2025.

5. Trinh C, Shi V, Pham T, et al. Preoperative breast MRI for extent of disease evaluation following new breast cancer diagnosis: a retrospective cohort study. J Am Coll Radiol. 2025 Oct 9:S1546-1440(25)00580-0.

6. Hall J. What new research reveals about preoperative breast MRI. Diagn Imaging. Available at: https://www.diagnosticimaging.com/view/what-new-research-reveals-about-preoperative-breast-mri . Published October 10, 2025. Accessed October 27, 2025.

7. Nedelcu A, Oerther B, Benkendorff A, et al. PI-RADS version 2,1 for prostate MRI interpretation: associations of study quality and cancer detection metrics — a systematic review and meta-analysis. AJR Am J Roentgenol. 2025 Oct 15. doi: 10.2214/AJR.25.33583. Online ahead of print.

8. Hall J. What a new meta-analysis reveals about the PI-RADS v2.1 system for prostate MRI. Diagn Imaging. Available at: https://www.diagnosticimaging.com/view/meta-analysis-pi-rads-v2-1-system-prostate-mri . Published October 16, 2025. Accessed October 27, 2025.

9. Hall J. FDA approves iron-based contrast agent for brain MRI. Diagn Imaging. Available at: https://www.diagnosticimaging.com/view/fda-approves-iron-based-contrast-agent-brain-mri . Published October 18, 2025. Accessed October 27, 2025.

10. Bove R, Langdon D, Boer I, et al. Ofatumumab safety and efficacy in people living with relapsing multiple sclerosis with breakthrough disease on oral fumarates or fingolimod: ARTIOS study. Presented at the 41st Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), September 24-26, 2025, Barcelona, Spain.

11. Hall J. MRI research shows ‘virtually complete abrogation’ of new lesions with switch to ofatumumab for multiple sclerosis patients. Diagn Imaging. Available at: https://www.diagnosticimaging.com/view/mri-research-virtually-complete-abrogation-of-new-lesions-switch-to-ofatumumab-multiple-sclerosis- . Published October 2, 2025. Accessed October 27, 2025.

(Editor’s note: This article was written with artificial intelligence and reviewed by human editors for accuracy.)