Compared with conventional imaging, contrast-enhanced MR provides a more accurate assessment of the extent of invasive lobular carcinoma in the breast, according to researchers in Canada."Invasive lobular carcinoma grows in a single-file fashion," said
Compared with conventional imaging, contrast-enhanced MR provides a more accurate assessment of the extent of invasive lobular carcinoma in the breast, according to researchers in Canada.
"Invasive lobular carcinoma grows in a single-file fashion," said Dr. Supriya Kulkarni, an assistant professor of medical imaging at the University of Toronto.
Keeping this pathology in mind, Kulkarni and colleagues sought to examine how MR would compare with conventional imaging methods in determining the extent of disease. They prospectively studied 24 women over 16 months. The women all had biopsy-proven invasive lobular cancer, and the researchers used contrast-enhanced MR to preoperatively stage the cancer. They compared results from the CE MR with conventional imaging and lumpectomy or mastectomy.
Thirteen of the women had invasive lobular cancer, while 11 exhibited invasive lobular cancer with ductal features. Conventional imaging captured multicentric disease in 54% of the patients, compared with 83% using CE MR. The researchers found multifocal disease in 17% of the population using conventional imaging and in 29% using CE MR.
"MR revealed additional findings in 61% of the patients compared with conventional imaging," Kulkarni said.
In the 13 women who exhibited multicentric cancer on conventional imaging, CE MR showed:
· larger size of primary focus in 10 patients
· additional tumor foci in nine patients
· multifocal cancer in one patient
· confirmed multifocal disease in two patients
In the seven women with unifocal invasive lobular cancer as characterized by conventional imaging, CE MR showed:
· multicentric disease in two patients
· larger tumor size in five patients
· multifocal disease in two patients
Excisional pathology found both larger tumor size and multifocal cancer in the three women classified as having unifocal disease by both conventional imaging and MR. In all of the study participants, pathology revealed larger tumor sizes in 50% of the women and additional tumor foci in 46% of the women. Results of the study were presented at the RSNA conference.
Even though MR is better at depicting the extent of invasive lobular cancer than conventional imaging, more extensive disease should be anticipated, said Kulkarni.
For more information from the Diagnostic Imaging online archives:
Concerns remain for breast MR even as popularity grows
MRI, ultrasound find larger role in staging breast cancer
MRI-Based AI Radiomics Model Offers 'Robust' Prediction of Perineural Invasion in Prostate Cancer
July 26th 2024A model that combines MRI-based deep learning radiomics and clinical factors demonstrated an 84.8 percent ROC AUC and a 92.6 percent precision-recall AUC for predicting perineural invasion in prostate cancer cases.
Breast MRI Study Examines Common Factors with False Negatives and False Positives
July 24th 2024The absence of ipsilateral breast hypervascularity is three times more likely to be associated with false-negative findings on breast MRI and non-mass enhancement lesions have a 4.5-fold likelihood of being linked to false-positive results, according to new research.
Can Polyenergetic Reconstruction Help Resolve Streak Artifacts in Photon Counting CT?
July 22nd 2024New research looking at photon-counting computed tomography (PCCT) demonstrated significantly reduced variation and tracheal air density attenuation with polyenergetic reconstruction in contrast to monoenergetic reconstruction on chest CT.