title: Comparing post-operative human breast specimen radiograph and MRI in lesion margin and volume assessment.
abstract: The purpose of this research is to evaluate the potential for identifying malignant breast lesions and their margins on large specimen MRI, in comparison to specimen radiography and clinical dynamic contrast enhanced MRI (DCE-MRI). Breast specimens were imaged with an MR scanner immediately after surgery, with an IRB-approved protocol and with the patients' informed consent. Specimen sizes were at least 5 cm in diameter and approximately 1 to 4 cm thick. Coronal and axial gradient echo MR images without fat suppression were acquired over the whole specimens using a 9.4T animal scanner. Findings on specimen MRI were compared with findings on specimen radiograph, and their volumes were compared with measurements obtained from clinical DCE-MRI. The results showed that invasive ductal carcinoma (IDC) lesions were easily identified using MRI and the margins were clearly distinguishable from nearby tissue. However, ductal carcinoma in situ (DCIS) lesions were not clearly discernible and were diffused with poorly defined margins on MRI. Calcifications associated with DCIS were visualized in all specimens on specimen radiograph. There is a strong correlation between the maximum diameter of lesions as measured by radiograph and MRI (r = 0.93), as well as the maximum diameter measured by pathology and radiograph/MRI (r&gt;0.75). The volumes of IDC measured on specimen MRI were slightly smaller than those measured on DCE-MRI. Imaging of excised human breast lumpectomy specimens with high magnetic field MRI provides promising results for improvements in lesion identification and margin localization for IDC. However, there are technical challenges in visualization of DCIS lesions. Improvements in specimen imaging are important, as they will provide additional information to standard radiographic analysis.
authors.affiliation: Department of Radiology, The University of Chicago, Chicago, IL 60637, USA. habe@radiology.bsd.uchicago.edu
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Abe
authors.forename: Akiko
authors.initials: A
authors.lastname: Shimauchi
authors.forename: Xiaobing
authors.initials: X
authors.lastname: Fan
authors.forename: Jonathan N
authors.initials: JN
authors.lastname: River
authors.forename: Husain
authors.initials: H
authors.lastname: Sattar
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Mueller
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Karczmar
authors.forename: Gillian M
authors.initials: GM
authors.lastname: Newstead
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D015412:Mastectomy, Segmental; D008875:Middle Aged; D011184:Postoperative Period; D011859:Radiography