title: Image quality and diagnostic performance of silicone-specific breast MRI.
abstract: OBJECTIVE
  To compare the image quality of three techniques and diagnostic performance in detecting implant rupture.
  
  
  METHODS
  The study included 161 implants for the evaluation of image quality, composed of water-saturated short TI inversion recovery (herein called "water-sat STIR"), three-point Dixon techniques (herein called "Dixon"), and short TI inversion recovery fast spin-echo with iterative decomposition of silicone and water using least-squares approximation (herein called "STIR IDEAL") and included 41 implants for the evaluation of diagnostic performance in detecting rupture, composed of water-sat STIR and STIR IDEAL. Six image quality categories were evaluated and three classifications were used: normal implant, possible rupture, and definite rupture.
  
  
  RESULTS
  Statistically significant differences were noted for the image quality categories (p<0.001). STIR IDEAL was superior or equal to water-sat STIR in all image quality categories except artifact effects and superior to Dixon in all categories. Water-sat STIR performed the poorest for water suppression uniformity. The sensitivity and specificity in detecting implant rupture of STIR-IDEAL were 81.8 % and 77.8 % and the difference between two techniques was not statistically significant.
  
  
  CONCLUSIONS
  STIR-IDEAL is a useful silicone-specific imaging technique demonstrating more robust water suppression and equivalent diagnostic accuracy for detecting implant rupture, than water-sat STIR, at the cost of longer scan time and an increase in minor motion artifacts.
authors.affiliation: Department of Radiology, Stanford University, Stanford, CA 94305-5621, USA; Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Sung Hun
authors.initials: SH
authors.lastname: Kim
authors.forename: Jafi A
authors.initials: JA
authors.lastname: Lipson
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Moran
authors.forename: Ann
authors.initials: A
authors.lastname: Shimakawa
authors.forename: James
authors.initials: J
authors.lastname: Kuo
authors.forename: Debra M
authors.initials: DM
authors.lastname: Ikeda
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Daniel
mesh_terms: D000273:Adipose Tissue / Q000473:pathology; D000328:Adult; D000465:Algorithms; D016477:Artifacts; D001940:Breast / Q000473:pathology*; D018427:Breast Implants; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016018:Least-Squares Analysis; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D015588:Observer Variation; D011475:Prosthesis Failure; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012828:Silicones / Q000737:chemistry*
chemical_list: D012828:Silicones
keywords: Diagnosis; Image quality enhancement; Magnetic resonance imaging; Silicone gel