title: Positioning in breast MR imaging to optimize image quality.
abstract: Improper positioning of the breasts in a dedicated breast coil causes inhomogeneous fat saturation as well as other artifacts that decrease the sensitivity of breast magnetic resonance imaging. Improper positioning can create artifacts that can obscure a malignancy or cause it to be missed. Goals of proper positioning include imaging the maximum area of breast tissue, minimizing skin folds, and achieving homogeneous fat suppression and nondeformed breast parenchyma. Review of prior images gives the technologist an impression of what the positioning and imaging challenges may be in each patient before the patient enters the imaging unit. Checking the triplane localizer images and repositioning as necessary before any diagnostic or interventional imaging is key. Using a fat saturation pad, changing the arm position, or "rolling" the patient may be considered in difficult cases. Padding to support the patient in an oblique position, using angled sponges to increase breast compression thickness, and raising the grid to access posterior lesions may be helpful in targeting difficult-to-access lesions for biopsy. Using the presented positioning techniques and suggestions, in addition to strict attention to detail before imaging, will improve image quality, decrease imaging time and suboptimal images, and limit the need for repeat imaging studies.
authors.affiliation: From the Division of Breast Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, RA Bldg, RA-014, Boston, MA 02115 (E.D.Y., D.G.S., S.R., L.B., R.L.B.); and Department of Radiology, Dana-Farber Cancer Institute, Boston, Mass (J.P.H.).
authors.forename: Eren D
authors.initials: ED
authors.lastname: Yeh
authors.forename: Dianne
authors.initials: D
authors.lastname: Georgian-Smith
authors.forename: Sughra
authors.initials: S
authors.lastname: Raza
authors.forename: Lisa
authors.initials: L
authors.lastname: Bussolari
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Pawlisz-Hoff
authors.forename: Robyn L
authors.initials: RL
authors.lastname: Birdwell
mesh_terms: D016477:Artifacts; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000473:pathology*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000295:instrumentation* / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000295:instrumentation* / Q000379:methods*; D056888:Patient Positioning / Q000295:instrumentation* / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity