title: MRI evaluation of post-mastectomy irradiated breast implants: prevalence and analysis of complications.
abstract: OBJECTIVE
  To evaluate the effect of post-mastectomy radiation therapy (RT) on breast implants as detected by magnetic resonance imaging (MRI) searching for short-term complications.
  
  
  METHODS
  One hundred and forty patients (total of 144 implants) were evaluated by MRI; 80 (group 1) had undergone RT, whereas the remaining 60 patients (group 2) underwent mastectomy with implant reconstruction without RT. Two radiologists evaluated MRI images searching for implant rupture signs, sub-capsular seromas, capsular contracture, soft-tissue oedema, peri-implant fluid collections. Implant ruptures were classified as severe complications; seromas and capsular contractures as moderate complications; oedema and fluid collections as mild complications. The prevalence of MRI findings in the two groups was calculated and compared by unpaired t-test. Cohen's kappa statistics was used to assess interobserver agreement.
  
  
  RESULTS
  Sixty-nine out of 144 (48%) implants presented pathological findings at MRI with complication rates of 47.5 and 48.4 for groups 1 and 2, respectively. Two (5%) severe complications, 10 (26%) moderate complications, and 26 (69%) mild complications occurred in group 1 and surgical treatment was performed in 10 cases. Two (6%) severe complications, seven (23%) moderate complications, and 22 (71%) mild complications occurred in group 2 and surgical treatment was performed in eight cases. No significant difference between the two groups was found (p>0.1). Almost perfect agreement between the two radiologists was found for MRI image detection (k=0.86).
  
  
  CONCLUSIONS
  RT does not seem to cause a significant effect on breast implants in terms of complication rate in patients undergoing implant-based breast reconstruction. One-stage immediate implant-based breast reconstruction performed at the same time as mastectomy could be proposed.
authors.affiliation: DIM - Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Piazza Giulio Cesare 11, 70124, Bari, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Rella
authors.affiliation: DIM - Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Piazza Giulio Cesare 11, 70124, Bari, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Telegrafo
authors.affiliation: Department of Oncologic Radiotherapy, IRCCS Giovanni Paolo II Oncologic Institute of Bari, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Nardone
authors.affiliation: Department of Oncologic Radiotherapy, IRCCS Giovanni Paolo II Oncologic Institute of Bari, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Milella
authors.affiliation: DIM - Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Piazza Giulio Cesare 11, 70124, Bari, Italy.
authors.forename: A A
authors.initials: AA
authors.lastname: Stabile Ianora
authors.affiliation: Department of Oncologic Radiotherapy, IRCCS Giovanni Paolo II Oncologic Institute of Bari, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Lioce
authors.affiliation: DIM - Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Piazza Giulio Cesare 11, 70124, Bari, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Angelelli
authors.affiliation: DIM - Interdisciplinary Department of Medicine, Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Piazza Giulio Cesare 11, 70124, Bari, Italy. Electronic address: marco.moschetta@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Moschetta
mesh_terms: D000328:Adult; D000368:Aged; D018427:Breast Implants; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D003287:Contrast Media; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008408:Mastectomy; D008536:Meglumine / Q000031:analogs & derivatives; D008875:Middle Aged; D009942:Organometallic Compounds; D011183:Postoperative Complications / Q000175:diagnosis*; D015995:Prevalence; D011446:Prospective Studies
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine