title: Intraoperative Supine Breast MR Imaging to Quantify Tumor Deformation and Detection of Residual Breast Cancer: Preliminary Results.
abstract: Purpose To use intraoperative supine magnetic resonance (MR) imaging to quantify breast tumor deformation and displacement secondary to the change in patient positioning from imaging (prone) to surgery (supine) and to evaluate residual tumor immediately after breast-conserving surgery (BCS). Materials and Methods Fifteen women gave informed written consent to participate in this prospective HIPAA-compliant, institutional review board-approved study between April 2012 and November 2014. Twelve patients underwent lumpectomy and postsurgical intraoperative supine MR imaging. Six of 12 patients underwent both pre- and postsurgical supine MR imaging. Geometric, structural, and heterogeneity metrics of the cancer and distances of the tumor from the nipple, chest wall, and skin were computed. Mean and standard deviations of the changes in volume, surface area, compactness, spherical disproportion, sphericity, and distances from key landmarks were computed from tumor models. Imaging duration was recorded. Results The mean differences in tumor deformation metrics between prone and supine imaging were as follows: volume, 23.8% (range, -30% to 103.95%); surface area, 6.5% (range, -13.24% to 63%); compactness, 16.2% (range, -23% to 47.3%); sphericity, 6.8% (range, -9.10% to 20.78%); and decrease in spherical disproportion, -11.3% (range, -60.81% to 76.95%). All tumors were closer to the chest wall on supine images than on prone images. No evidence of residual tumor was seen on MR images obtained after the procedures. Mean duration of pre- and postoperative supine MR imaging was 25 minutes (range, 18.4-31.6 minutes) and 19 minutes (range, 15.1-22.9 minutes), respectively. Conclusion Intraoperative supine breast MR imaging, when performed in conjunction with standard prone breast MR imaging, enables quantification of breast tumor deformation and displacement secondary to changes in patient positioning from standard imaging (prone) to surgery (supine) and may help clinicians evaluate for residual tumor immediately after BCS.©RSNA, 2016 Online supplemental material is available for this article.
authors.affiliation: From the Departments of Breast Imaging (E.C.G.), Radiology (J.J., D.M.R., F.A.J.), and Surgery (D.L.C., M.A.M., M.G.), Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115.
authors.forename: Eva C
authors.initials: EC
authors.lastname: Gombos
authors.affiliation: From the Departments of Breast Imaging (E.C.G.), Radiology (J.J., D.M.R., F.A.J.), and Surgery (D.L.C., M.A.M., M.G.), Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115.
authors.forename: Jagadeesan
authors.initials: J
authors.lastname: Jayender
authors.affiliation: From the Departments of Breast Imaging (E.C.G.), Radiology (J.J., D.M.R., F.A.J.), and Surgery (D.L.C., M.A.M., M.G.), Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115.
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Richman
authors.affiliation: From the Departments of Breast Imaging (E.C.G.), Radiology (J.J., D.M.R., F.A.J.), and Surgery (D.L.C., M.A.M., M.G.), Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115.
authors.forename: Diana L
authors.initials: DL
authors.lastname: Caragacianu
authors.affiliation: From the Departments of Breast Imaging (E.C.G.), Radiology (J.J., D.M.R., F.A.J.), and Surgery (D.L.C., M.A.M., M.G.), Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Mallory
authors.affiliation: From the Departments of Breast Imaging (E.C.G.), Radiology (J.J., D.M.R., F.A.J.), and Surgery (D.L.C., M.A.M., M.G.), Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115.
authors.forename: Ferenc A
authors.initials: FA
authors.lastname: Jolesz
authors.affiliation: From the Departments of Breast Imaging (E.C.G.), Radiology (J.J., D.M.R., F.A.J.), and Surgery (D.L.C., M.A.M., M.G.), Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115.
authors.forename: Mehra
authors.initials: M
authors.lastname: Golshan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000473:pathology*; D056888:Patient Positioning / Q000379:methods; D011446:Prospective Studies; D016683:Supine Position; D055815:Young Adult