title: Feasibility of Intraoperative Breast MRI and the Role of Prone Versus Supine Positioning in Surgical Planning for Breast-Conserving Surgery.
abstract: We assessed the feasibility of supine intraoperative MRI (iMRI) during breast-conserving surgery (BCS), enrolling 15 patients in our phase I trial between 2012 and 2014. Patients received diagnostic prone MRI, BCS, pre-excisional supine iMRI, and postexcisional supine iMRI. Feasibility was assessed based on safety, sterility, duration, and image-quality. Twelve patients completed the study; mean duration = 114 minutes; all images were adequate; no complications, safety, or sterility issues were encountered. Substantial tumor-associated changes occurred (mean displacement = 67.7 mm, prone-supine metric, n = 7). We have demonstrated iMRI feasibility for BCS and have identified potential limitations of prone breast MRI that may impact surgical planning.
authors.affiliation: Department of Surgery, Brigham and Women's Hospital/Harvard Medical School, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Mallory
authors.affiliation: Department of Surgery, Brigham and Women's Hospital/Harvard Medical School, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Sagara
authors.affiliation: Department of Surgery, Brigham and Women's Hospital/Harvard Medical School, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Fatih
authors.initials: F
authors.lastname: Aydogan
authors.affiliation: Breast Oncology Center, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Stephen
authors.initials: S
authors.lastname: DeSantis
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Jagadeesan
authors.initials: J
authors.lastname: Jayender
authors.affiliation: Department of Surgery, Brigham and Women's Hospital/Harvard Medical School, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Diana
authors.initials: D
authors.lastname: Caragacianu
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Eva
authors.initials: E
authors.lastname: Gombos
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Kirby G
authors.initials: KG
authors.lastname: Vosburgh
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Ferenc A
authors.initials: FA
authors.lastname: Jolesz
authors.affiliation: Department of Surgery, Brigham and Women's Hospital/Harvard Medical School, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Mehra
authors.initials: M
authors.lastname: Golshan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D015412:Mastectomy, Segmental; D008875:Middle Aged; D019990:Perioperative Care; D011237:Predictive Value of Tests; D016684:Prone Position; D016683:Supine Position; D055815:Young Adult
keywords: 
  MRI
  ; breast-conserving surgery; image-guided therapy; margins; surgical planning