By Peri Gretton
MRI is a useful tool for identifying breast lesions. Although mammography remains the most convenient and cost-effective breast screening exam for most women, a subset of women is advised to be screened with MRI. For example, the American College of Radiology recommends screening MRI for women with a known genetic mutation or a greater than 20% lifetime risk of breast cancer.
Another area where breast MRI has proven to be particularly effective in imaging is with dense breasts. That’s significant, because invasive cancers may be masked on mammograms. One study of 176 lesions in dense breasts showed that lesion visibility using MR was 96.6%, compared to 67.6% with mammography. In addition, MR screening may be recommended for those for whom conventional mammography is compromised by implants or scar tissue.
Diagnosis and Biopsy
In addition, breast MRI is often used after an initial mammography to confirm diagnosis. In patients with known breast cancer, MRI can be used to evaluate if the cancer is multicentric (multiple tumors that form separately), multifocal (multiple tumors arising from one original tumor), or contralateral (occurring on both sides), as well as to evaluate treatment. MRI also plays a role in biopsy, helping radiologists pinpoint the biopsy target.
Obstacles to Use in Breast MRI
Despite its promise, there are obstacles that prevent breast MRI from serving more women. One of these obstacles is exam length, which may be as long as 20-30 minutes. However, new studies indicate that an abbreviated protocol may be very effective. Shortening exam length would make breast MRI exams more attractive in two ways: It would be more cost-effective for the provider, and it could decrease patient anxiety, because patients would spend less time in the confining MR system gantry.
Coils Can Boost Patient Comfort
Exam length is just one element that causes discomfort. Another way to increase patient comfort is by using more comfortable coils. During a breast MRI, the patient lays on a patient support and contoured coils are moved to the breast to increase the signal-to-noise ratio, thus creating sharper images.
For biopsies, this coil must have open areas through which the radiologist can insert a biopsy needle. Coil and coil accessories features like ergonomic design and dedicated comfort cushions can relieve stress points and make the patient more comfortable. A shoulder bridge and padding allow for imaging with the patient’s arms at their side, which decreases pressure on the sternum. An adjustable headrest that can adapt to a variety of patient configurations also supports patient comfort. A mirror that enables the patient to see outside the gantry can improve patient satisfaction by reducing anxiety.
Minimizing Motion Artifacts in Breast MRI
Comfort is more than just a patient satisfaction issue. When patients are uncomfortable, they are more likely to move, as they search for a more comfortable position. This movement can cause motion artifacts in the images, which may make diagnosis more difficult. The same cushions that relieve stress points minimize vibration, which also decreases the risk of motion artifacts.
Moreover, as each breast on every woman is different, adjustable coil elements are critical. Variable coil technology allows clinicians to put coils close to the breast for high signal-to-noise ratio, and to provide full coverage of the breast tissue. Variable coil technology also accommodates patients of all sizes.
As the use of breast MRI increases, it’s important to address all issues that create barriers to use. By making exams more comfortable, well-designed breast coils advance both image quality and patient satisfaction.
Peri Gretton is responsible for product development and market research of Dunlee’s MRI coils, including the Sentinelle breast coil with open imaging apertures and patented variable coil geometry. Questions and comments can be directed to [email protected].