Original Article
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Radiol. Aug 28, 2013; 5(8): 285-294
Published online Aug 28, 2013. doi: 10.4329/wjr.v5.i8.285
3.0 Tesla vs 1.5 Tesla breast magnetic resonance imaging in newly diagnosed breast cancer patients
Reni S Butler, Christine Chen, Reena Vashi, Regina J Hooley, Liane E Philpotts
Reni S Butler, Christine Chen, Reena Vashi, Regina J Hooley, Liane E Philpotts, Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT 06437, United States
Reena Vashi, Department of Diagnostic Radiology, Memorial Hermann Healthcare System, Houston, TX 77074, United States
Author contributions: All the authors contributed to this manuscript.
Correspondence to: Reni S Butler, MD, Assistant Professor, Department of Diagnostic Radiology, Yale University School of Medicine, 70 Woodside Road, Guilford, CT 06437, United States. reni.butler@yahoo.com
Telephone: +1-847-3466755 Fax: +1-203-2005170
Received: April 29, 2013
Revised: June 27, 2013
Accepted: July 17, 2013
Published online: August 28, 2013
Processing time: 121 Days and 12.1 Hours
Abstract

AIM: To compare 3.0 Tesla (T) vs 1.5T magnetic resonance (MR) imaging systems in newly diagnosed breast cancer patients.

METHODS: Upon Institutional Review Board approval, a Health Insurance Portability and Accountability Act-compliant retrospective review of 147 consecutive 3.0T MR examinations and 98 consecutive 1.5T MR examinations in patients with newly diagnosed breast cancer between 7/2009 and 5/2010 was performed. Eleven patients who underwent neoadjuvant chemotherapy in the 3.0T group were excluded. Mammographically occult suspicious lesions (BIRADS Code 4 and 5) additional to the index cancer in the ipsilateral and contralateral breast were identified. Lesion characteristics and pathologic diagnoses were recorded, and results achieved with both systems compared. Statistical significance was analyzed using Fisher’s exact test.

RESULTS: In the 3.0T group, 206 suspicious lesions were identified in 55% (75/136) of patients and 96% (198/206) of these lesions were biopsied. In the 1.5T group, 98 suspicious lesions were identified in 53% (52/98) of patients and 90% (88/98) of these lesions were biopsied. Biopsy results yielded additional malignancies in 24% of patients in the 3.0T group vs 14% of patients in the 1.5T group (33/136 vs 14/98, P = 0.07). Average size and histology of the additional cancers was comparable. Of patients who had a suspicious MR imaging study, additional cancers were found in 44% of patients in the 3.0T group vs 27% in the 1.5T group (33/75 vs 14/52, P = 0.06), yielding a higher positive predictive value (PPV) for biopsies performed with the 3.0T system.

CONCLUSION: 3.0T MR imaging detected more additional malignancies in patients with newly diagnosed breast cancer and yielded a higher PPV for biopsies performed with the 3.0T system.

Keywords: Breast; Breast cancer; Cancer staging; Outcome; Magnetic resonance imaging; Breast magnetic resonance imaging; 3 Tesla; Technical

Core tip: 3.0 Tesla (T) breast magnetic resonance (MR) imaging offers superior image quality through improved signal-to-noise ratio and resolution. In a comparison of two nearly identical patient populations of women with newly diagnosed breast cancer, a greater number of suspicious lesions and mammographically occult malignancies were detected using an optimized 3.0T system compared to a conventional 1.5T system. The positive predictive value of an abnormal MR imaging study was higher for 3.0T MR imaging compared to 1.5T imaging. These results attest to a clinical benefit and higher accuracy achievable with a 3.0T magnet.