Breast MRI
 

"The extent of DCIS involvement is frequently underestimated at mammography, which can reliably help detect only calcified DCIS; consequently, magnetic resonance (MR) imaging evaluation can alter the course of treatment."


Anne Marie Sawyer, B.S., R.T.(R)(MR), FSMRT, Editor
 

  

We are pleased to present the SMRT Educational Seminars, Volume 14, Number 1: “Breast MRI: DCIS and Skin Lesions.” This is the 51st accredited home study developed by the SMRT, exclusively for the SMRT members. The accreditation is conducted by the SMRT that acts as a RCEEM (Recognized Continuing Education Evaluation Mechanism) for the ARRT. Category A credits are assigned to each educational symposia, which can be used to maintain one’s ARRT registry and are approved for AIR (Australian Institute of Radiography) continuing professional development (CPD) activities. For this issue, we have selected two articles describing MRI of the breast but with a more specific focus than previously described in our home study publication. With the advancement of MR imaging software, hardware and RF coils, the applications continue to grow offering improved detection and characterization for a variety of breast diseases.

 

As stated by the authors from the article Ductal Carcinoma in Situ of the Breast, "Ductal carcinoma in situ (DCIS) is a noninvasive malignancy that is commonly encountered at routine breast imaging. It may be a primary tumor or may be seen in association with other focal higher-grade tumors. Early detection is important because of the large proportion of DCIS that can progress to invasive carcinoma. The extent of DCIS involvement is frequently underestimated at mammography, which can reliably help detect only calcified DCIS; consequently, magnetic resonance (MR) imaging evaluation can alter the course of treatment." Higher resolution MR imaging in the sub-millimeter range is now being reliably obtained at many facilities allowing more reliable detection of ductal disease.

According to the authors from the article Lesions of the Skin and Superficial Tissue at Breast MR Imaging, "Although numerous studies have outlined the benefits of contrast material-enhanced magnetic resonance (MR) imaging for the detection of breast parenchymal findings, the assessment of lesions of the skin and superficial tissue at breast MR imaging has largely been overlooked. Such lesions, both benign and malignant, are commonly encountered at breast MR imaging, and their detection and diagnosis are often imperative." While skin involvement may, in some cases, be missed or not included in the parenchymal disease diagnosis, MR imaging may provide more specific information especially if the skin and superficial breast tissue are more carefully evaluated. As with the imaging of DCIS, higher resolution MR imaging can provide a more comprehensive evaluation to improve characterization.

Many thanks to Beth Winningham, B.S., R.T.(R)(CT)(CV)(MR) from Birmingham, Alabama, USA for acting as our Expert Reviewer for this home study issue and the accompanying quiz that provides the continuing education credits.

Thanks to John Totman, SMRT Publications Chair from Nottingham, UK, for his support and continuing direction of the SMRT Publications Committee.

Thanks also to Jennifer Olson, Associate Executive Director, Mary Keydash, Publications Director, and the staff in the Berkeley, California, USA office of the ISMRM/SMRT for their insight and long hours supporting these educational symposia.

We would especially like to thank John Wilkie and all of the people at Invivo Corporation who generously support our home studies program, the SMRT Educational Seminars. Their continuing investment advancing technologist and radiographer knowledge brings quality continuing education to the SMRT membership worldwide.