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REVIEW ARTICLE Wei Tse Yang, MBBS, FRCR (Top Magn Reson Imaging 2017;26:181) Technical improvements over the past decades have led to newer MRI sequences including diffusion-weighted imaging (DWI) that complement dynamic contrast-enhanced (DCE) MRI. xcluding cancers of the skin, breast cancer is the most common DWI reflects tissue microstructure, and evidence is growing that this E newly diagnosed cancer and the second-leading cause of cancer additional functional dimension may aid in breast tissue character- death among women in the US according to figures from the ization by providing additional biologic information. Advancements American Cancer Society published for 2015 to 2016. The current in DWI acquisition and modeling have led to notable improvements imaging recommendation for breast cancer screening is mammog- in image quality and the incorporation of DWI in multicenter trials. raphy. Breast magnetic resonance imaging (MRI) is indicated for Drs. Partridge and Amornsiripanitch provide an eloquent overview high-risk screening of women with a lifetime risk that exceeds 20%. on emerging evidence that DWI may expand diagnostic and prog- There is ongoing debate and controversy on the socioeconomic nostic value for breast cancer patients. impact of the over- and underdiagnosis of breast cancer that include Current state-of-the-art breast MRI includes multi-parametric cost, morbidity, and survival advantages. (MP) MRI in which established functional parameters such as DWI Ongoing research focuses on the development of sensitive and or MR spectroscopy complement the conventional morphologic and accurate diagnostic tools to enable individualized and customized kinetic information provided by T2-weigthed imaging and DCE- screening recommendations and treatment algorithms for women with MRI. Dr. Pinker et al explore the added specificity that MP-MRI breast cancer, currently regarded as a heterogeneous disease with provides to breast cancer diagnosis through a purposeful discussion protean biologic subtypes. The 4 manuscripts in this issue provide a and detailed illustrations. Specifically, the role of breast MRI in the comprehensive clinical review outlining exciting and novel advances assessment of BI-RADS 4 lesions diagnosed on mammography, in breast imaging that focus specifically on the use of MRI technology digital tomosynthesis, or ultrasound may benefit from noninvasive to enhance screening workflow, diagnostic work-up, and the charac- breast MRI to decrease the false-positive rate (thus reducing terization, staging, and therapeutic monitoring of breast cancer. unnecessary biopsies) while decreasing the false-negative rate (thus Drs. Abe and Sheth provide an excellent and thorough review of maintaining high sensitivity). ‘‘abbreviated breast MRI,’’ which represents a shortened version of Drs. Adrada and Rauch provide a comprehensive and thoughtful the conventional breast MRI protocol that relies primarily on literature review that examines the evidence for and against MRI morphologic assessment and does not incorporate new magnetic in the staging of breast cancer and response monitoring to neo- resonance (MR) techniques. Preliminary screening studies using adjuvant therapy. abbreviated breast MRI have reported encouraging results. They I am deeply appreciative of the remarkable expertise and also describe ‘‘accelerated breast MRI protocols’’ that involve new contributions by all authors. My thanks to Scott Atlas for his techniques and enable kinetic assessment to be performed in a invitation to serve as a guest editor for this issue, and to Stella reduced time period. The potential to combine accelerated and Bebos and Sam Martin at Wolters Kluwer for their editorial assist- abbreviated MRI protocols could enhance the diagnostic potential ance. Special credit goes to Christina Lazard for her assistance in of breast MRI while maintaining reduced study time that simul- assembling this piece of work. I hope that you will find this an taneously addresses cost and patient throughput challenges. exciting update on breast MRI. From the University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, TX. Address correspondence to Wei Tse Yang, MBBS, FRCR, Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1459, Houston, TX 77030 (e-mail: wyang@mdanderson.org). There is no financial support for this manuscript. The authors report no conflicts of interest. Copyright 2017 Wolters Kluwer Health, Inc. All rights reserved. DOI: 10.1097/RMR.0000000000000132 Topics in Magnetic Resonance Imaging Volume 26, Number 5, October 2017 www.topicsinmri.com 181 Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
Topics in Magnetic Resonance Imaging – Wolters Kluwer Health
Published: Oct 1, 2017
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