Feasibility of Mapping Breast Cancer with Supine Breast MRI in Patients Scheduled for Oncoplastic Surgery

Overview

Journal Eur Radiol

Specialty Radiology

Date 2018 Aug 19

PMID 30120494

Citations 8

Authors

S Joukainen

A Masarwah

M Kononen

M Husso

A Sutela

V Karja

R Vanninen

M Sudah

Affiliations

Soon will be listed here.

Abstract

Objectives: To prospectively determine the feasibility of preoperative supine breast MRI in breast cancer patients scheduled for oncoplastic breast-conserving surgery.

Methods: In addition to a diagnostic prone breast MRI, a supplementary supine MRI was performed with the patient in the surgical position including skin markers. Tumours' locations were ink-marked on the skin according to findings obtained from supine MRI. Changes in tumours' largest diameter and locations between prone and supine MRI were measured and compared to histology. Nipple-to-tumour and tumour-to-chest wall distances were also measured. Tumours and suspicious areas were surgically removed according to skin ink-markings. The differences between MRI measurements with reference to histopathology were evaluated with the paired-sample t test.

Results: Fourteen consecutive patients, 15 breasts and 27 lesions were analysed. Compared to histology, prone MRI overestimated tumour size by 47.1% (p = 0.01) and supine MRI by 14.5% (p = 0.259). In supine MRI, lesions' mean diameters and areas were smaller compared to prone MRI (- 20.9%, p = 0.009 and - 38.3%, p = 0.016, respectively). This difference in diameter was more pronounced in non-mass lesions (- 31.2%, p = 0.031) compared to mass lesions (- 9.2%, p = 0.009). Tumours' mean distance from chest wall diminished by 69.4% (p < 0.001) and from nipple by 18.2% (p < 0.001). Free microscopic margins were achieved in first operation in all patients.

Conclusions: Supine MRI in the surgical position is feasible and useful in the precise localisation of prone MRI-detected lesions and provides a helpful tool to implement in surgery. Supine MRI more accurately determines tumours' size and location and might have an important role to diminish overestimations.

Key Points: • Breath-hold supine breast MRI is feasible using commercially available coils and sequences. • Size and area of lesions on MRI were consistently smaller when measured from the supine position as compared to the prone position. • Supine breast MRI is useful in the precise preoperative localisation of prone MRI-detected lesions. •.

Citing Articles

Target volumes comparison between postoperative simulation magnetic resonance imaging and preoperative diagnostic magnetic resonance imaging for prone breast radiotherapy after breast-conserving surgery.

Jin Y, Zhao C, Wang L, Su Y, Shang D, Li F Cancer Med. 2024; 13(3):e6956.

PMID: 38247382 PMC: 10905334. DOI: 10.1002/cam4.6956.

Feasibility of online non-rigid motion correction for high-resolution supine breast MRI.

Isaieva K, Meullenet C, Vuissoz P, Fauvel M, Nohava L, Laistler E Magn Reson Med. 2023; 90(5):2130-2143.

PMID: 37379467 PMC: 10953366. DOI: 10.1002/mrm.29768.

Supine magnetic resonance image registration for breast surgery: insights on material mechanics.

Ringel M, Richey W, Heiselman J, Luo M, Meszoely I, Miga M J Med Imaging (Bellingham). 2022; 9(6):065001.

PMID: 36388143 PMC: 9659944. DOI: 10.1117/1.JMI.9.6.065001.

Dual-Layer Rotation: A Versatile Therapeutic Mammoplasty Technique.

Joukainen S, Laaksonen E, Vanninen R, Kaarela O, Sudah M Ann Surg Oncol. 2022; 29(11):6716-6727.

PMID: 35711016 PMC: 9492593. DOI: 10.1245/s10434-022-11977-4.

Tumor deformation correction for an image guidance system in breast conserving surgery.

Richey W, Heiselman J, Ringel M, Meszoely I, Miga M Proc SPIE Int Soc Opt Eng. 2022; 12034.

PMID: 35611302 PMC: 9126640. DOI: 10.1117/12.2611570.

References

Tozaki M, Fukuda K . Supine MR mammography using VIBE with parallel acquisition technique for the planning of breast-conserving surgery: clinical feasibility. Breast. 2005; 15(1):137-40. DOI: 10.1016/j.breast.2005.03.003. View

Esserman L, Kumar A, Herrera A, Leung J, Au A, Chen Y . Magnetic resonance imaging captures the biology of ductal carcinoma in situ. J Clin Oncol. 2006; 24(28):4603-10. PMC: 4087112. DOI: 10.1200/JCO.2005.04.5518. View

Schouten van der Velden A, Schlooz-Vries M, Boetes C, Wobbes T . Magnetic resonance imaging of ductal carcinoma in situ: what is its clinical application? A review. Am J Surg. 2009; 198(2):262-9. DOI: 10.1016/j.amjsurg.2009.01.010. View

Turnbull L, Brown S, Harvey I, Olivier C, Drew P, Napp V . Comparative effectiveness of MRI in breast cancer (COMICE) trial: a randomised controlled trial. Lancet. 2010; 375(9714):563-71. DOI: 10.1016/S0140-6736(09)62070-5. View

Behjatnia B, Sim J, Bassett L, Moatamed N, Apple S . Does size matter? Comparison study between MRI, gross, and microscopic tumor sizes in breast cancer in lumpectomy specimens. Int J Clin Exp Pathol. 2010; 3(3):303-9. PMC: 2836507. View

Sardanelli F, Boetes C, Borisch B, Decker T, Federico M, Gilbert F . Magnetic resonance imaging of the breast: recommendations from the EUSOMA working group. Eur J Cancer. 2010; 46(8):1296-316. DOI: 10.1016/j.ejca.2010.02.015. View

Siegler P, Holloway C, Causer P, Thevathasan G, Plewes D . Supine breast MRI. J Magn Reson Imaging. 2011; 34(5):1212-7. DOI: 10.1002/jmri.22605. View

Litiere S, Werutsky G, Fentiman I, Rutgers E, Christiaens M, Van Limbergen E . Breast conserving therapy versus mastectomy for stage I-II breast cancer: 20 year follow-up of the EORTC 10801 phase 3 randomised trial. Lancet Oncol. 2012; 13(4):412-9. DOI: 10.1016/S1470-2045(12)70042-6. View

Carbonaro L, Tannaphai P, Trimboli R, Verardi N, Fedeli M, Sardanelli F . Contrast enhanced breast MRI: spatial displacement from prone to supine patient's position. Preliminary results. Eur J Radiol. 2012; 81(6):e771-4. DOI: 10.1016/j.ejrad.2012.02.013. View

10.

Ebrahimi M, Siegler P, Modhafar A, Holloway C, Plewes D, Martel A . Using surface markers for MRI guided breast conserving surgery: a feasibility survey. Phys Med Biol. 2014; 59(7):1589-605. DOI: 10.1088/0031-9155/59/7/1589. View

11.

Pallone M, Poplack S, Avutu H, Paulsen K, Barth Jr R . Supine breast MRI and 3D optical scanning: a novel approach to improve tumor localization for breast conserving surgery. Ann Surg Oncol. 2014; 21(7):2203-8. DOI: 10.1245/s10434-014-3598-5. View

12.

Macmillan R, James R, Gale K, McCulley S . Therapeutic mammaplasty. J Surg Oncol. 2014; 110(1):90-5. DOI: 10.1002/jso.23659. View

13.

Satake H, Ishigaki S, Kitano M, Naganawa S . Prediction of prone-to-supine tumor displacement in the breast using patient position change: investigation with prone MRI and supine CT. Breast Cancer. 2014; 23(1):149-158. DOI: 10.1007/s12282-014-0545-z. View

14.

Lai H, Chen D, Wu Y, Chen C, Lee C, Kuo S . Comparison of the Diagnostic Accuracy of Magnetic Resonance Imaging with Sonography in the Prediction of Breast Cancer Tumor Size: A Concordance Analysis with Histopathologically Determined Tumor Size. Ann Surg Oncol. 2015; 22(12):3816-23. DOI: 10.1245/s10434-015-4424-4. View

15.

Fancellu A, Turner R, Dixon J, Pinna A, Cottu P, Houssami N . Meta-analysis of the effect of preoperative breast MRI on the surgical management of ductal carcinoma in situ. Br J Surg. 2015; 102(8):883-93. DOI: 10.1002/bjs.9797. View

16.

Conley R, Meszoely I, Weis J, Pheiffer T, Arlinghaus L, Yankeelov T . Realization of a biomechanical model-assisted image guidance system for breast cancer surgery using supine MRI. Int J Comput Assist Radiol Surg. 2015; 10(12):1985-96. PMC: 4776656. DOI: 10.1007/s11548-015-1235-9. View

17.

Leddy R, Irshad A, Metcalfe A, Mabalam P, Abid A, Ackerman S . Comparative accuracy of preoperative tumor size assessment on mammography, sonography, and MRI: Is the accuracy affected by breast density or cancer subtype?. J Clin Ultrasound. 2015; 44(1):17-25. DOI: 10.1002/jcu.22290. View

18.

Ramiao N, Martins P, Rynkevic R, Fernandes A, Barroso M, Santos D . Biomechanical properties of breast tissue, a state-of-the-art review. Biomech Model Mechanobiol. 2016; 15(5):1307-23. DOI: 10.1007/s10237-016-0763-8. View

19.

Gombos E, Jayender J, Richman D, Caragacianu D, Mallory M, Jolesz F . Intraoperative Supine Breast MR Imaging to Quantify Tumor Deformation and Detection of Residual Breast Cancer: Preliminary Results. Radiology. 2016; 281(3):720-729. PMC: 5118055. DOI: 10.1148/radiol.2016151472. View

20.

Hayes M . Update on Preoperative Breast Localization. Radiol Clin North Am. 2017; 55(3):591-603. DOI: 10.1016/j.rcl.2016.12.012. View