MR-Elastography of the breast: Initial experience with a novel transducer system


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Sweta Sethi1,Stefan Heinz Hoelzl2,Ayse Sila Dokumaci2,Christian Guenthner3,Daniel Fovargue2,David Nordsletten2,Arnie Purushotham2,Ralph Sinkus2
1Guy's and St.Thomas' NHS Foundation Trust,2King's College London,3University and ETH Zurich

Abstract

Background

Magnetic Resonance Elastography (MRE) has in recent years been considered a promising novel imaging modality for the quantification of viscoelastic properties of breast tumours, which conventional imaging is not capable of. However, any approaches so far were unable to achieve exact correlation between anatomy of the breast and elasticity maps. The purpose of this study was to evaluate the reproducibility of a new developed breast system allowing for bilateral, high resolution MRE of the breast, test its ability to achieve exact correlation to the anatomy, and investigate its capacity to identify biomarkers to assess metastatic potential.

Method

Twenty healthy volunteers, 2 patients with benign lesions and 10 patients with biopsy-proven breast tumours were recruited at Guy’s and St.Thomas’ NHS Foundation Trust. Bilateral MRE was conducted on all participants on a clinical 3T MR Scanner (Achieva, Philips Healthcare) with a nominal frequency of 36Hz utilizing a novel MRE system. Data acquisition was done at an isotropic image resolution of 2mm with a total acquisition time of less than 10 minutes.

Results

Bilateral wave penetration was observed and mean stiffness values between both breasts showed to be significantly correlated (p-value <0.001). The mean stiffness value of the tumours (0.93 kPa) consistently demonstrate increased stiffness in the magnitude of the complex shear modulus G* (kPa) in comparison to the fibroglandular (0.54 kPa) and adipose tissue (0.34 kPa) within the same breast. In the fibroadenoma and the cyst, a reduction in G* was observed. In a cohort of participants, reproducibility was tested and repeatability was around 10%. No asymmetry was found in stiffness maps between the left and the right breast. 

Conclusion

This study demonstrates the high performance of the newly developed breast MRE system within the clinical breast cancer environment. This introduces the possibility to identify new biomarkers for the assessment of metastatic potential.