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Breast Imaging

E2535. Nondiagnostic Breast MRI: When Should We Say It?

Hussien R. University of Rochester, Rochester, NY

Address correspondence to A. Radwan Hussien (mohsen104@yahoo.com)

Background Information: MRI of the breast is an important tool for evaluation of breast cancer. The study can be minimally degraded without limiting the diagnostic quality or severely degraded and not diagnostic. This can happen for several different reasons. Decision making of whether the study is readable (e.g., has some artifacts but diagnostic quality is not affected or definitely not diagnostic) can be a difficult decision, considering the cost of repeat MRI and the potential danger of missing a significant finding, as the surgeon will plan the treatment relying on the final radiology report. These issues will be emphasized in this exhibit.

Educational Goals/Teaching Points: Various examples of breast MRI showing artifacts that affect the diagnostic quality and others that do not will be provided, along with suggestions to obtain better image quality. Ways to differentiate a real MRI finding from common artifacts will also be discussed.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: Specific issues that will be addressed in this exhibit include index lesion motion artifacts, timing of gadolinium injection and image acquisition, coil problems, breast cancer, last menstrual period, CAD server problems, and fat saturation problems.

Conclusion: Increased awareness among radiologists of the various defects that might render an MRI study nondiagnostic is important, as this would enable more accurate decision making regarding the MRI quality and whether or not to repeat the study. This will also help avoid unnecessary cost of repeat MRI or missing important information from a defective study.