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MR Elastography of Breast Cancer: Preliminary Results

¹ Department of Radiology, Mayo Clinic, 200 First St., S.W., Rochester, MN 55905.
² Present address: Department of Radiology, Veterinary Hospital, 3800 Spruce St., University of Pennsylvania, Philadelphia, PA 19104.
³ Department of Physiology and Biophysics, Mayo Clinic, Rochester, MN 55905.
⁴ Department of Oncology, Mayo Clinic, Rochester, MN 55905.

View larger version (16K): [in a new window]   Fig. 1. —Drawing shows device used for MR elastography of breast. Electromechanical drivers, integrated into radiofrequency coil unit, are used to generate acoustic shear waves in breast tissues via contact plates on medial and lateral aspects of breast.

View larger version (18K): [in a new window]   Fig. 2. —Schematic diagram shows special gradient-echo phase-contrast MR imaging sequence, incorporating cyclic motion-encoding gradients, which can be applied along any axis. Trigger pulses from sequencing computer of imager are used to control acoustic driver, ensuring synchronization of applied acoustic waves with motion-encoding gradients. Resulting phase images depict propagating acoustic waves with motion amplitudes of less than 1 µm. RF = radiofrequency; x, y, z = gradient axes.

View larger version (53K): [in a new window]   Fig. 3A. —MR elastography of tissue-simulating breast phantom containing embedded 2.5-cm-diameter nodule of stiffer material. MR image was acquired with sequence shown in Figure 2. During imaging, acoustic waves at 100 Hz were applied to phantom using device shown in Figure 1. Image clearly shows propagating shear waves, with maximal amplitudes of approximately 100 µm. Series of eight similar images were acquired at evenly spaced phases of wave cycle.

View larger version (57K): [in a new window]   Fig. 3B. —MR elastography of tissue-simulating breast phantom containing embedded 2.5-cm-diameter nodule of stiffer material. MR elastogram was generated from data set shown in A. Elastogram indicates that shear stiffness at center of tumor is approximately 12 kPa, considerably higher than stiffness of background material (2.6 kPa).

View larger version (88K): [in a new window]   Fig. 4A. —Breast surgical specimen of 55-year-old woman with invasive carcinoma. T1-weighted MR image shows low-intensity tumor mass, which was firm to palpation.

View larger version (69K): [in a new window]   Fig. 4B. —Breast surgical specimen of 55-year-old woman with invasive carcinoma. MR elastogram delineates hard tumor from surrounding softer tissues.

View larger version (98K): [in a new window]   Fig. 5A. —27-year-old healthy volunteer. T1-weighted MR image shows normal breast.

View larger version (52K): [in a new window]   Fig. 5B. —27-year-old healthy volunteer. MR elastogram at 100 Hz shows modestly heterogeneous pattern of shear stiffness ranging from 2 to 14 kPa.

View larger version (83K): [in a new window]   Fig. 6A. —69-year-old woman with large invasive ductal breast carcinoma. T1-weighted MR breast image depicts large tumor mass involving most of breast.

View larger version (107K): [in a new window]   Fig. 6B. —69-year-old woman with large invasive ductal breast carcinoma. T2-weighted MR breast image shows cystic or necrotic area anteriorly.

View larger version (71K): [in a new window]   Fig. 6C. —69-year-old woman with large invasive ductal breast carcinoma. MR elastogram shows large area of high shear stiffness corresponding to mass delineated in conventional MR images.

View larger version (77K): [in a new window]   Fig. 7A. —51-year-old woman with large invasive lobular breast carcinoma in central breast. T1-weighted MR breast image delineates large tumor mass.

View larger version (66K): [in a new window]   Fig. 7B. —51-year-old woman with large invasive lobular breast carcinoma in central breast. MR elastogram shows corresponding region of high shear stiffness.

View larger version (102K): [in a new window]   Fig. 8A. —43-year-old woman with invasive ductal breast carcinoma in lateral breast. T1-weighted MR image of breast shows irregular tumor mass (arrow), with thickening of overlying cutaneous tissue.

View larger version (69K): [in a new window]   Fig. 8B. —43-year-old woman with invasive ductal breast carcinoma in lateral breast. MR elastogram shows focal area of high shear stiffness corresponding to location of known tumor mass.

View larger version (13K): [in a new window]   Fig. 9. —Graph shows MR elastography—based shear stiffness estimates of adipose and fibroglandular breast tissues (from volunteer series) and adipose tissue and breast carcinoma (from patient series).

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