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Total-body echo-planar MR imaging in the staging of breast cancer: comparison with conventional methods--early
L J Horvath1, B A Burtness, S McCarthy
1Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT 06510, USA.
Purpose:
To test breast cancer staging with total-body echo-planar magnetic resonance (MR) imaging.
Materials And Methods:
Nineteen patients with newly diagnosed breast cancer were imaged by using a 1.5-T echo-planar MR system. By using a table sweep method, 180 contiguous axial images were obtained from the cranial vertex through the feet with T2-weighted spin-echo and inversion-recovery sequences. Results were compared with those of conventional imaging. Therapeutic decisions based on echo-planar MR imaging and conventional imaging results were compared. Diagnostic truth was determined by means of tissue diagnosis, further imaging findings, and follow-up findings (median, 18 months).
Results:
Staging with total-body echo-planar MR imaging was correct in 18 patients (95%)--eight with metastases and 10 without--while staging with conventional imaging was correct in 15 patients (79%). In one patient, both echo-planar MR imaging and conventional imaging findings incorrectly indicated probable metastases. In one patient thought to have bone metastases at conventional imaging, echo-planar MR imaging findings were normal, which was correct. Two patients with stage IV disease were not suspected to have disease at conventional imaging: One had liver involvement and the other had skeletal metastases. The therapeutic decisions in these two patients were altered by the echo-planar MR imaging results.
Conclusion:
Total-body echo-planar MR imaging was at least as accurate as conventional imaging for staging newly diagnosed breast cancer and was faster, simpler, and completely noninvasive.