The emerging role of breast magnetic resonance imaging

The barriers to magnetic resonance imaging (MRI) in the staging and diagnosis of breast cancer are being resolved through merging technologies and the new ability to perform MRI-guided biopsies. Detailed spatial resolution and excellent sensitivity are the strengths of this modality, whereas specificity is the primary challenge, requiring a strong commitment by the interested radiologist. While the original indication for breast MRI was in the evaluation of implant integrity, this modality is now recommended for: mapping tumor extent in newly diagnosed breast cancer patients, diagnosing breast cancer when conventional imaging is complex and indeterminate, and possibly for screening high-risk patients who have dense mammograms. A breast-dedicated magnetic resonance unit offers several advantages, including the first commercially available biopsy device. RODEOtm software (ROtating Delivery of Excitation Off-resonance) is an anticipated upgrade to this breast-dedicated unit, offering such a high degree of sensitivity and resolution that improved detection of Ductal Carcinoma In Situ will be possible.