Breast MRI in patients with implantable loop recorder: initial experience.

Area of Science:

• Radiology
• Medical Imaging
• Oncology

Background:

• Implantable loop recorders (ILRs) are used for cardiac monitoring.
• The presence of an ILR may pose challenges for breast MRI interpretation and feasibility.
• Assessing the impact of ILRs on breast MRI is crucial for patient management.

Purpose of the Study:

• To evaluate the feasibility and safety of performing breast MRI and guided biopsies in patients with an ILR.
• To determine the impact of ILRs on breast MRI image interpretation and diagnostic accuracy.
• To characterize artifacts associated with ILRs during breast MRI.

Main Methods:

• Retrospective analysis of breast MRIs performed in patients with ILRs between April 2008 and September 2022.
• Review of radiological reports and electronic medical records for safety and imaging findings.
• Statistical comparison of artifact quantification across different MRI pulse sequences.

Main Results:

• Breast MRIs were successfully completed in all patients with ILRs without adverse events.
• The primary artifact observed was a signal intensity void near the ILR, with variations in intensity and location.
• Artifacts were most prominent on diffusion-weighted imaging and in the cranio-caudal and anterior-posterior axes.
• MRI detected additional suspicious findings in 20% of cases, including malignant lesions, though visualization of the inner left breast could be limited.

Conclusions:

• Breast MRI is a feasible and safe procedure for patients with an ILR, providing significant diagnostic value.
• Radiologists must be aware of characteristic artifacts and potential limitations, such as obscured areas in the inner left breast.
• Indicated breast MRI exams and guided biopsies can be safely performed in this patient population when considering these factors.