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Dynamic Contrast-Enhanced Breast MRI at 7 Tesla Utilizing a Single-loop Coil

Posted Jul 31, 2010 Updated Apr 7, 2023
By Lale Umutlu MD , Stefan Maderwald PhD , Oliver Kraff MSc , Jens M. Theysohn MD , Sherko Kuemmel MD , Elke A. Hauth MD , Michael Forsting MD , Gerald Antoch MD , Mark E. Ladd PhD , Harald H. Quick PhD , Thomas C. Lauenstein MD
7 min read

Rationale and Objectives

The aim of this study was to assess the feasibility of dynamic contrast-enhanced ultra–high-field breast imaging at 7 Tesla.

Material and Methods

A total of 15 subjects, including 5 patients with histologically proven breast cancer, were examined on a 7 Tesla whole-body magnetic resonance imaging system using a unilateral linearly polarized single-loop coil. Subjects were placed in prone position on a biopsy support system, with the coil placed directly below the region of interest. The examination protocol included the following sequences: 1) T2-weighted turbo spin echo sequence; 2) six dynamic T1-weighted spoiled gradient-echo sequences; and 3) subtraction imaging.

Results

Contrast-enhanced T1-weighted imaging at 7 Tesla could be obtained at high spatial resolution with short acquisition times, providing good image accuracy and a conclusively good delineation of small anatomical and pathological structures. T2-weighted imaging could be obtained with high spatial resolution at adequate acquisition times. Because of coil limitations, four high-field magnetic resonance examinations showed decreased diagnostic value.

Conclusions

This first scientific approach of dynamic contrast-enhanced breast magnetic resonance imaging at 7 Tesla demonstrates the complexity of ultra–high-field breast magnetic resonance imaging and countenances the implementation of further advanced bilateral coil concepts to circumvent current limitations from the coil and ultra–high-field magnetic strength.

Since the early 1980s, contrast-enhanced magnetic resonance imaging (MRI) of the breast has gone through substantial developments. The first MRI exams were performed on 0.2 Tesla MRI scanners in supine position using a body coil . Through the years, there have been major improvements involving the introduction of dedicated breast coils as well as of specific examination protocols. With the increase of the magnetic field strength, the associated higher signal-to-noise ratio (SNR) has helped in the acquisition of high spatial resolution at high temporal resolution .

Currently, 1.5 Tesla breast MRI is considered the worldwide clinical standard. However, 3 Tesla breast imaging has been nearing clinical readiness within the last few years . Recent studies correlating 1.5 Tesla and 3 Tesla breast MRI demonstrate better image quality of the 3 Tesla breast images, yet also alluding to new obstacles associated with high magnetic field strength, such as inhomogeneities of the radiofrequency (RF) field and RF-related limitations of specific absorption rate (SAR) . There are theoretical advantages of using even higher field strengths than 3 Tesla, including higher SNR and higher spatial resolution images.

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Methods and materials

Study Population

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Scanner and Coil Systems

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Figure 1, For examination of a single breast, a unilateral linear polarized (LP) 10-cm-diameter single loop transmit/receive coil (Rapid Biomedical, Wuerzburg, Germany) was used at the 7 Tesla whole-body magnetic resonance imaging system ( arrow ). A biopsy support system (Noras MRI Products, Hoechberg, Germany) was used for prone positioning of the subjects.

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Examination at 7 Tesla

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Figure 2, B 1 mapping of a breast phantom (a) and a healthy volunteer (b) . The color distribution demonstrates the distinct B1 field inhomogeneities by means of variable distribution of flip angles.

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Image Evaluation

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Results

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Figure 3, T1-weighted precontrast 7 Tesla examination of a 39-year-old female volunteer with large breasts. Imaging reveals a deformation of the lateral side of the breast because of the limited diameter of the loop coil ( arrow ). Caused by an inadequate depth penetration of the rapid loop coil, assessment of the posterior breast tissue and the axilla was restricted in 4 of 15 examinations ( dashed arrows ).

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Dynamic T1-weighted imaging and subtraction imaging

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Figure 4, T1-weighted dynamic contrast enhanced imaging of a healthy volunteer, providing a detailed depiction of anatomical structures in precontrast (a) and postcontrast images (b) . Subtraction imaging (c) reveals no suspicious contrast enhancement.

Figure 5, T1-weighted postcontrast imaging (a) and subtraction imaging (b) of 49-year-old show invasive carcinoma on the lateral side of the breast ( arrow ) with strong initial enhancement and fast postinitial washout in curve analysis (c) . Because of high spatiotemporal resolution, tiny satellite lesions are well depicted ( dashed arrow ).

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T2-weighted Imaging

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Figure 6, T2-weighted imaging of a 47-old-healthy volunteer showing good definition of anatomical details (a) . (b) Impaired assessment of subcutaneous parts of the breast resulting from the delineation of strong black band artifacts in 4 subjects. Dashed arrows mark insufficient depiction of posterior parts of the breast and axilla due to an inadequate depth penetration of the rapid loop coil.

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Discussion

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Conclusion

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Academic Radiology, Volume 17, Issue 8
Journals General Radiology
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