Abstract PO2-07-08: the Efficacy of an MRI/US Fusion Technique for MRI-detected Lesions Previously Undetected by Conventional B-mode Second-Look US
Cancer Research(2024)
摘要
Abstract Introduction Breast magnetic resonance imaging (MRI) is performed for preoperative screening of breast cancer and surveillance of BRCA gene carriers, and some lesions, called MRI-detected lesions, can only be detected by MRI. When MRI-detected lesions are found, second-look ultrasound (US) is recommended as the first choice for confirmation. However, the detection of MRI-detected lesions by conventional B-mode (cB-mode) second-look US varies from institution to institution, and it is often difficult to ensure objectivity and reproducibility. We use an MRI/US fusion technique called real-time virtual sonography (RVS) for the detection of MRI-detected lesions. RVS uses a magnetic position tracking system to display real-time US images on the same monitor as MRI images. Few reports on second-look US using RVS have examined its detection rate of MRI-detected lesions and the histopathological results of these lesions. In this study, we retrospectively reviewed MRI-detected lesions identified by second-look US using RVS but not by cB-mode second-look US from January 2018 to December 2022, with the goal of evaluating these lesions’ pathological characteristics. Materials and methods Consecutive patients who had one or more MRI-detected lesions not detected by cB-mode second-look US were enrolled in this study between January 2018 and December 2021. Second-look US using RVS was conducted after an additional supine MRI with a body surface coil was performed. Results A total of 36 patients with 38 lesions were included in this study. The mean age was 54 years old (range: 31–76). We were able to detect 31 (82%) of the 39 MRI-detected lesions by second-look US using RVS. These lesions were characterized as follows: mass, 14; non-mass-enhancement (NME), 13; and focal, 4. US-guided biopsy or excisional biopsy was performed on all lesions, and 11 (35%) of 31 lesions were malignant. We were able to detect 14 (74%) of the 19 mass lesions, and 3 were malignant (invasive ductal carcinoma (IDC) [luminal A type] in all 3 cases). We detected 13 (93%) of the 14 NME lesions, and 7 were malignant: 6 were ductal carcinoma in situ (DCIS) (high grade, 3; intermediate grade, 2; and low grade, 1), and 1 was IDC (luminal A type). Finally, we were able to detect 4 (80%) of the 5 focal lesions, 1 of which was malignant (DCIS [low grade]). Of 22 patients aged 55 years or younger, 3 had malignant lesions (IDC [luminal A type] in 2, DCIS [high grade] in 1). Of 15 patients aged 56 years or older, 8 had malignant lesions (DCIS in 7 [high grade, 2; intermediate grade, 2; low grade, 1] and IDC [luminal A type] in 1). Conclusions In this study, second-look US using RVS identified 82% of MRI-detected lesions that were not identified with cB-mode second-look US. Of these MRI-detected lesions, 35% were malignant. These results suggest that second-look US using RVS is useful for identifying MRI-detected lesions that are not detected by cB-mode second-look US. Citation Format: Masayuki Saito, Hirona Banno, Yukie Ito, Mirai Ido, Manami Goto, Takahito Ando, Yukako Mouri, Junko Kousaka, Kmihito Fujii, Tsuneo Imai, Shogo Nakano. The efficacy of an MRI/US fusion technique for MRI-detected lesions previously undetected by conventional B-mode second-look US [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-07-08.
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