Newer Breast MRI May Be More Accurate and Easier
A new type of MRI (magnetic resonance imaging) that doesn't use a contrast agent appears better at detecting what's really cancer and what's likely just a harmless lesion, researchers report.
In a study in Germany, the new technique reduced false-positive findings by 70 percent. The scan was also able to detect 98 percent of breast cancers correctly, the researchers said.
"This more advanced imaging technique is very good at distinguishing things that might be invasive cancer and things that are likely not cancer," said Dr. Otis Brawley, chief medical officer for the American Cancer Society. He wasn't involved in the study.
The new test is known as diffusion kurtosis imaging. To create it, the researchers altered another special type of MRI. Then they combined the new scanning technique with software that decides whether a suspicious breast lesion is benign (harmless) or malignant (cancerous).
The new MRI "basically maps the movement of water molecules in the tissue. If a malignant tumor grows in the tissue, it disrupts the healthy tissue structure, which changes the movement of water molecules in this area," explained the study's lead researcher, Dr. Sebastian Bickelhaupt. He's the head of the Breast Imaging Research Group at the German Cancer Research Center in Heidelberg.
Currently, MRI scans are used as part of screening for women with a particularly high risk of breast cancer.
This may include women with a breast cancer gene or genes, women with a family history of a breast cancer gene who haven't been tested themselves, those who've had radiation to the chest to treat lymphoma, and women with certain syndromes that raise the risk of breast cancer significantly, according to the American Cancer Society.
The problem is that MRIs currently finds a lot of areas in the breasts that are deemed suspicious.
"I advise patients to ready themselves emotionally. MRI delivers a lot of false positives and there's a high probability that you will need several biopsies," Brawley explained.
Along with reducing the need for unnecessary biopsies due to false positive findings, the benefits of the new MRI type include no contrast agent, the researchers. A contrast agent is a substance introduced intravenously that makes it easier to see certain areas on an imaging test.
The new test also has a shorter imaging time. Bickelhaupt said the test only takes about 10 minutes. And unlike mammography or CT scans, there is no exposure to radiation.
These two factors -- no need for an IV contrast agent and shorter test -- potentially could reduce MRI costs.
The study included 222 women from two sites in Germany. Ninety-five of the women were only included in the training portion of the study. The second group included 127 women. Their average age was 59. All had undergone X-ray mammography that indicated potential cancer.
All the women underwent the new MRI test, then had a biopsy to see if the suspicious area was cancer. The researchers then compared the findings from the new test to the biopsy results. They also assessed the results of conventional MRI images.
The investigators found that the new test was significantly better than standard MRI at detecting breast cancers.
"Although the numbers are pretty small in this study, this technique is an exciting thing. My gut is that if larger studies continue like this, this technique will be available in hospitals in the next decade or so," Brawley said.
Bickelhaupt and Brawley said this technique isn't designed to replace current standards, such as mammograms or ultrasounds.
Instead, Bickelhaupt said this test would expand the options available to women based on their clinical needs.
"Implementing such imaging approaches into the clinical routine might expand the diagnostic toolbox of the radiologist in the future," he said.
The study was published Feb. 20 in the journal Radiology.
Learn more about new imaging tests to detect breast cancer from the American Cancer Society.
SOURCES: Sebastian Bickelhaupt, M.D., head, Breast Imaging Research Group, German Cancer Research Center, Heidelberg, Germany; Otis Brawley, M.D., chief medical officer, American Cancer Society; Feb. 20, 2018, Radiology