The role of real-time virtual sonography in the management of enhancing breast lesions on contrast-enhanced MRI.

CTRC-AACR San Antonio Breast Cancer Symposium: 2008 Abstracts Abstract #4001 [Purpose] The aim of this study was to evaluate the role of real-time virtual sonography (RVS) in the management of enhancing breast lesions visualized with contrast-enhanced MRI. [Materials] Between April 2006 and May 2008, 92 women underwent breast MRI at our hospital. Of these 92 patients, 55 underwent MRI for staging of known breast cancer, and the remaining 37 underwent MRI for problem solving, including abnormal findings at physical examination or on conventional images. All patients were examined using mammography, sonography, MRI and RVS. The RVS system is capable of superimposing a sonography image with the MRI image of the same section in real time using a position tracking system with a magnetic sensor. Breast MR images were obtained on a 1.5-T imager using a flexible body surface coil, with the patient in the supine position. [Results] Overall sensitivity for detecting primary breast cancer was 74% (43/58) for mammography, 93% (54/58) for sonography, 97% (56/58) for MRI, and 97% (56/58) for RVS. Incidental enhancing / suspicious lesions (IELs) which were not predicted by the previous conventional imaging techniques were found in 55% of the patients (51/92),. Of these, 59% (24/41) of IELs could be identified only on repeated sonography, but 85% (35/41) of them were identified easily using the RVS system (p<0.05). The RVS system was able to project enhanced MRI information onto a body surface correctly while checking sonography form images without the use of large-scale equipment. Histologically, 10% (4/41) of the IELs were invasive ductal carcinoma. [Conclusions] The present results suggest that the RVS system offers excellent accuracy for identification of enhancing breast lesions. RVS can accurately select the cases in which MR guided biopsies are required. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4001.