Browsing by Author "Rubina Manuela Trimboli"

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    Contrast enhanced breast MRI: Spatial displacement from prone to supine patient's position. Preliminary results
    (2012-06-01) Luca Alessandro Carbonaro; Penampai Tannaphai; Rubina Manuela Trimboli; Nicola Verardi; Maria Paola Fedeli; Francesco Sardanelli; IRCCS Policlinico San Donato; Mahidol University; Universita degli Studi di Milano
    Objective: To estimate the spatial displacement of breast lesions and nipples in MR images when the patient is moved from the standard prone to a supine position close to ultrasound (US) or surgical setting. Materials and methods: Eleven patients underwent breast MRI in prone position with dynamic 3D T1-weighted sequences using 0.1 mmol/kg gadobenate dimeglumine. Subsequently, the patient was repositioned in supine position and a 3D volumetric interpolated breathhold examination sequence was acquired using a thoracic surface coil. For both positions we measured the following minimal distances: (A) from lesion margin to the coronal plane passing through the anterior surface of the sternum, antero-posterior, on native axial images; (B) from lesion margin to the medial sagittal plane, on native axial images, latero-medial; (C) from lesion margin to the axial plane passing through the tracheal bifurcation, cranio-caudal; (D) from lesion margin to the thoracic wall/pectoral muscle, on native axial images; (E) from lesion margin to the skin, on native axial images; (F) from lesion margin to the base of the nipple, on oblique reconstructions. Measurements from A t o D were also obtained for each nipple. The prone-to-supine spatial displacement was calculated as the absolute difference between the measurement obtained in supine position and the same measurement obtained in prone position. Displacements were presented as mean ± standard deviation and median in parenthesis. Results: Lesion displacements were (mm): A = 60 ± 38 (55); B = 40 ± 26 (41); C = 41 ± 33 (34); D = 32 ± 31 (27); E = 6 ± 5 (7); and F = 8 ± 6 (7). Nipple displacements were (mm): A = 84 ± 44 (91); B = 54 ± 24 (56); C = 27 ± 15 (24); and D = 48 ± 20 (48). Conclusion: These preliminary results show that preoperative breast MRI in prone position implies a median lesion displacement of about 3-6 cm along the three orthogonal directions in comparison with supine MRI. Conversely, median lesion-to-skin and lesion-to-nipple displacements were less than 1 cm, even though nipple displacements were similar to or larger than those of lesions. The lesion-to-nipple distance may be the most reliable measure to be used for second look breast US. Larger studies are warranted in order to define an optimized breast MRI protocol in the preoperative setting. © 2012 Elsevier Ireland Ltd. All rights reserved.
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    Washout of mass-like benign breast lesions at dynamic magnetic resonance imaging
    (2012-05-01) Penampai Tannaphai; Rubina Manuela Trimboli; Luca Alessandro Carbonaro; Sara Viganò; Giovanni Di Leo; Francesco Sardanelli; Universita degli Studi di Milano; Mahidol University
    Objective: This study aimed to estimate the frequency and timing of washout in a series of pathologically proven benign mass-like breast lesions at dynamic magnetic resonance imaging. Methods: Institutional review board approval was obtained for this retrospective study. We evaluated enhancement kinetics of 33 pathologically confirmed benign breast lesions: fibroadenomas (n = 22), adenosis (n = 6), typical ductal hyperplasia (n = 2), fibroadenoma with ductal hyperplasia (n = 1), fibrosclerosis (n = 1), and inflammatory lesion (n = 1). Coronal 3-dimensional T1-weighted gradient-echo sequences were acquired before/after intravenous injection of 0.1 mmol/ kg gadoterate meglumine (time resolution, 111 seconds), 1 before and 5 after contrast injection. The time point at which the kinetic curve demonstrated a washout was recorded. Cumulative distribution of lesions showing washout was built. Paired comparisons of specificity for washout kinetics were performed using the McNemar test. Results: Of 33 lesions, washout was never observed in 20 (61%), whereas 13 (39%) showed washout during the study. Of these 13 lesions, only 1 (inflammatory mass) exhibited washout within the first 3 minutes (specificity, 97%), 9 within 6 minutes (specificity, 73%), and 13 within 8 minutes (specificity, 61%). Specificity of washout kinetics within 3 minutes (97%) was significantly larger than that from the sixth minute (73%) and thereafter (P < 0.016). Conclusions: A prolonged observation for dynamic breast magnetic resonance imaging may result in false-positive washout, especially after 6 minutes. Late washout should not be considered a reliable marker of malignancy. Copyright © 2012 by Lippincott Williams & Wilkins.