Notes in 05 Breast MRI

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New Card	05/02/2023	Breast Imaging: Breast MRI  Breast MRI {{c1::complements::replaces/complements}} mammography in the evaluation of breast cancer.
New Card	05/02/2023	Breast Imaging: Breast MRI Breast MRI {{c1::does::does/does not}} require contrast as part of the breast cancer screening protocol.
New Card	05/02/2023	Breast Imaging: Breast MRI The preferred imaging modality for evaluation of small calcifications is {{c1:: mammography}}.
New Card	05/02/2023	Breast Imaging: Breast MRI Intraductal proteinaceous fluid inherently appears {{c1::hyperintense::hyperintense/hypointense}} on {{c2::T1}}-weighted…
New Card	05/02/2023	Breast Imaging: Breast MRI  "Subtraction" images are computed from {{c1::post::pre/post}} contrast images subtracted from the {{c2::initial}} {…
New Card	05/02/2023	Breast Imaging: Breast MRI Maximum-intensity projection (MIPs) is a post-processing tool used from the {{c2::subtraction}} images, they highlight t…
New Card	05/02/2023	Breast Imaging: Breast MRI Computer-aided detection (CAD) is an adjunct for analysis of contrast-enhanced MRI which creates an "{{c2::angio…
New Card	05/02/2023	Breast Imaging: Breast MRI "High risk" is defined as a {{c1::20}}% or greater lifetime risk of developing breast cancer.
New Card	05/02/2023	Breast Imaging: Breast MRIRisk factors for breast cancer that may require MRI screening:‒ {{c1::Family}} history‒ Gene {{c2::mutations}}‒ Thoracic {{c…
New Card	05/02/2023	Breast Imaging: Breast MRIBRCA1 or BRCA2 gene mutation carriers (or first-degree relatives of confirmed carrier) are high risk, with {{c1::50}}-{{c1::…
New Card	05/02/2023	Breast Imaging: Breast MRI{{c2::MRI}} has been shown to detect occult breast cancer in {{c1::2}}-{{c1::5}}% of high-risk women.
New Card	05/02/2023	Breast Imaging: Breast MRIIn patients with {{c1::established}} diagnosis of breast cancer, {{c2::MRI::imaging modality}} can be helpful to evaluate th…
New Card	05/02/2023	Breast Imaging: Breast MRI{{c1::Multifocal}} disease is defined as presence of {{c2::two}} or more sites of cancer in one {{c3::quadrant}}.
New Card	05/02/2023	Breast Imaging: Breast MRI {{c1::Multifocal disease::Multifocal/Multicentric}} may preclude breast conservation therapy, depending on {{c2::size}} of …
New Card	05/02/2023	Breast Imaging: Breast MRIMRI has been reported to find additional cancer in the same quadrant (multifocal disease) in {{c1::1}}-{{c1::20}}% of women.
New Card	05/02/2023	Breast Imaging: Breast MRI{{c1::Multicentric}} disease is defined as presence of cancer in more than one {{c2::quadrant}}.
New Card	05/02/2023	Breast Imaging: Breast MRI {{c1::Multicentric::Multifocal/Multicentric}} disease usually requires {{c2::mastectomy::treatment}}.
New Card	05/02/2023	Breast Imaging: Breast MRIUnsuspected multicentric disease was found by MRI in {{c1::2}}-{{c1::24}}% of women.
New Card	05/02/2023	Breast Imaging: Breast MRI Breast {{c1::MRI::imaging modality}} can most accurately measure tumor {{c2::size}} and has the best {{c3::pathologic}…
New Card	05/02/2023	Breast Imaging: Breast MRI In addition to accurate measurement of tumor size, breast MRI can assess for enlarged/abnormal axillary {{c1::lymph node…
New Card	05/02/2023	Breast Imaging: Breast MRI Case: Axial (left) and sagittal (right) contrast-enhanced fat-suppressed MRI of breastYellow arrows: Ill-defined {{c1:…
New Card	05/02/2023	Breast Imaging: Breast MRI  Breast conservation therapy combines {{c1::lumpectomy::surgery}} with {{c1::radiation}} therapy, desired therapy in…
New Card	05/02/2023	Breast Imaging: Breast MRI  If resection margins after lumpectomy pathologically show remaining tumor, {{c1::MRI::imaging modality}} can evalua…
New Card	05/02/2023	Breast Imaging: Breast MRI Residual tumor after lumpectomy may manifest as small {{c1::nodular::morphologic}} areas of {{c2::enhancement}} around the …
New Card	05/02/2023	Breast Imaging: Breast MRI  "Normal" enhancement on MRI following lumpectomy can be seen for up to {{c1::18}} months due to {{c2::granulation}}…
New Card	05/02/2023	Breast Imaging: Breast MRISuspicious features on MRI s/p lumpectomy include:‒ Enhancement beyond {{c2::18 months::length of time}}‒ {{c1::New enhancem…
New Card	05/02/2023	Breast Imaging: Breast MRIAside from evaluating margins s/p breast cancer treatment, MRI is also used to evaluate for local {{c1::recurrence}} or a {{…
New Card	05/02/2023	Breast Imaging: Breast MRI Local breast cancer recurrence rates at 15 years are:Women who did receive radiation → {{c1::12}}% Women who d…
New Card	05/02/2023	Breast Imaging: Breast MRICase: Unilateral contrast-enhanced fat-saturated T1-weighted MRI of the L breast in a patient s/p mastectomyYellow arro…
New Card	05/02/2023	Breast Imaging: Breast MRI  {{c2::Neoadjuvant}} therapy is employed to {{c1::reduce the size}} of large tumors prior to {{c3::resection}}.
New Card	05/02/2023	Breast Imaging: Breast MRI After one or two cycles of neoadjuvant chemotherapy, follow-up {{c2::MRI::imaging modality}} can evaluate if the tumor h…
New Card	05/02/2023	Breast Imaging: Breast MRI{{c1::Cytotoxic}} therapy of breast cancer can reduce tumor {{c2::vascuarity}}, which can often alter the enhancement {{c3::…
New Card	05/02/2023	Breast Imaging: Breast MRIAfter completion of neoadjuvant therapy, {{c1::MRI::imaging modality}} can detect the location and extent of residual diseas…
New Card	05/02/2023	Breast Imaging: Breast MRIIn certain situations, MRI can be helpful after thorough {{c1::mammographic}} and {{c1::ultrasound}} workup remains {{c2::in…
New Card	05/02/2023	Breast Imaging: Breast MRI The best imaging modality for evaluation of silicone breast impant integrity is {{c1::non-contrast}} MRI, though this techn…
New Card	05/02/2023	Breast Imaging: Breast MRIMRI has highest sensitivity/specificity for evaluation of {{c1::silicone::saline or silicone}} implants.Physical exam, mammo…
New Card	05/02/2023	Breast Imaging: Breast MRIWhat is the major difference between the mammographic and MRI lexicon?MRI incorporates terms to describe…
New Card	05/02/2023	Breast Imaging: Breast MRI  On the BIRADS MRI Lexicon, a mass is defined as a {{c1::space-occupying}} lesion that displaces normal breast {{c2:…
New Card	05/02/2023	Breast Imaging: Breast MRI Breast masses (similar to mammo/US) can be categorized by shape into {{c1::round}}, {{c1::oval}} or {{c1::irregular}}.
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconMass shape‒ Round: {{c1::Spherical}} in shape
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconMass shape‒ Oval: {{c1::Ellipitical}} or {{c1::oblong}} in shape. May include {{c2::2}}-{{c2::3}} …
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconMass shape‒ Irregular: {{c1::Uneven}} in shape. Suspicious for {{c2::malignancy}}.
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconMass margins should be categorized as {{c1::circumscribed}}, {{c1::irregular}}, or {{c1::spiculate…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconWhat is the most predictive feature of malignancy on breast MRI?{{c1::Margins}} of enhancing mass.
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconUnlike the mammographic lexicon, "{{c1::irregular}}" is used to describe both mass {{c2:…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI Lexicon{{c1::Circumscribed}} margins suggest benignity, where as non-{{c1::circumscribed}} ({{c2::irregul…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconA mass with {{c1::spiculated}} margins on breast MRI is thought to represent cancer {{c2::84}}–{{c…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI Lexicon The shape and margin of a mass are best evaluated in the {{c1::early::early or late}} {{c1::pos…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconThe enhancement pattern of a mass can be described as {{c1::homogenous}}, {{c2::heterogenous}}, {{…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI Lexicon Homogenous internal enhancement is associated with {{c1::both benign and malignant::benign/mali…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI Lexicon Heterogenous internal enhancement is associated with {{c1::malignant::benign/malignant/both}} l…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI Lexicon Rim enhancement is associated with {{c1::malignant**::benign/malignant}} lesions.
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconWhich pattern of internal enhancement is highly suspicious for cancer?{{c1::Rim enhancem…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconRim enhancement is associated with malignancy in up to {{c1::84}}% of cases, although this finding…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconAlthough rim enhancement is highly suspicious for malignancy, it also be a feature of inflamm…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI Lexicon{{c1::Dark internal septations}} are highly {{c3::specific::sensitive/specific}} for a {{c2::benig…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconDark internal septations have a >{{c1::95}}% positive predictive value for benign fibroadenoma.
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconA fibroadenoma will typically be {{c2::circumscribed::shape}} and {{c1::hyper}}intense on {{c3::T2…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconA {{c2::hyalinizing}} fibroadenoma, typically seen in {{c1::older women::demographic}} {…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI Lexicon A {{c3::focus}} is a small dot of {{c2::enhancement}} <{{c1::5}} mm in size that does n…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconA focus is too small to accurately assess {{c1::margins::characteristic of mass}} or {{c1::interna…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconIt can be difficult to differentiate {{c1::a single::a single or multiple}} focus/foci f…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI Lexicon Multiple bilateral enhancing foci are generally considered {{c1::benign::benign or malignant}}.…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconAlthough multiple bilateral enhancing foci are deemed benign, a conspicuous, isolated focus m…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconAlthough enhancement kinetics of foci are typically impossible to characterize with CAD, if kineti…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconIf a focus has any suspicious features, it should be described as {{c1::a mass}} even if…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI Lexicon Non-mass enhancement (NME) is an enhancing region that is not a {{c1:mass}} or a {{c1::focus}}.…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconSimilar to mammographic calcifications, non-mass enhancement (NME) is described in terms of {{c1::…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconThe purpose of the lexicon for non-mass enhancement (NME) is to distinguish between {{c1::mal…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconNon-mass enhancement (NME) with a {{c1::focal}} distribution makes up {{c2::<25}}% of a {{c3::q…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconNon-mass enhancement (NME) with a {{c1::linear}} distribution is arranged in a {{c2::line}} o…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconNon-mass enhancement in a linear distribution is malignant {{c1::26}}% of the time and can su…
New Card	05/02/2023	Breast Imaging: Breast MRI Non-mass enhancement (NME) with a {{c1::segmental}} distribution follows a {{c2::triangular}}-shaped distribution…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconNon-mass enhancement in a segmental distribution is the most common distribution of {{c3::DCI…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconNon-mass enhancement (NME) with a {{c1::regional}} distribution involves at least a…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconNon-mass enhancement (NME) with a {{c1::diffuse}} distribution globally affects the…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconNon-mass enhancement (NME) with {{c1::multiple regions}} of distribution invol…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconNon-mass enhancement (NME) with diffuse distribution may suggest prominent backgrou…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconNon-mass enhancement (NME) with a {{c1::homogenous}} internal enhancement pattern h…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconNon-mass enhancement (NME) with a homogenous internal enhancement pattern is usuall…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconNon-mass enhancement (NME) with a {{c1::heterogenous}} internal enhancement pattern is c…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconNon-mass enhancement (NME) with heterogenous internal enhancement is seen in {{c1::21}}%…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconNon-mass enhancement (NME) with a {{c1::clumped}} internal enhancement pattern rese…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconNon-mass enhancement (NME) with a {{c1::clumped}} internal enhancement pattern is M…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconNon-mass enhancement (NME) with a clumped internal enhancement pattern necessitates…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconNon-mass enhancement (NME) with a {{c1::clustered ring}} internal enhancement pattern&nb…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS MRI LexiconNon-mass enhancement (NME) with a clustered ring internal enhancement pattern {{c1:…
New Card	05/02/2023	Breast Imaging: Breast MRICase: Axial (left) and sagittal (right) fat-saturated T1-weighted post-contrast imagesYellow arrows: Area of {{c1:…
New Card	05/02/2023	Breast Imaging: Breast MRICase: MRI subtraction imageYellow arrow: Extensive {{c1::non-mass}} enhancement in L breast in a {{c2::regional}} …
New Card	05/02/2023	Breast Imaging: Breast MRI: Kinetic analysis in dynamic contrast-enhanced breast MRITumor {{c1::angiogenesis}} and resultant {{c2::capillary}} pe…
New Card	05/02/2023	Breast Imaging: Breast MRI: Kinetic analysis in dynamic contrast-enhanced breast MRI Dynamic contrast enhancement of tissue is dependent on …
New Card	05/02/2023	Breast Imaging: Breast MRI: Kinetic analysis in dynamic contrast-enhanced breast MRIAfter repeated imaging of the breast over time ({{c1::dynamic…
New Card	05/02/2023	Breast Imaging: Breast MRI: Kinetic analysis in dynamic contrast-enhanced breast MRIThe enhancement curve is divided into {{c1::early}} (within {…
New Card	05/02/2023	Breast Imaging: Breast MRI: Kinetic analysis in dynamic contrast-enhanced breast MRIPer the BI-RADS lexicon, the kinetics of early enhancement ca…
New Card	05/02/2023	Breast Imaging: Breast MRI: Kinetic analysis in dynamic contrast-enhanced breast MRI A malignant lesion would be expected to have {{c1::rapid}…
New Card	05/02/2023	Breast Imaging: Breast MRI: Kinetic analysis in dynamic contrast-enhanced breast MRI Per the BI-RADS lexicon, the three kinetic patterns of del…
New Card	05/02/2023	Breast Imaging: Breast MRI: Kinetic analysis in dynamic contrast-enhanced breast MRI A type {{c1::I}} or {{c1::persistent}} enhancement curve …
New Card	05/02/2023	Breast Imaging: Breast MRI: Kinetic analysis in dynamic contrast-enhanced breast MRIA type I (persistent) delayed enhancement curve is …
New Card	05/02/2023	Breast Imaging: Breast MRI: Kinetic analysis in dynamic contrast-enhanced breast MRI A type {{c1::II}} or {{c1::plateau}} enhancement curve ha…
New Card	05/02/2023	Breast Imaging: Breast MRI: Kinetic analysis in dynamic contrast-enhanced breast MRIA type II (plateau) curve is {{c1::less::less or more}} …
New Card	05/02/2023	Breast Imaging: Breast MRI: Kinetic analysis in dynamic contrast-enhanced breast MRIA type II (plateau) curve has a positive predictive valu…
New Card	05/02/2023	Breast Imaging: Breast MRI: Kinetic analysis in dynamic contrast-enhanced breast MRI A type {{c1::III}} or {{c1::washout}} enhancement cur…
New Card	05/02/2023	Breast Imaging: Breast MRI: Kinetic analysis in dynamic contrast-enhanced breast MRIA type III (washout) is the {{c1::most::least or most}} …
New Card	05/02/2023	Breast Imaging: Breast MRI: Kinetic analysis in dynamic contrast-enhanced breast MRIA type III (washout) curve has a positive predictiv…
New Card	05/02/2023	Breast Imaging: Breast MRI: Kinetic analysis in dynamic contrast-enhanced breast MRIAlthough a type III (washout) curve is very suspici…
New Card	05/02/2023	Breast Imaging: Breast MRI: Kinetic analysis in dynamic contrast-enhanced breast MRI False "positive" benign lesions that may demonstrate …
New Card	05/02/2023	Breast Imaging: Breast MRI: Kinetic analysis in dynamic contrast-enhanced breast MRIIn the evaluation of a lesion, which holds more weight in ter…
New Card	05/02/2023	Breast Imaging: Breast MRI  T{{c1::1::1/2}}-weighted images best show susceptibility artifact from {{c2::biopsy clips}} or {{c3::calcifications…
New Card	05/02/2023	Breast Imaging: Breast MRI{{c1::T1}}-weighted images demonstrate {{c2::hyper}}intense {{c3::hemorrhagic}} cysts and {{c4::proteinaceous}} {{c5::ductal…
New Card	05/02/2023	Breast Imaging: Breast MRI  T2 {{c1::hyper::hypo/hyper}}-intensity within the enhancing portion of a mass is generally suggestive of a {{c2::be…
New Card	05/02/2023	Breast Imaging: Breast MRICase: Contrast-enhanced MRI, post-processed color CAD angiomapFindings in L breast: Extensive {{c1::regional}} {{c…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS Classification of Masses or NMEMass or NME with a type I kinetic curve and benign morphology: ‒ BI-RADS {{c1::2}}:…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS Classification of Masses or NMEMass or NME with a type I kinetic curve and benign morphology:‒ BI-RADS {{c1::3}}: …
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS Classification of Masses or NMEMass or NME with a type I kinetic curve and benign morphology:‒ BI-RADS {{c1::4}}:&…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS Classification of Masses or NMEMass or NME with a type II or III kinetic curve and benign morphology:‒ BI-RAD…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS Classification of Masses or NMEMass or NME with a type I kinetic curve and malignant morphology:‒ BI-RADS {{c…
New Card	05/02/2023	Breast Imaging: Breast MRI: BI-RADS Classification of Masses or NMEMass or NME with a type II or III kinetic curve and malignant morphology:‒ BI-…
New Card	05/02/2023	Breast Imaging: Breast MRI One of the major challenges with breast MRI is that both tumors and benign lesions may {{c1::enhance}} and may exhibit…
New Card	05/02/2023	Breast Imaging: Breast MRI Strategies to differentiate between tumors and benign lesions with breast MRI include characterization of enhancement …
New Card	05/02/2023	Breast Imaging: Breast MRI Breast MRI is notably weaker in detecting {{c1::microcalcifications}} compared to mammography.
New Card	05/02/2023	Breast Imaging: Breast MRI In clinical use to evaluate for breast cancer, standard {{c1::1.5}} or {{c1::3}} Tesla breast MRI has {{c2::very high:…
New Card	05/02/2023	Breast Imaging: Breast MRI Breast MRI technique:RIsk stratification of an enhancing lesion involves separate evaluation of the lesion {{c1::morph…
New Card	05/02/2023	Breast Imaging: Breast MRI Breast MRI technique:Breast MRI is performed with the patient in a {{c1::prone}} position using a {{c2::dedicated brea…
New Card	05/02/2023	Breast Imaging: Breast MRI Breast MRI technique:In what situation would you not image both breasts simultaneously?Patient has had {{c1::previous …
New Card	05/02/2023	Breast Imaging: Breast MRI Breast MRI technique:Bilateral breast imaging is helpful to distinguish {{c1::background parenchymal}} enhancement fro…
New Card	05/02/2023	Breast Imaging: Breast MRI Breast MRI technique:Standard sequences include {{c1::T1- and T2-}} weighted images with and without {{c2::fat saturat…
New Card	05/02/2023	Breast Imaging: Breast MRI Breast MRI technique:{{c1::Pre-}} and {{c1::post-contrast}} images are essential to the breast MRI exam, typically obt…
New Card	05/02/2023	Breast Imaging: Breast MRI Breast MRI technique:Dynamic enhanced images are obtained {{c1::sequentially}} to evaluate enhancement over time.
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