Breast Mri. Fundamentals and Technical Aspects (Hardcover)

About this book

Author Dr. Hendrick is a renowned educator and researcher in breast imaging
Provides step-by-step instructions to establish breast MRI protocols and maximize image quality
Contains numerous examples of good and poor breast MR imaging
Offers an in-depth explanation of the technical aspects of breast MR imaging

Breast MRI has emerged as a valuable diagnostic adjunct to mammography and breast ultrasound in the detection of primary and recurrent breast cancers and as an important screening tool in women at high risk for breast cancer. Still, many radiologists who rely on MRI do not have knowledge of the fundamentals essential to achieving and maintaining high image quality. With a focus on the basic imaging principles of breast MRI rather than on mathematical equations, this book takes a practical approach to breast imaging that helps radiologists improve their breast MRI protocols. The text walks the reader through the basics of MRI, making it especially accessible to beginners. From a detailed outline of equipment prerequisites for obtaining high quality breast MRI to instructions on how to optimize image quality, expanded discussions on how to obtain optimized dynamic information, and examples of good and bad imaging techniques, the book covers the topics relevant to performing high quality breast MRI. By presenting the key aspects of breast MRI in a straightforward manner and with clear images, this practical book benefits all practitioners seeking to increase their working knowledge and competence in breast MRI, and is also of value to residents preparing for board exams in diagnostic radiology.

Written for: General radiologists, breast radiologists, medical physicists, breast fellows and radiology residents

Keywords:

• Breast
• Cancer Detection
• Cancer Diagnosis
• Contrast Agents
• ER
• Imaging
• MR Protocol
• MR Safety
• MR Spectroscopy
• MRI
• MRI Physics
• Principles

Contents

Foreword by Dan Kopans
Preface

1 Fundamentals of Magnetic Resonance Imaging
Subatomic Particles
The Atom
Magnetic Dipole Moments
Nuclear Magnetic Moments
Tissue Magnetization
Magnetic Fields
Precession and Magnetic Resonance
Tissue Excitation
Measuring the Magnetic Resonance Signal
The Basic Nuclear Magnetic Resonance Experiment
Chapter Take-home Points
References

2 Tissue Relaxation
Nuclear Magnetic Resonance
T1 Relaxation
T2 Relaxation
Distinguishing T2 and T2*
The Physical Basis of Relaxation Times
Chapter Take-home Points
References

3 Spatial Resolution in Magnetic Resonance Imaging
Basic Components of a Magnetic Resonance Imaging System
Magnets
Radiofrequency Transmitter Coils
Radiofrequency Receiver Coils
Magnetic Gradients
Slice Selection in Magnetic Resonance Imaging
Magnetic Resonance Imaging Pulse Sequence
Forming a Magnetic Resonance Image
Voxel Size
k-Space
Chapter Take-home Points
References

4 The Spin-echo Pulse Sequence
Spin-echo Pulse Sequence Diagram
Signal Dependence on TR and TE in Spin-echo Imaging
Contrast in Spin-echo Imaging
Acquisition Times in Spin-echo Imaging
Multi-slice Imaging
Chapter Take-home Points
References

5 Gradient Echo Sequences and 3D Imaging
The Gradient-echo Pulse Sequence Diagram
Variants of Gradient-echo Imaging
Signal Dependence on TR, TE, and ? in Spoiled Gradient-echo Imaging
Contrast in Spoiled Gradient-echo Pulse Sequences
Steady-state Gradient-echo Imaging
Total Acquisition Time in 2D Gradient-echo Imaging
3D Gradient-echo Imaging
Chapter Take-home Points
References
Suggested Reading

6 Fast-spin Echo, Echo Planar, Inversion Recovery, and Short-T1 Inversion Recovery Imaging
Fast Spin-echo Imaging
Echo-planar Imaging
Inversion Recovery and Short-T1 Inversion Recovery Imaging
Real and Magnitude Reconstructions of IR Spin-echo Signal
Short T1 Inversion Recovery Imaging
Chapter Take-home Points
References

7 Signal, Noise, Signal-to-Noise, and Contrast-to-Noise Ratios
Magnetic Resonance Signal
Noise in a Magnetic Resonance Image
System Parameters Affecting Noise
Volume of the Radiofrequency Receiver Coil
Receiver Bandwidth
Signal-to-Noise Ratios
Effect of Magnetic Field Strength on Signal-to-Noise Ratios
Effect of User-selectable Image Acquisition Parameters on Signal-to-Noise Ratios
Effects of TR, TE, and Flip Angle on Signal-to-Noise Ratios
Effect of Spatial Parameters on Signal-to-Noise Ratios
Effect of Slice Thickness on Signal-to-Noise Ratios
Effect of the Number of Frequency-encoding Steps
Effect of the Number of Phase-encoding Steps
Putting Together All Factors Affecting Signal-to-Noise Ratios
Signal-to-Noise Ratios in 2D (Planar) Imaging
Signal-to-Noise Ratios in 3D (Volume) Imaging
Contrast and Contrast-to-Noise Ratios
The Rose Model
Effect of Image Addition on Signal, Noise, Signal-to-Noise Ratios and Contrast-to-Noise Ratios
Effect of Image Subtraction on Signal, Noise, Signal-to-Noise Ratios and Contrast-to-Noise Ratios
Chapter Take-home Points
References

8 Contrast Agents in Breast Magnetic Resonance Imaging
A Brief History of Contrast Media in the Breast
Gadolinium-based Contrast Agents
The Physiologic Basis of Contrast Enhancement
Dosage of Gadolinium-chelated Contrast Agents
Safety of Gadolinium-chelated Contrast Agents
Possible Adverse Events Resulting from Gadolinium-chelates
Nephrogenic Systemic Fibrosis: A New Adverse Event of Gadolinium-chelates
Sensitivity and Specifi city of Contrast-enhanced Breast Magnetic Resonance Imaging
Timing of Pulse Sequences After Contrast Injection
Temporal Resolution in Contrast-enhanced Breast Magnetic Resonance Imaging
Trade-offs Between Adequate Temporal Resolution and Adequate Spatial Resolution
Obtaining High Temporal Resolution and High Spatial Resolution Contrast-enhanced Studies
Enhancement of Normal Fibroglandular Tissues in Pre-menopausal Women
Chapter Take-home Points
References
Suggested Reading

9 Breast Magnetic Resonance Imaging Acquisition Protocols
Essential Elements of an Image Acquisition Protocol
Pre-contrast T1-weighted Non-fat-saturated Pulse Sequence
Pre-contrast T2-weighted Sequences
Contrast-enhanced Sequences
Magnetic Field Strength of at Least 1.5 T and High Magnetic Field Homogeneity
Bilateral Imaging with Prone Positioning
3D Gradient-echo T1-weighted Pulse Sequences for Contrast-enhanced Imaging
Good Fat Suppression over Both Breasts in Contrast-enhanced Breast Magnetic Resonance Imaging
Adequately Thin Image Slices
Pixel Sizes of Less than 1 mm in Each in-plane Direction
Proper Selection of the Phase-encoding Direction to Minimize Artifacts Across the Breasts
A Total 3D Fourier Transform Acquisition Time for Both Breasts of Less than 2 Minutes
Meeting Temporal and Spatial Resolution Requirements in 3D Gradient-echo Imaging
Time-saving Measures in 3D Gradient-echo Imaging
Optimizing Contrast-enhanced Studies
Examples of Contrast-enhanced Scanning Protocols Meeting Temporal and Spatial Requirements
Examples of Defi cient Contrast-enhanced Protocols
Chapter Take-home Points
References

10 Image Post-processing Protocols
Automated or Prescribed Post-processing Techniques
Image Subtraction and Re-registration
Maximum Intensity Projections of Subtracted Data
Multiplanar Image Reconstruction
Creation of Enhancement Maps Based on Multiple Time Point Acquisitions
Creation of Time-enhancement Curves for Suspicious Enhancing Lesions
Breast Magnetic Resonance Imaging Computer-aided Diagnosis Workstations
Chapter Take-home Points
References

11 Artifacts and Errors in Breast Magnetic Resonance Imaging
Artifacts
Ghost Artifacts
Aliasing Artifacts
Truncation Artifacts
Chemical Shift Artifacts
Metallic Artifacts
Radiofrequency Transmission Artifacts
Reconstruction Artifacts
Other Randomly Occurring Image Artifacts
Other Equipment and User Errors
Chapter Take-home Points
References

12 Magnetic Resonance Imaging Safety and Patient
Considerations
Static Magnetic Fields
Magnetic Shielding
Metallic Objects in the Scan Room
Gradient Magnetic Fields
Acoustic Noise During MR Scanning
Radiofrequency Fields
Other Patient and Personnel Safety Considerations
Patients, Visitors, or Site Personnel with Metallic Implants and Devices
Pregnant Patients or Technologists
Cryogens and Quenches
Chapter Take-home Points
References

13 New Developments in Breast Magnetic Resonance Imaging
Higher Field Systems
Dedicated Breast Magnetic Resonance Imaging Systems
Dedicated Breast Magnetic Resonance Imaging Table and Coils
Novel Techniques to Improve the Specifi city of Breast Magnetic Resonance Imaging
Diffusion-weighted Breast Imaging
Perfusion Imaging of the Breast
Choline Peak in Hydrogen Spectroscopy
Combining Novel Magnetic Resonance Imaging Techniques to Gain Specifi city
The Choline Peak in 1H Spectroscopy as a Predictor of Treatment Response
Spectroscopic Imaging
Conclusion
Chapter Take-home Points
References
Appendix: Magnetic Resonance Imaging Patient and Non-Patient Screening Forms
Index