Modern imaging has produced new and innovative imaging technologies, such as magnetic resonance imaging (MRI), targeting the early detection of breast cancer, with unprecedented accuracy and efficiency. In fact, there are few centers in Florida equipped with integrated 3D Breast MRI and 3D Breast Ultrasound, in combination with Computer Aided Detection (CAD) Technology, for early breast cancer detection.

 

Automated Breast Ultrasound provides a fast, cost-effective, patient-friendly solution for scanning of the breast, with a display system that allows for comprehensive review and diagnosis using 3D data. The 3-D real-time rendering uses tomosynthesis technology, which scans multiple adjacent scan planes using voxel synthesis, or volumetric sweeps of the breast, allowing the breast to be displayed as a volumetric image. Detailed positional references within the images provide a visual reference in the breast relative to the nipple, depth, and distance from the skin line. At the acquisition workstation, radiologists are able to scroll through images with 'virtual' scanning capability, simulating real-time scanning. Such technology allows radiologists to identify occult lesions detected by MRI, for example, or 'second-look' ultrasound, without the need for repeat scanning. 

 

Breast MRI is a non-invasive imaging procedure that uses non-ionizing radiofrequency waves within an applied magnetic field to visualize images with exceptional clarity and resolution. Breast MRI is frequently employed after less expensive screening mammography procedures to further interpret results of film-based or digital mammography studies. As clinical indications and study numbers expand, the amount of data produced per breast MRI exam is increasing exponentially, with exams often producing 600 to 1500 high resolution images in millimeter scan increments.

 

CAD technology is advancing breast MRI by enhancing efficiency, standardization, access and compatibility of studies. The system automates analysis, reporting and interventional planning of studies and promotes standardization with the incorporation of the ACR BI-RADS® Atlas. CAD is designed for any workflow scenario, integrating with existing equipment and providing access to studies anywhere on the network. Automated features include adaptive image registration (2D/3D), multiplanar reformatting, subtractions, angiogenesis maps, curves, maximum intensity projections (MIPs), volume summaries, morphology characterization, and portfolio for reporting. The American College of Radiology's BI-RADS® Atlas for breast MRI advocates that physicians report both kinetic and morphologic information for lesions identified in a breast MRI study. CAD has the capability of providing more detailed morphologic information than conventional MRI alone, such as confidently reporting the shape and margin of a 3-dimensional lesion. Data is sent directly from the MR imager to the CAD server where, after correcting for patient movement, the system automatically creates subtraction images, region of interest summary series and interactive real-time dynamic contrast curves.

 

The goal of imaging is early detection in the precancerous ductal carcinoma in-situ (DCIS) stage, now much improved with the use of 3D Breast MRI, which increases the sensitivity of breast cancer detection from 40% to 95% from traditional mammography screening alone. Surgical planning now includes 3D Breast MRI with CAD for non-invasive and fast imaging for staging of breast cancer into multiple quadrants of the breast, establishing tumor size and margins, involvement of axillary lymph nodes, and chest wall. MRI detects multifocal/multicentric breast cancers in 8% and contralateral breast cancers in 5% of newly diagnosed breast cancer cases, otherwise missed by conventional methods. 

 

Vincon Diagnostic Center is among the first centers in Florida to integrate 3D Breast MRI with CAD and 3D Automated Breast Ultrasound (ABRUS) in the outpatient setting. Following a digital mammography examination, ABRUS is typically used for rapid localization of cysts, masses, and areas of architectural distortion of the breast. If a lesion is complex, 3D Breast MRI with CAD is then applied to further characterize and stage the lesion. At Vincon, 'second- look' ABRUS is sometimes performed from the original source data, without the need for additional scanning, to identify lesions detected by MRI but initially missed by mammography and/or ultrasound. In many cases, 'second-look' ultrasound is successful and reproducible, allowing surgeons to perform stereotactic biopsy of the lesion conveniently in the office setting for tissue diagnosis. This protocol saves considerable time and expense and facilitates seamless continuity of care and patient management issues, often integrating surgical and non-surgical therapy (such as radiation, hormonal, and chemotherapy). This integrated approach significantly lowers the potential cancer re-excision rate, from 40% to less than 10%, in most cases, even when surgical margins are apparently clear on pathologic specimens. MRI also can be used for presurgical chemotherapy or to monitor the progress of neoadjuvant chemotherapy. In many cases, decisions regarding breast conservation and mastectomy can be made well in advance, due to the advancements in technology made possible through 3D Breast MRI with CAD and 3D Automated Breast Ultrasound.

 

 

 

 

Vincon Diagnostic Center
3D Breast MRI/3D Breast Ultrasound
Digital Mammography
5732 Canton Cove
Winter Springs, Florida 32708
(407) 699-7787
www.vincondiagnostic.com