New MRI technique could mean fewer breast biopsies in high-...( MADISON A University of Wisconsin-M...)

MADISON A University of Wisconsin-Madison biomedical engineer and colleagues have developed a method that, applied in MRI scans of the breast, could spare some women with increased breast cancer risk the pain and stress of having to endure a biopsy of a questionable lump or lesion.

The universal technology will give radiologists greater confidence in visually classifying a lesion as malignant or benign.

The American Cancer Society recommends that women with certain breast cancer risk factors including inherited genetic mutations, family or personal history of breast cancer, or previous radiation therapy to the chest receive an annual MRI screening in addition to their yearly mammogram.

During a breast MRI, which lasts about a half hour, the technician injects a contrast agent into a vein in the patient's arm. Over time, the contrast agent flows throughout the body, including the breasts. Because they are growing quickly, cancerous lesions often have immature vasculature, and the contrast agent flows in and "leaks" out quickly. Conversely, benign lesions show more gradual in and out flow.

"The tricky ones are the ones that enhance quickly and then fall off more slowly," says Wally Block, a UW-Madison associate professor of biomedical engineering and medical physics. "Many of these lesions turn out to be difficult to classify and lead to biopsy."

Yet, it turns out that with the right kind of MRI scan, radiologists can visually identify a cancerous lesion based on characteristics about its shape. For example, breaks or interruptions in a lesion can indicate a benign fibroadenoma. Lumps with smooth edges often are benign, while those with jagged edges can signal cancer.

To generate the kind of crisp, three-dimensional images necessary for such a diagnosis, Block, UW-Madison radiology associate professor Fred Kelcz and graduate student Catherine Moran are capitalizing on their unique MRI data-acquisition me
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