MR elastography of the breast:preliminary clinical results.

PURPOSE: Imaging of breast tumors and various breast tissues using magnetic resonance (MR) elastography (MRE) to explore the potential of elasticity as a new parameter for the diagnosis of breast lesions. METHODS: Low-frequency mechanical waves are transmitted into breast tissue by means of an oscillator. The local characteristics of the mechanical wave are determined by the underlying elastic properties of the tissue. Theses waves can be displayed by means of a motion-sensitive spin-echo MR sequence within the phase of the MR image. Elasticity reconstruction is performed on the basis of 8 "snapshots" of each wave within the three spatial directions. We performed in-vivo measurements in 15 female patients with malignant tumors of the breast, 5 patients with benign breast tumors, and 15 healthy volunteers. RESULTS: Malignant invasive breast tumors documented the highest values of elasticity with a median of 15.9 kPa and a wide range of stiffnesses between 8 and 28 kPa. In contrast, benign breast lesions represented low values of elasticity, which were significantly different from malignant breast tumors (median elasticity: 7.0 kPa; p = 0.0012). This was comparable to the stiffest tissue areas in healthy volunteers (median elasticity 7.0 kPa), whereas breast parenchyma (median: 2.5 kPa) and fatty breast tissue (median: 1.7 kPa) showed the lowest values of elasticity. Two invasive ductal carcinomas had elasticity values of 8 kPa and two stiff parenchyma areas in healthy volunteers had elasticities of 13 and 15 kPa. These lesions could not be differentiated by their elasticity. CONCLUSION: We conclude that MRE is a promising new imaging modality with the capability to assess the viscoelastic properties of breast tumors and the surrounding tissues. However, from our preliminary results in a small number of patients it is obvious that there is an overlap in the elasticity ranges of soft malignant tumors and stiff benign lesions.

[Imaging of breast tumors using MR elastography]. / Darstellung von Tumoren der weiblichen Brust mit MR-Elastographie.

PURPOSE: Imaging of breast tumors using MR-Elastography. MATERIAL AND METHOD: Low-frequency mechanical waves are transmitted into breast-tissue by means of an oscillator. The local characteristics of the mechanical wave are determined by the elastic properties of the tissue. By means of a motion-sensitive spin-echo-sequence these waves can be displayed within the phase of the MR image. Subsequently, these images can be used to reconstruct the local distribution of elasticity. In-vivo measurements were performed in 3 female patients with malignant tumors of the breast. RESULTS: All patients tolerated the measurement set-up without any untoward sensation in the contact area of skin and oszillator. The waves completely penetrated the breast, encompassing the axilla and regions close to the chest wall. All tumors were localized by MRE as structures of markedly stiffer tissue when compared to the surrounding tissue. Furthermore, in one patient, a metastasis in an axillary lymph node was detected. In all patients, local regions of increased elasticity were found in the remaining parenchyma of the breast, which, however, did not reach the high levels of elasticity found in the tumors. CONCLUSION: MRE is an imaging modality enabling adjunct tissue differentiation of mammary tumors.

High-resolution tensor MR elastography for breast tumour detection.

MR elastography is a novel imaging technique for the visualization of elastic properties of tissue. It is expected that this method will have diagnostic value for the clarification of suspicious breast lesions. Low-frequency mechanical waves are coupled into the tissue and visualized via an MR sequence which is phase-locked to the mechanical excitation. Commonly, elasticity is assumed to be isotropic and reconstruction is performed in only two dimensions. The technique is extended to three dimensions such that the entire symmetric elasticity tensor is assessed. This is achieved by measuring different phases of the mechanical wave during one oscillatory cycle. Thereby it is possible to provide information about the anisotropy of the elasticity tensor. Finite-element simulations as well as phantom experiments are performed to demonstrate the feasibility of the method. Initial clinical results of a breast carcinoma are presented. The analysis of the eigenvalues of the elasticity tensor support the hypothesis that breast carcinoma might exhibit an anisotropic elasticity distribution. The surrounding benign tissue appears isotropic. Thereby new and additional diagnostic information is provided which might help in distinguishing between benign and malignant breast diseases.