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Why Breast MRI is particularly good at 3T, 3T is twice as good

Philip CHAO MD
Delaware
Radiology
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* Date : 03-03-2008 - 03:30 PM (5869 days ago),

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Why Breast MRI is particularly good at 3T, 3T is twice as good

3T-MRI (3 Tesla magnetic resonance imaging) is MRI done with a stronger magnet. Using a stronger magnet results in better images. Tesla is a unit of “magnetic field.” Using 3T-MRI, we can get better and sharper pictures in less time than is possible with a weaker magnet. 3T-MRI is the best way to do MRI.

Breast MRI is improved at 3T for at least four reasons. 3T has higher signal to noise and this makes MR imaging of both breasts, more detailed (for ductal anatomy and tumor borders) and higher in resolution. And it is twice as sensitive to contrast enhancement. Fat saturation of the breasts is also improved at 3T. So when you combine fat saturation plus contrast you get more sensitive studies to find areas of inflammation, tumors and healing. All of these will have increased blood flow and enhancement which is easier to detect when you use fat sat. We also scan 1mm thin with contiguous slices and this means we scan up to 30% more of the breast than other scanners. Other scanners will scan with a skip and for most patients since the early breast lesion can be as small as 5mm you could only get a small piece of the lesion if you skip 1mm.

Higher signal to noise (which is doubled at 3T) theoretically means the scan can scan up to four times as fast. In real practice it is better to say we only scan twice as fast. But twice as fast is a true improvement. The patients are getting more restless and if you can produce a higher quality scan in half the time this is a true advance in technology. Our Breast MRI studies create about 1700 images in a half hour. This is incredible. We probably make at least double the number of images than any other scanner in the same time.

Bring more sensitive to tumor margin detail makes the scanner much more sensitive to find cancers. We expect cancers to have an irregular margin but if your scanner has lower resolution it will smooth out those margins and make an irregular lesion more rounded. The higher resolution also impacts on our ability to see if the lesion extends into ducts.

Our ability to scan with thinner sections and higher resolution also directly impacts our ability to see abnormalities. If the images are of lower resolution and detail they basically are less sensitive for finding an abnormality. Being able to scan faster, thinner and with higher spatial resolution has given us the ability to see very subtle things, like small areas of ductal carcinoma in situ. You need the ability to see better especially when we do breast MRI. The other day I watched a presentation done using images from a GE system with VIBRANT and they used 3mm thick sections. We use triple their resolution. We scan with 1mm contiguous images. We see more and can diagnose more cancers. And we often see much more extensive changes than the doctors think are present. This is the key for breast MRI. It can detect things in your breasts that no other test can see. I generally recommend that a patient have a mammogram and sonogram before having abreast MRI. But when you compare what we see to what they see it is astounding what both ultrasound and mammography can miss. It’s amazing how well we can see without any xrays or high energy particles. Using ionizing radiation is problematic for our current society. It has not been explained to most patients that the risk of getting cancer is 1/500 for children per CT scan and 1/100 in adults. What is worse is that a CTA (computer tomography angiographic) study is 3 times more radiation dose. And a CT colonoscopy can be up to 4 times the radiation dose.

Breast MRI is simply much better when we do it at 3T. Almost every paper in the literature and all the doctors who use 3T says so. It simply is the best way to look at the breast. We can see the effects of neoadjuvant chemotherapy for breast cancer. Some patient drive to us from Lewes because we are the closest 3T-MRI machine. Educated doctors insist on 3T-MRI quality. I hope you will think the same in the future.

My point? If you need a breast MRI, have it done on the very best machine available. The first time. Having an MRI done on a less powerful, inferior, machine—which can miss things—will result in your needing a second one on a better, more powerful, machine to confirm the results. If your test is positive on the poor test you may repeat it at 3T-MRI because you can see more. If your test is negative, you will repeat it to make sure there is nothing there. So, why waste your time and money? Why not be sure from the beginning? 3T-MRI is better than CT and OPEN MRI, both of which give inconclusive results. If you need imaging, get the very best available. Use 3T-MRI. (www.3t-mri.net) Be certain use 3T for your MRI.

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