mrimaster

MRI Breast

Indications for Breast MRI scan

Contraindications for Breast MRI scan

Patient preparation for breast MRI scan

Positioning for breast MRI scan

MRI breast implant protocol positioning photo

Recommended MRI Breast Protocols, Parameters, and Planning

breast MRI localiser

A three-plane localizer must be taken to plan the sequences. Localizers are normally less than 25 seconds and consist of T1-weighted low-resolution scans.

MRI breast localizer image

T2 SPACE axial 3D 1.5mm

Plan the axial slices on the sagittal plane and align the position block parallel to the breast. Verify the positioning block in the other two planes. Ensure an appropriate angle is set in the coronal plane, parallel to the right and left nipples. The slices should be sufficient to cover the entire breast. To prevent wrap-around artifacts, oversampling of both the slice and phase should be applied. Phase direction in the axial scans must be right to left, this is to avoid the artefacts from chest and heart motion.

If 3D sequences are unavailable on your scanner, please utilize 2D T2 axial scans with a slice thickness of 2 to 3mm.

Parameters T2 SPACE 3D

TR

1500-2000

TE

94

FLIP

170

NXA

1.4

SLICE

1.5 MM

MATRIX

320X256

FOV

350-390

PHASE

R>L

GAP

10%

OVERSAMPLE

10%  and 20%

Parameters T2 TSE

TR

4000-5000

TE

110

FLIP

130

NXA

2

SLICE

3 MM

MATRIX

320X320

FOV

350-390

PHASE

R>L

GAP

10%

OVERSAMPLE

20%

T1 flash 3D axial non fat sat 1mm

Plan the axial slices on the sagittal plane and align the position block parallel to the breast. Verify the positioning block in the other two planes. Ensure an appropriate angle is set in the coronal plane, parallel to the right and left nipples. The slices should be sufficient to cover the entire breast. To prevent wrap-around artifacts, oversampling of both the slice and phase should be applied. Phase direction in the axial scans must be right to left, this is to avoid the artefacts from chest and heart motion.

Parameters

TR

6-7

TE

3-4

FLIP

20

NEX

1

SLICE

1MM

MATRIX

384X320

FOV

350

PHASE

R>L

OVERSAMPLE

30%

IPAT

ON

DWI zoomit \ epi 3 scan trace axial

Plan the axial slices on the sagittal plane and align the position block parallel to the breast. Verify the positioning block in the other two planes. Ensure an appropriate angle is set in the coronal plane, parallel to the right and left nipples. The slices should be sufficient to cover the entire breast. For axial DWI zoomit scans, the phase direction should be from anterior to posterior. This helps avoid artifacts caused by the air-tissue interface by minimizing unwanted areas within the field of view (FOV). To mitigate wrap-around and motion artifacts originating from the chest and heart, it is recommended to apply two saturation bands over the chest region.

MRI breast protocol and planning of zoomit or epi DWI scans

Parameters EPI DWI

TR

5000-6000

TE

90

IPAT

ON

NEX

4

SLICE

4MM

MATRIX

192X192

FOV

320-360

PHASE

R>L

GAP

10%

B VALUE

0          
500
1400

Zoomit DWI For Breast imaging

Zoomit DWI is an advanced MRI imaging technique that leverages Siemens’ TimTX TrueShape platform and the application called Syngo ZOOMit. TimTX TrueShape introduces a new transmit platform with two independent transmitters, enabling flexible switching of RF waveforms and gradient shapes. This dynamic parallel transmission (pTX) capability opens up new possibilities for imaging applications.

Syngo ZOOMit, the first application based on TimTX TrueShape, utilizes the concept of “zooming” in MR imaging. Similar to optical zoom in a camera, ZOOMit allows for exciting a smaller field-of-view (FOV) than the object in the phase-encoding direction, thereby avoiding aliasing artifacts. By reducing the FOV, fewer phase-encoding lines are required, leading to faster scan times, improved spatial resolution in the region of interest, and reduced motion and flow artifacts.

Zoomit DWI offers several advantages over conventional DWI techniques. It employs multiple parallel radiofrequency pulse sequences simultaneously, capturing high signal specifically from the area of interest. This approach reduces folding artifacts, provides better anatomical detail, decreases distortion and blurring, and improves overall image quality. Additionally, it allows for faster screening, increased spatial resolution, and minimized susceptibility artifacts and geometric distortions.

With ZOOMit, radiologists and researchers can selectively image the volume of interest, achieve faster and higher-resolution imaging, enhance diagnostic confidence by detecting and evaluating smaller lesions in challenging areas, and broaden the scope of clinical MR imaging.

ZOOMit DWI breast images

T1 flash axial 3D fat sat dynamic 1 pre and 5 post

Plan the axial slices on the sagittal plane and align the position block parallel to the breast. Verify the positioning block in the other two planes. Ensure an appropriate angle is set in the coronal plane, parallel to the right and left nipples. The slices should be sufficient to cover the entire breast. To prevent wrap-around artifacts, oversampling of both the slice and phase should be applied. Phase direction in the axial scans must be right to left, this is to avoid the artefacts from chest and heart motion.

A dynamic flash 3D fat saturation sequence comprises six flash 1mm 3D scans with a 10-second delay between the first and second scans. The first scan in the dynamic sequence serves as a pre-contrast scan, which is utilized as a subtraction mask for the post-contrast scans. The second through sixth scans are considered post-contrast scans. According to the manufacturer’s instructions and departmental policy, a gadolinium-based contrast agent should be injected at a dose of 0.2ml/kg between the first and second scans, specifically during the 10-second delay period.

Parameters

TR 4-5

TE

2-3

FAT SAT

SPAIR

NEX

1

SLICE

1 MM

MATRIX

448X320

FOV

350-380

PHASE

R>L

DYNAMIC

6 SCANS

IPAT

ON

What is the reason for performing breast scans using the dynamic contrast-enhanced method?

Dynamic contrast-enhanced MRI (DCE-MRI) helps in the detection and characterization of breast lesions, especially in cases where mammography or ultrasound may not provide sufficient information. By tracking the contrast agent’s uptake and washout over a series of sequential images, DCE-MRI can help differentiate between benign and malignant lesions, assess tumor size, determine the extent of disease, and evaluate treatment response.

During the scan, multiple sets of images are acquired at different time points after the contrast injection, typically in the arterial, venous, and delayed phases. These images capture the contrast agent as it circulates through the blood vessels, allowing radiologists to observe patterns of enhancement and identify areas of abnormal vascularity associated with tumors or other breast abnormalities.

T1 flash coronal 3D fat sat post contrast .7mm

Plan the coronal slices on the axial plane and position the block perpendicular to the right and left breast. Verify the positioning block in the other two planes. Ensure an appropriate angle is set in the sagittal plane, perpendicular to the right and left breast. The slices should adequately cover the entire breast from the nipple to the axilla. In axial scans, the phase direction should be from right to left to avoid artifacts caused by motion from the chest and heart.

Parameters

TR 

5-6

TE

2-3

FLIP

10

NEX

2

SLICE

.7MM

MATRIX

512X512

FOV

350-360

PHASE

R>L

OVERSAMPLE

PH 30% and SL 20%

IPAT

Off

Optional Scans

T2 tse sagittal RT

Plan the sagittal slices on the axial plane and position the block parallel to the right breast. Verify the positioning block in the other two planes. Ensure an appropriate angle is set in the coronal plane, vertically across the right breast. The slices should sufficiently cover the right breast. In sagittal scans, the phase direction should be from head to feet to avoid artifacts caused by motion from the chest and heart. The field of view (FOV) should be small enough to accommodate just the right breast, typically around 180 to 250mm.

Parameters

TR

3000-4000

TE

100-120

SLICE

3MM

FLIP

130-150

PHASE

H>F

MATRIX

288X288

FOV

180-250

GAP

10%

NEX(AVRAGE)

2

T2 tse sagittal LT

Plan the sagittal slices on the axial plane and position the block parallel to the left breast. Verify the positioning block in the other two planes. Ensure an appropriate angle is set in the coronal plane, vertically across the left breast. The slices should sufficiently cover the left breast. In sagittal scans, the phase direction should be from head to feet to avoid artifacts caused by motion from the chest and heart. The field of view (FOV) should be small enough to accommodate just the left breast, typically around 180 to 250mm.

MRI planning of breast scan sagittal lt

Parameters

TR

3000-4000

TE

100-120

SLICE

3MM

FLIP

130-150

PHASE

H>F

MATRIX

288X288

FOV

180-250

GAP

10%

NEX(AVRAGE)

2

T1 flash 3d .7mm SFOV bilateral

Plan the sagittal slices on the axial plane and position the right block parallel to the right breast and the left block parallel to the left breast. Verify the positioning block in the other two planes. Ensure an appropriate angle is set in the coronal plane, running vertically across the right and left breast. The slices should adequately cover both the left and right breasts. In sagittal scans, the phase direction should be from head to feet to minimize artifacts caused by motion from the chest and heart. The field of view (FOV) should be small enough to accommodate just the left breast, typically ranging from 180 to 250mm.

MRI breast protocol and planning of sigital both side scans

Parameters

TR

5.5

TE

2.14

SLICE

.7MM

FS

SPAIR

PHASE

H>F

MATRIX

288X288

FOV

180-250

OVERSAMPLE

SL 20% and PH 100%

NEX(AVRAGE)

1