Abbreviated and Ultrafast Breast MRI in Clinical Practice

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Breast Sonography: 1.00
Patient Care: 1.00
Patient Interactions and Management: 1.00

Mammography: 1.00
Procedures: 1.00
Mammographic Positioning, Special Needs, and Imaging Procedures: 1.00

Magnetic Resonance Imaging: 2.00
Image Production: 0.50
Sequence Parameters and Options: 0.25
Data Acquisition, Processing, and Storage: 0.25
Procedures: 1.50
Body: 1.50

Registered Radiologist Assistant: 1.00
Procedures: 1.00
Thoracic Section: 1.00

Radiation Therapy: 1.00
Patient Care: 1.00
Patient and Medical Record Management: 1.00

Outline

1. Introduction
2. The Basics
   1. Structural versus Functional Imaging
   2. Basic Terminology
3. Abridged MRI Techniques
   1. Abbreviated MRI
   2. Ultrafast MRI
   3. Newer Terminology
   4. Existing Challenge and Potential Solution
4. Abridged MRI: Advantages
   1. Lesion Conspicuity
   2. Functional Depiction
   3. Discriminating Power
5. Abridged MRI: Disadvantages
   1. Spatial Resolution
   2. Loss of Sensitivity
   3. Benign Cofounders
6. Clinical Indications
   1. High-Risk Screening
   2. Average-Risk Screening
   3. Caveats
7. Other Considerations
8. Conclusion

Objectives

Upon completion of this course, students will:

1. know how abbreviated and ultrafast breast MRI compare to full protocol contrast-enhanced breast MRI
2. define functional imaging
3. understand the difference between structural and functional imaging
4. realize what causes limits to mammography’s sensitivity
5. know the type of cancer dynamic contrast-enhanced MRI tends to identify
6. state the attributes of ultrafast MRI
7. define spatial resolution
8. define temporal resolution
9. recognize tumor enhancement characteristics
10. realize characteristics of abbreviated breast MRI
11. identify approaches used to attain high temporal resolution
12. compare enhancement characteristics of malignant and benign breast lesions
13. pinpoint a limitation of full protocol dynamic contrast-enhanced breast MRI
14. know what early reader studies have shown regarding ultrafast breast MRI
15. recognize the tradeoffs in ultrafast MRI
16. recall the type of postprocessed images from abridged MRI that allow for quick interpretation while maintaining a high negative predictive value
17. realize what you don’t see by eliminating the later postcontrast sequences in abbreviated MRI
18. know the principles of contrast-enhanced MRI and the functional depiction of tumor vascularity
19. define neoangiogenesis
20. know what type of breast imaging evaluation ultrafast MRI is best suited to
21. know statistics of the high risk population for breast cancer
22. recall recommended breast exams for average breast cancer risk individuals
23. define diffusion-weighted MRI
24. know what conditions must be met for a breast MRI exam to be billable