ISMRM23 - MRI in Breast Cancer: Update & New Approaches Toward Diagnosis & Treatment

ISMRM & ISMRT Annual Meeting & Exhibition • 03-08 June 2023 • Toronto, ON, Canada

MRI in Breast Cancer: Update & New Approaches Toward Diagnosis & Treatment

Weekend Course

ORGANIZERS: Mami Iima, Katja Pinker-Domenig

Sunday, 04 June 2023

713A/B

07:45 - 11:30

Moderators: Almir Bitencourt & Jean Seely

Skill Level: Intermediate to Advanced

Session Number: WE-19

CME Credit

Session Number: WE-19

Overview
Breast magnetic resonance imaging (MRI) is a fundamental method in screening, diagnosis, management, and follow-up of breast cancer patients. The aim of this course is to discuss the increasing role of breast MRI in improving the management of breast cancer patients, updating clinical recommendations, highlighting new evidence, emphasizing updates in technical advances and implementation of AI that allow better correlation between MRI findings and histologic, immunohistochemical, and molecular features, as well as response assessment and treatment outcomes.

Target Audience
M.D.s and Ph.D.s interested in utilizing breast MRI in all aspects of the patient's journey: establishing new standards of care in screening, disease characterization, treatment, and development and implementations of new technologies and AI.

Educational Objectives
As a result of attending this course, participants should be able to:
- Recall new image protocol and updated reporting standards in breast MRI;
- List current recommendations and new standards for screening and disease assessment; and
- Recognize potential and challenges of technical development and AI in patient-centric breast imaging.

07:45		Update on MRI: Protocols, Artifacts & Pitfalls View Presentation Video Masako Kataoka Keywords: Body: Breast This talk focuses on describing standard breast MRI protocol including T2WI, T1WI, DWI, and dynamic contrast enhanced (DCE) images. Purpose of each sequence in a clinical setting will be explained. The talk also covers pitfalls and artifacts that are commonly encountered in the image acquisition and interpretation.
08:10		Interpretation: BI-RADS & More View Presentation Video Lilian Wang Keywords: Body: Breast This lecture will present basic breast MRI interpretation principles, with focus on the Breast Imaging Reporting and Data System (BI-RADS). The BI-RADS lexicon for MRI findings and BI-RADS assessment and recommendation categories will be reviewed. A systematic approach to image interpretation will be discussed, including the potential for multiparametric MRI to improve diagnostic accuracy.
08:35		Beyond DCE: DWI & Emerging Techniques View Presentation Video Nariya Cho Keywords: Body: Breast Diffusion MRI has emerged as an alternative and complementary technology for breast evaluation. It has already shown the clinical value of diffusion MRI for improving specificity leading to a decreased benign biopsy for suspicious lesions on contrast-enhanced breast MRI. In addition, studies are actively underway to evaluate its value as a stand-alone screening method. To help radiologists implement DWI in clinical practice and to inspire physicists to develop new technologies, this lecture will outline principles, standardized techniques, clinical applications, and research of diffusion MRI using ADC. Furthermore, advanced DWI techniques, including IVIM, DKI, and DTI, will be briefly reviewed.
09:00		Patient Safety & Information to Women View Presentation Video Naoko Mori
09:25		Break & Meet the Teachers
09:50		New Approaches & Recommendations for Screening (Risk-Adapted) View Presentation Video Ritse Mann
10:15		Pre-Operative MRI: An Update on the Evidence View Presentation Video Julia Camps Herrero
10:40		Treatment Response Assessment, Prediction & Prognosis & Image-Guided Minimally Invasive Therapy View Presentation Video Federica Pediconi Keywords: Body: Breast, Education Committee: Clinical MRI This talk will focus on the assessment of NAT response with breast MRI-derived biomarkers, and the use of minimally invasive therapies in breast cancer, their current indications and future perspectives.
11:05		The Treated Breast, Breast Implants & Oncoplastic Reconstructions View Presentation Video Alexandra Athanasiou Keywords: Body: Breast Imaging the treated and reconstructed breast could be a challenge. Knowledge of the type of reconstruction is essential to tailor the MRI protocol. Current techniques of reconstruction include implants, autologous tissue reconstruction and fat grafting. Although breast cancer recurrence in this setting is rare, one should never overlook this possibility. Breast-Implant related Anaplastic Large Cell Lymphoma is a rare entity, commonly presenting as large fluid collection typically developing at least more than one year after receiving an implant (average after 8-10 years). CD30 immune staining is required after fluid drainage to establish the diagnosis.