Elizabeth O'Flynn1, Anna Kirby2,
Maria Schmidt1, Ashutosh Nerurkar3, Veronica A. Morgan1,
Erica Scurr1, John Yarnold2, Nandita M. deSouza1
1Cancer Research UK and EPSRC Cancer
Imaging Centre, Institute of Cancer Research & Royal Marsden NHS
Foundation Trust, Sutton, Surrey, United Kingdom; 2Clinical
Academic Radiotherapy, Institute of Cancer Research & Royal Marsden NHS
Foundation Trust, Sutton, Surrey, United Kingdom; 3Histopathology,
Institute of Cancer Research & Royal Marsden NHS Foundation Trust,
Sutton, Surrey, United Kingdom
This
pilot study demonstrates the accuracy of dynamic contrast-enhanced (DCE)-MRI
and diffusion-weighted (DW)-MRI in detecting and localising multifocal and
multicentric disease in patients with breast cancer by correlating imaging
with histopathology findings at mastectomy. DCE-MRI alone was most accurate
in detecting satellite lesions (sensitivity of 89%), DW-MRI was least
accurate (sensitivity 55%). Satellite lesions were found up to 22 mm from the
edge of the index lesion. Accurate identification of satellite lesions with
multifunctional MRI offers potential for monitoring the effects of local
therapies on multifocal and multicentric disease, and in defining the target
volume for partial breast irradiation.