Breast MRI – How we got Here ACR releases Breast MRI Guidelines Several independent studies released supporting efficacy of Breast MRI ACR/SBI Recommends Breast MRI Screening for “High Risk Patients” Breast MRI volumes steadily increase

What is the Need? MRI exam produces ~ 800 to 2,500 images  Need for Organization of Images Exams display ready to read  Workflow efficiency Post-processing capability  Automation of routine tasks Image manipulation  3D Modality unlocks great potential MRI Biopsies  Streamline/Simplify a sophisticated procedure

Hanging Protocols Users can be outfitted with up to 12 selectable viewing options tailored to their preferences Cases open into viewing arrangements (Hanging Protocols) ready to read

Post Processing of Images Subtraction Images Kinetic Assessment Multi Planar Reformatting ONCAD Morphology Analysis (Option) Maximum Intensity Projections Color Overlay ADC Overlay Motion Correction

Segment Findings Auto 3D segmentation of structures Morphological surface rendering of segmented areas Creation of landmark distances Volume, lesion composition, and histogram statistical outputs Propagate segmentation results onto multiple image series

Structured Reporting Result images and statistics automatically captured and incorporated into standardized reports Report templates can be customized with Hospital or Imaging Center’s logos Report Images can be printed or saved to the patient’s file

Implementation – Data Flow

Interventional Planning Visualization of needles and interventional instruments Integration with breast vacuum assisted biopsy systems Library of interventional instruments for site specific, customized workflow Support for popular breast biopsy imaging coils

Interventional Planning Confirm the equipment selections

Interventional Planning Identify the Fiducial Marker Scroll through the images until the fiducial marker appears and double click on the marker.

Interventional Planning Identify the target area for intervention Navigate to image showing the lesion and double click on the target area

Interventional Planning Options to save and print targeting results Visual indication of the equipment targeting setup Target coordinates listed in the overview panel Needle trajectory visualized

Additional Features Support for PACS system integration Oblique image reformatting All time point analysis Lesion diameter measurements ADC/high b-value calculation Lesion volume analysis ADC color maps Movie and Image file export for presentations Pharmacokinetic modeling Chest wall/Cardiac mask