1. NZIMRT Conference 2014

3. The BasicsThe Basics  Equipment required  Clinical Indications  Patient Preparation  Sequences  Image Appearances

4. GE Signa HDx 1.5T scanner Dedicated 8ch Breast Coil Power Injector 10mls Multihance CADstream postprocessing

5. The BasicsThe Basics  Equipment required  Clinical Indications  Patient Preparation  Sequences  Image Appearances

6. Screening for strong family history Extent of known lesion Evaluate for disease in opposite breast Screening with BRCA 1 and BRCA 2

7. The BasicsThe Basics  Equipment required  Clinical Indications  Patient Preparation  Sequences  Image Appearances

8.  45mins allocated exam time  Patient completes paperwork Screening and consent form Contrast assessment form Breast questionnaire  20g IV line inserted  Patient positioned feet first prone  Breast in centre of the coil, hanging freely.  Check there is no breast folds or tissue caught between chest wall and coil  Arms above head resting on arm supports

12. The BasicsThe Basics  Equipment required  Clinical Indications  Patient Preparation  Sequences  Image Appearances

13.  3 plane localizer  Calibration scan  AXIAL STIR  Gadolinium given  VIBRANT 32CM  SAG T2 FAT SAT – Right  SAG T2 FAT SAT – Left  AXIAL DWI b 750

14. The BasicsThe Basics  Equipment required  Clinical Indications  Patient Preparation  Sequences  Image Appearances

15. AXIAL STIR VIBRANT PH 2 SAG T2 FAT SAT

16.  TYPE I Progressive enhancement pattern  TYPE II Plateau pattern  TYPE III Washout pattern II III I SIGNAL INTENSITY TIME Early post contrast phase Intermediate and late Contrast phase

17. 65yr old Invasive lobular cancer of the right breast Pre-operative MRI

20. 79yr old Gross lymphadenopathy in the right axilla ? Primary or secondary disease

22. DWIADC

23. Case 2 SINGLE VOXEL SPECTROSCOPY CHOLINE PEAK 3.28ppm

24. 52yr old Nipple inversion L breast when raising arms Palpable lump next to the left areola

26. High Field Strength MRI Breast Spectroscopy

27. 7T Provide higher SNR Higher spatial resolution Improved detection of small lesions However…. Lack of widespread availability No large clinical trials to show clinical advantage

28. Demonstrates the chemical components or metabolites of selected tissue Single voxel 20mm 5min scan For detection of choline peak

29. MRI breast scans have steadily increased in number Commonly used as a screening tool for BRCA positive patients Able to scan both breasts simultaneously Contrast has changed from 20mls Magnevist to 10mls of Multihance Diffusion weighted imaging is now routine part of examination