Comparing Restriction Spectrum Imaging (RSI) to Conventional and Abbreviated Breast MRI for Breast Cancer Screening
Breast Cancer

About this trial
This is an interventional screening trial for Breast Cancer focused on measuring Breast Cancer
Eligibility Criteria
Inclusion Criteria:
Group 1 will consist of women who present for screening breast MRI:
- Age >= 18
- Female
- Asymptomatic for breast disease
- Presenting for routine breast cancer screening with MRI
Group 2 will consist of women who presented for a screening mammogram (2D or 3D tomosynthesis) AND who have had a biopsy recommended after diagnostic workup:
- Age >= 18
- Female
- Asymptomatic for breast disease
- Presenting for routine breast cancer screening with mammogram (2D or 3D tomosynthesis) and/or ultrasound
- Biopsy recommended after subsequent diagnostic workup (BI-RADS 4 or 5)
Radiologist Reader Participant
Inclusion Criteria
- Must have clinical experience in interpreting breast MRI.
- Must have interpreted at least 10 breast MRI exams with RSI interpretation.
Exclusion Criteria:
-Known or suspected renal insufficiency, rendering the participant unable to safely receive intravenous contrast based on institutional clinical protocol.
Renal insufficiency for the purposes of exclusion includes any of the following:
- Failed Chokye questionnaire
- Known history of end stage renal disease with EGFR<30 mL/min/1.73m2
Point of care (POC) measure of creatinine clearance (eGFR) prior to obtaining the MRI <35. We will perform this POC test as needed per institutional policy for routine MRI if: (a) no creatinine result is available in the OMR within 30 days of the MRI exam, (b) the patient is > 60 years old, or (c) the patient is on hydroxyurea.
- History of adverse or allergic-like reaction to gadolinium MRI intravenous contrast, rendering the participant unable to safely receive intravenous contrast based on institutional clinical protocol.
- Presence of MRI unsafe devices or objects which would make having an MRI unsafe, as per institutional clinical protocol. MRI unsafe devices or objects for the purposes of exclusion include but are not limited to certain intracranial aneurysm clips, cardiac pacemaker, and implantable defibrillator devices, metallic heart valve, or coronary artery stents, breast tissue expanders, bio or neurostimulators, pellets and bullets, ocular implants and devices, otologic and cochlear implants. Other devices or metallic objects may be deemed unsafe for MRI at the radiologist's discretion.
- Unable to tolerate exam (i.e., secondary to untreatable claustrophobia, positioning constraints/unable to lie prone).
- Body weight exceeds that allowable by the MRI table.
- Breast biopsy or surgical intervention planned before the test RSI-MRI in this study.
Breast implants (silicone or saline).
8. Nursing or thinks she may be or is pregnant, as gadolinium contrast-enhanced MRI is unsafe. We will perform a pregnancy test as needed per institutional policy for routine breast MRI. Per institutional clinical protocol, all females of childbearing potential who are uncertain if they are pregnant or think they are pregnant must have a blood test or urine study within 2 weeks prior to the MRI exam to rule out pregnancy. A female of childbearing potential is any woman, regardless of sexual orientation or prior tubal ligation, who:
- Has not had a hysterectomy or bilateral oophorectomy OR
- Has not been naturally post-menopausal for at least 2 years (i.e., has had menses at any time in the preceding 2 years
Radiologist Reader Participant
-None.
Sites / Locations
- Beth Israel Deaconess Medical Center
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
SCREENING MRI
SCREENING MG BI-RADS 4/5
Standard MRI procedure will be used.
RSI is a DWI sequence with a built in distortion-correction technique that can be applied to any diffusion technique using echo planar imaging acquisition. RSI will be performed using pulsed-field gradient, spin-echo, echo planar imaging with "multi-shell" diffusion data . The b0 images will be collected in both the forward and reverse phase encoding directions to allow for post-processing correction of spatial distortion from magnetic field.