MR elastography of breast cancer: preliminary results

OBJECTIVE: Motivated by the long-recognized value of palpation in detecting breast cancer, we tested the feasibility of a technique for quantitatively evaluating the mechanical properties of breast tissues on the basis of direct MR imaging visualization of acoustic waves. SUBJECTS AND METHODS: The prototypic elasticity imaging technique consists of a device for generating acoustic shear waves in tissue, an MR imaging-based method for imaging the propagation of these waves, and an algorithm for processing the wave images to generate quantitative images depicting tissue stiffness. After tests with tissue-simulating phantom materials and breast cancer specimens, we used the prototypic breast MR elastography technique to image six healthy women and six patients with known breast cancer. RESULTS: Acoustic shear waves were clearly visualized in phantoms, breast cancer specimens, healthy volunteers, and patients with breast cancer. The elastograms of the tumor specimens showed focal areas of high shear stiffness. MR elastograms of healthy volunteers revealed moderately heterogeneous mechanical properties, with the shear stiffness of fibroglandular tissue measuring slightly higher than that of adipose tissue. The elastograms of patients with breast cancer showed focal areas of high shear stiffness corresponding to the locations of the known tumors. The mean shear stiffness of breast carcinoma was 418% higher than the mean value of surrounding breast tissues. CONCLUSION: The results confirm the hypothesis that the prototypic breast MR elastographic technique can quantitatively depict the elastic properties of breast tissues in vivo and reveal high shear elasticity in known breast tumors. Further research is needed to evaluate the potential applications of MR elastography, such as detecting breast carcinoma and characterizing suspicious breast lesions.