BLADE Software Changes Everything!
3T MRI is MRI done with the most powerful magnet approved for routine clinical imaging. The T of 3T stands for “Tesla.” Tesla is a unit of “magnetic field” and experts speak in terms of higher or lower “field strength.” Simply put, the stronger the magnet (“higher” the field strength), the better the images. 3T-MRI takes better and sharper pictures and does it much faster than weaker magnets. In May 2009, the American College of Radiology published a paper demonstrating that 3T-MRI is the best way to do breast MRI. In their study only 3T Breast MRI was found to be 100% sensitive for cancer in about 500 participants.
There are several reasons why Breast MRI is better at 3T. It has higher “signal to noise,” which generates more detailed images (crucial for seeing tumor borders and ductal anatomy) and higher resolution, which results in clearer/sharper images (vital for detecting subtle cancers and even less subtle cancers in earlier stages). 3T images deal far better with fat saturation of the breasts and are twice as sensitive to contrast enhancement. The most important reason is that it is much faster. We can complete a complete study in about 10 minutes of scan time if we eliminate all the frills.
3T MRI has twice the signal to noise of a 1.5T MRI—and up to ten times that of most OPEN MRI scanners. Simply put, “signal to noise” is a measure of the elements used to create MRI images. It’s a bit like talking about the number of “pixels” in a digital camera. The more pixels (higher the signal to noise), the clearer and more detailed the image. Theoretically, a 3T scan could be done four times more quickly than at 1.5T (and up to 100 times faster than with an OPEN MRI). In practice, however, we prefer to say that 3T scans twice as fast—already a great improvement. The average patient nowadays can’t seem to stay still for as long as they used to. Producing a high quality scan in 10 minutes increases the odds of getting a good image while, at the same time, reducing the likelihood of having to repeat the scan because the patient moved.
At MRI Consultants, our breast studies create approximately 1700 images in half an hour. In 10 minutes we do about 720 images.
One very important issue related to Breast MRI is how the fat in the breast is seen by the MRI scanner. Both fat and cancer show up as bright white. We deal with this by using “fat saturation” and “contrast.” Fat saturation is actually how the MRI scanner uses radio waves to exclude the white of fatty tissue while leaving cancer cells visible. Contrast (Magnevist TM) is essentially a dye that is injected into the bloodstream to highlight tumors and other areas of high blood flow. It makes a tumor appear much brighter and more detailed. As 3T MRI is much better at fat saturation than weaker MRI scanners—and twice as sensitive to the effects of contrast—the stronger scanner is much better at detecting breast cancer. You do not want to miss any potentially cancerous areas so demand 3T MRI for your breast MRI.
3T MRI is also much more sensitive to tumor margin detail, which greatly increases the chances of detecting cancers. Cancers typically have irregular margins but scanners with lower resolution smooth out these margins, making an irregular lesion appear more rounded and, therefore, less likely to be properly diagnosed. Higher resolution also impacts on our ability to see whether lesions extend into ducts.
3T MRI scanners can scan contiguous slices that are 1 mm thin, allowing us to scan up to 25% more of the breast than other scanners. Other scanners (even good ones) scan with a “skip”— missing up to 25% of the breast. Since early breast lesions can be as small as 5mm, “skipping” even 1 mm (1 “slice”) might result in not seeing all of a patient’s lesion … or, worse, not seeing it at all.
In the past two and a half years we have picked up many cancers that were totally missed on U/S and mammography. In most cases the poor imaging from just mammography and sonography contributed to a significant delay in diagnosis. At MRI Consultants, we use four times that resolution. As mentioned above, we scan with 1mm contiguous images. For every 1 slice they get, we get 4. Because of this, we “see more” and can diagnose more cancers. At 3T, doctors are often surprised to see more extensive changes than they’d initially thought were present. This is vital—especially for Breast MRI. 3T MRI can detect lesions in your breasts that no other test can. Patients are generally advised to have a mammogram and sonogram before having a breast MRI. But when you compare what a 3T MRI can “see” with these other tests, the difference is truly astounding. Ultrasound and mammography can both miss things that are easily seen by 3T-MRI. And, MRI does this without exposing the patient to x-rays or high energy particles. Ionizing radiation is becoming increasingly problematic. Most patients are completely unaware that the risk of getting cancer is 1/500 for children per CT scan and 1/1000 in adults. A CTA (computer tomography angiographic) study uses 3 times that amount radiation; a CT colonoscopy uses up to 4 times.
When a routine breast MRI study is positive there is a new procedure that can further characterize breast tumors. This new technique is called REVEAL diffusion weighted imaging. So far this software is only available on our 1.5T Espree system.
At 3TMRI, we have more than 25 years of experience reading and performing MRI. For pelvic MRI using BLADE motion correction, MRI allows for sharper more detailed images. The newest software makes a difference in the diagnostic capabilities of your MRI study.
My point? If you need a breast MRI, have it done on the very best machine available. The first time. Having an MRI done on a less powerful, inferior, machine—which can miss things—will result in your needing a second MRI on a better, more powerful, machine to confirm the results. If your test is positive on the poor test you may repeat it at 3T-MRI because you can see more. If your test is negative, you will need to repeat it to make sure there is nothing there. So, why waste your time and money? Why not be sure from the beginning? 3T-MRI is better than CT (which exposes you to radiation) and OPEN MRI (which has terrible resolution)—both of which give inconclusive results. If you need imaging, get the very best available. Be certain, use 3T-MRI.
 It should be noted that OPEN MRI cannot be used for Breast MRI because it is so low in resolution and detail.
Dr. Philip Chao graduated Phi Beta Kappa from Yale University and was Scholar of the House. He continued his studies at the University of Rochester School of Medicine and Dentistry, receiving his medical degree in 1983. After a transitional internship year at the Mary Imogene Bassett Hospital in Cooperstown NY, Dr. Chao did his residency in Radiology at Brooklyn’s SUNY Health Science Center (1984-1987), where he became Chief Resident. He stayed on to complete a fellowship in Neuroradiology (1987-1988). Dr. Chao has been interested in MRI technology since its very beginning – the first MRI scan took place in 1981 while he was pursuing his medical studies. The University of Pennsylvania, where Dr. Chao was both a Body MRI Fellow (1988-1990) and a Neuroradiology Fellow (1989-1990), was at the heart of the development of this technology and Dr. Chao was able to work with pioneers in MRI on the first GE Signa 1.5T (tesla) scanner. His advanced research and specializations complete, Dr. Chao left the University of Pennsylvania for a position as Director of MRI in Wilmington DE – a position he held for 14 years. Dr. Chao eventually left that position to create the best MRI center in Delaware, using the very latest technology: 3T MRI. While 3T (tesla) scanners have been used for scanning research patients since 2002, these advanced, more powerful MRI scanners only became available for clinical use in 2004. Dr. Chao worked hard to bring 3T technology to Delaware and in February 2007, MRI Consultants, LLC began operating the first 3T scanner in the State. 3T is the newest horizon for MRI.