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We are
pleased to present the SMRT Educational Seminars,
Volume 16, Number 2: “Diffusion-Weighted MR Imaging
of the Breast.” This is the 60th accredited home
study developed by the SMRT, exclusively for SMRT
members. The accreditation is conducted by the SMRT
acting as a RCEEM (Recognized Continuing Education
Evaluation Mechanism) for the ARRT. Category A
credits are assigned to each home study, which can
be used to maintain one’s ARRT advanced registry.
SMRT Home Studies are also approved for AIR
(Australian Institute of Radiography), NZIMRT (New
Zealand Institute of Radiation Technology) and CPD
Now (The College of Radiographers, United Kingdom)
continuing professional development (CPD)
activities.
Three peer-reviewed articles have been chosen for
this home study issue. The authors of the first,
"Diffusion-Weighted MR Imaging: Pretreatment
Prediction of Response to Neoadjuvent Chemotherapy
in Patients with Breast Cancer," introduce their
article by saying "Diffusion-weighted MR imaging
that can be used to measure apparent diffusion
coefficients (ADCs) - a quantitative measure of the
diffusivity of water - provides information related
to tumor cellularity and the integrity of cell
membranes and is sensitive to intratumoral changes
induced by chemotherapy." Because previous " . . .
clinical studies performed in patients with breast
cancer have shown that changes in ADCs precede
changes in tumor diameter. However, different
chemotherapeutic regimens were used, which may
affect the treatment response." Their purpose in
conducting the study was to focus on a single
chemotherapeutic regimen, specific changes in ADC
values, and continue the investigation.
In the second article, "Differential Diagnosis of
Mammographically and Clinically Occult Breast
Lesions on Diffusion-Weighted MRI", the authors
investigate the role of DWI as an alternative to DCE-MRI
in the screening of breast cancer. They state " . .
. the requirement for intravenous administration of
a gadolinium-based contrast agent increases the
associated time, costs, and potential toxicity of
the breast DCE-MRI examination. These factors limit
the accessibility of this screening tool for many
women."
The third and final article, "Diffusion-Weighted MRI
as an Adjunct to Mammography in Women Under 50 years
of Age: An Initial Study", seeks to " . . . evaluate
whether DW imaging can supplement mammography,
particularly for the detection of small invasive
breast cancer in women under 50 years of age." They
acknowledge that previous studies have been
conducted that "have already shown the value of this
method (DW MRI) in the characterization of breast
mass lesions. However, only one blinded study has
examined DW imaging for detection of breast cancer."
A special thank you to Nancy Hill Beluk from the
Pediatric Imaging Research Center, Children’s
Hospital of Pittsburgh (UPMC), Pennsylvania, USA for
acting as the Expert Reviewer.
Thanks also to Heidi Berns, M.S., R.T.(R)(MR), FSMRT,
Chair of the SMRT RCEEM Ad-hoc Committee from
Coralville, Iowa, USA and all those who participate
on this committee by reviewing the home studies for
accreditation. Finally, thanks to Jennifer Olson,
Associate Executive Director, Mary Keydash,
Publications Director, Linda O-Brown, SMRT
Coordinator, and the entire staff in the Berkeley,
California, USA office of the ISMRM and SMRT for
their insight and long hours spent supporting these
educations symposia.
We would also like to thank John Wilkie and all of
the individuals at Invivo Corporation (Philips
Healthcare) who generously support our home studies
program. Their continuing investment advances
technologist and radiographer knowledge and brings
quality continuing education to the SMRT membership
worldwide. |
