by
Christina Hwang, Contributing Reporter | June 22, 2016
Study finds better outcomes with
face up MR rather than face down
Have we been conducting MR upside-down? Lying supine, or face up, during a pre-surgery MR scan for breast tumors may provide more accurate imaging than the current method of a patient lying face down, a new study from Brigham and Women’s Hospital has shown.
MR can be used as a way to examine breast cancer tumors, but according to the announcement, there is no evidence that pre-surgery MR currently translates into improved outcomes following surgery.
“Among women undergoing breast conserving surgery, 15 to 40 percent need to have a second operation to remove remnant tumor,” said senior author Dr. Mehra Golshan, distinguished chair in surgical oncology at Brigham and Women’s Hospital, in a statement.
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In a phase one clinical trial, researchers had taken MR images of 12 women prior to their undergoing lumpectomy for breast cancer. Half of the women underwent MR in the traditional prone position while the other half were in supine position. After surgery, all the women had a supine MR scan.
“Supine imaging allows the surgeon to visualize the position of the tumor in the position we operate, [which is] the patient on her back,” Golshan told HCB News. “MRI is done with the patient on her stomach, and we can't operate on her breast in that position. The breast is not a fixed organ and moves with positioning.”
The researchers had measured the size, position and shape of the tumor between the prone and supine images and found that certain characteristics of the tumor had substantial differences depending on how the patient was positioned during her MR exam.
Golshan said that if a surgeon can look at the picture of the tumor in the actual position the surgeon is operating in, it may accurately facilitate the removal of the tumor and lead to lower re-excision rates.
“If validated in future large studies, intra-operative, and, more importantly, pre-operative supine MRI could … reduce the need for re-operation, which negatively impacts the patient emotionally, delays postoperative therapy, and increases infection rates and cost,” said Dr. Eva C. Gombos, radiologist at the hospital and lead author of the study, in a statement.
