77048 Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time lesion detection, characterization and pharmacokinetic analysis), when performed; unilateral

Name of the Procedure:

Magnetic Resonance Imaging (MRI) of the Breast, Unilateral, Without and With Contrast Material, including Computer-Aided Detection (CAD)

Summary

Magnetic Resonance Imaging (MRI) of the breast is a non-invasive imaging technique that uses powerful magnets and radio waves to create detailed pictures of the breast tissue. When performed with contrast material and computer-aided detection (CAD), it helps to identify and characterize lesions more accurately.

Purpose

This procedure is primarily used to:

• Identify and evaluate breast abnormalities, including tumors and cysts.
• Determine the extent of breast cancer.
• Track the effectiveness of treatment methods such as chemotherapy. The goal is to provide a detailed and comprehensive evaluation of breast tissue to support accurate diagnosis and personalized treatment planning.

Indications

• Suspicious findings from a mammogram or ultrasound.
• High-risk patients for breast cancer (e.g., with a family history or genetic predisposition).
• Pre-surgical planning in breast cancer patients.
• Monitoring response to chemotherapy.

Preparation

• Fasting may be required for a few hours before the procedure.
• Inform your doctor about any allergies, particularly to contrast agents.
• Continue or stop medications as advised by your healthcare provider.
• Blood tests may be conducted to check kidney function before using the contrast material.

Procedure Description

1. The patient lies face down on an MRI table with their breasts positioned in a hollow space.
2. An intravenous (IV) line is started in the arm for the contrast material.
3. The table slides into the MRI machine, and the procedure begins.
4. Initial images are taken without contrast.
5. Contrast material is injected through the IV, and more images are taken.
6. The computer-aided detection (CAD) system analyzes images in real time for lesions, characterizing their nature and assessing pharmacokinetic properties.

Tools/Equipment: MRI machine, contrast material, CAD software. Anesthesia: Typically, no anesthesia or sedation is required.

Duration

The entire procedure typically takes about 30-60 minutes.

Setting

The procedure is performed in a hospital radiology department or an outpatient imaging center.

Personnel

• Radiologist: Interprets the MRI images.
• MRI Technologist: Operates the MRI machine.
• Nurse or Technologist: Assists with IV line and patient positioning.

Risks and Complications

• Allergic reaction to the contrast material.
• Claustrophobia due to the enclosed space of the MRI machine.
• Discomfort from lying still during the procedure.
• Rare risk of nephrogenic systemic fibrosis in patients with severe kidney disease.

Benefits

• Detailed images of breast tissue enhancing diagnostic accuracy.
• Better characterization of suspicious lesions.
• Assists in treatment planning and monitoring. Results are usually available within a few days after the procedure.

Recovery

• Patients can typically resume normal activities immediately.
• Drink plenty of fluids to help flush out the contrast material.
• Follow-up appointments may be necessary to discuss results with your doctor.

Alternatives

• Mammography: More common but less detailed than MRI.
• Ultrasound: Often used in conjunction with mammography but may be less effective for certain tissue types.
• Biopsy: Invasive procedure for definitive diagnosis. Each alternative has its pros and cons in terms of accuracy, invasiveness, and suitability for different patients.

Patient Experience

During the procedure, patients may feel:

• Minor discomfort from the IV injection.
• A warming sensation when the contrast material is injected.
• Noise from the MRI machine, usually managed with earplugs or headphones. Post-procedure, patients typically have no pain but may feel mildly fatigued.