77049 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; bilateral

Name of the Procedure:

Magnetic Resonance Imaging (MRI) of the Breast, Without and With Contrast, Including Computer-Aided Detection (CAD) for Bilateral Study

Summary

An MRI of the breast is a non-invasive imaging test that uses powerful magnets and radio waves to create detailed pictures of the breast tissue. This procedure involves the use of contrast material to enhance the images and includes computer-aided detection (CAD) technology to aid in real-time lesion detection and analysis. It is performed on both breasts.

Purpose

This procedure is typically conducted to:

• Detect and characterize breast lesions (masses or abnormalities).
• Monitor the effectiveness of treatment for breast cancer.
• Evaluate the extent of breast cancer. The goal is to provide clear and detailed images of the breast tissue to aid in accurate diagnosis and treatment planning.

Indications

• Abnormal findings on a mammogram or ultrasound.
• High risk of breast cancer due to genetic factors or family history.
• Post-diagnosis assessment of breast cancer.
• Pre-surgical planning.
• Monitoring for recurrence of breast cancer.
• Evaluating abnormalities in patients with dense breast tissue not easily examined by mammography.

Preparation

• Patients may need to fast for a certain period before the procedure.
• Removal of any metal objects or jewelry.
• Informing the medical team about any allergies, especially to contrast materials.
• Blood tests to assess kidney function (to ensure safe use of contrast).
• Possible administration of medication to avoid movement during the scan if the patient is claustrophobic.

Procedure Description

1. The patient will lie face down on a table with openings for the breasts.
2. An intravenous (IV) line will be inserted to administer the contrast material.
3. The table slides into the MRI machine, which is a tunnel-like structure.
4. Initial scans (without contrast) will be taken.
5. Contrast material is injected through the IV to enhance the images.
6. Further imaging is performed with the contrast agent.
7. CAD technology assists in real-time lesion detection and analysis during the scan.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

This procedure is performed in a hospital's radiology department or an outpatient imaging center.

Personnel

• Radiologist
• MRI technician
• Nursing staff (for IV insertion and monitoring)

Risks and Complications

• Allergic reaction to contrast material (though rare).
• Temporary discomfort from the IV insertion.
• Potential for slight risk related to exposure to strong magnetic fields.
• Claustrophobia-related anxiety, if the patient is uncomfortable in tight spaces.

Benefits

• Highly detailed images of breast tissue, aiding in accurate diagnosis.
• Can detect smaller abnormalities not visible on mammograms or ultrasounds.
• Non-invasive with no exposure to ionizing radiation.
• Benefits can be immediate in terms of accurate diagnosis and treatment planning.

Recovery

• Patients can usually return to normal activities immediately after the scan.
• Hydration is encouraged to help flush out contrast material.
• Follow-up appointment may be required to discuss results with the physician.

Alternatives

• Mammography: Less detailed images, uses ionizing radiation.
• Ultrasound: Good for certain lesions but may not detect deeper tissue abnormalities.
• Biopsy: Invasive, used for definitive tissue diagnosis but not imaging. Each alternative has its own pros and cons compared to MRI in terms of detail, invasiveness, and diagnostic capability.

Patient Experience

• The patient will feel a slight prick when the IV is placed.
• May experience a sensation of warmth when the contrast is injected.
• Lying still is necessary; the machine makes loud noises, which may be alleviated with earplugs or headphones.
• Most patients report little to no discomfort from the procedure itself. Pain management is not typically needed due to the non-invasive nature of the scan, and comfort measures include ear protection and staff support for positioning.