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Patient Repositioning May Deform Breast MRI

By MedImaging International staff writers
Posted on 07 Jul 2016

$Image: A woman undergoing a breast MRI. A new study suggests the position in which a woman is placed during her pre-surgical breast MRI could influence the scan’s accuracy (Photo courtesy of Brigham and Women\'s Hospital / NHV).$

Image: A woman undergoing a breast MRI. A new study suggests the position in which a woman is placed during her pre-surgical breast MRI could influence the scan’s accuracy (Photo courtesy of Brigham and Women\'s Hospital / NHV).

A new suggests that changes in patient positioning between MRI imaging and surgery results in deformation and displacement of the tumor during breast-conserving surgery (BCS).

Researchers at Brigham and Women's Hospital (BWH; Boston, AM, USA) conducted a study in 12 women who underwent lumpectomy and postsurgical intraoperative supine MRI imaging; six of 12 patients completed both a prone and a supine presurgical MRI. The geometric, structural, and heterogeneity metrics of the cancer tumor and distances of the tumor from the nipple, chest wall, and skin were computed, as were mean and standard deviations of the changes in volume, sphericity, distances from key landmarks, and other measures.

The results showed that the specifications of the tumor, including size and location in the breast, were substantially different between supine and prone MRI. The mean differences in tumor deformation metrics between prone and supine imaging were as follows: for volume, 23.8%; for surface area, 6.5%; for compactness, 16.2%; for sphericity, 6.8; and for decrease in spherical disproportion, −11.3%. All tumors were closer to the chest wall on supine images than on prone images. No evidence of residual tumor was seen on MRI obtained after the procedures. The study was published on June 22, 2016, in Radiology.

“Our analysis highlights that supine MRI before surgery may provide surgeons with more detailed and accurate information and could lead to effective tumor removal,” said lead author radiologist Eva Gombos, MD. “If validated in future large studies, intra-operative, and, more importantly, pre-operative supine MRI could be expected to help the surgeon in accurately planning removal of the tumor and reducing the need for re-operation which negatively impacts the patient emotionally, delays post-operative therapy and increases infection rates and cost.”

Traditionally, patients who are scheduled to undergo BCS lumpectomy undergo a breast MRI prior to surgery to help inform the surgeon about the size, shape, and location of the tumor. These MRIs are performed with the patient lying prone (face down), while the surgery is performed with the patient lying supine (face up). Supine MRI, when performed in addition to standard prone breast MRI, may help detect a remnant tumor and ensure clear margins.

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69 (31.948089599609): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

70 (358.10470581055): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294764969 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (294.92378234863): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294764969 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (41.007995605469): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (66.041946411133): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (60.796737670898): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294764969 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (30.040740966797): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294764969 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (39.815902709961): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (52.928924560547): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (92.983245849609): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294764969 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294764969 AND published='1' LIMIT 1

105 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294764969 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294764969 AND published='1' LIMIT 1

106 (56.982040405273): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294764969 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (45.061111450195): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294764969 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (77.962875366211): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294764969 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294764969 AND published='1' LIMIT 1

109 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294764969 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294764969 AND published='1' LIMIT 1

110 (47.922134399414): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294764969 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (594.8543548584): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294764969 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (622.03407287598): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (382.90023803711): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (78.916549682617): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294764969 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294764969 AND published='1' LIMIT 1

115 (97.036361694336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294764969 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294764969 AND published='1' LIMIT 1

116 (123.02398681641): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294764969 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294764969 AND published='1' LIMIT 1

117 (60.081481933594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294764969 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294764969 AND published='1' LIMIT 1

118 (77.962875366211): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294764969 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294764969 AND published='1' LIMIT 1

119 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294764969 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294764969 AND published='1' LIMIT 1

120 (311.85150146484): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 22925.853729248): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (141.14379882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294764969 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294764969 AND published='1' LIMIT 1

123 (80.82389831543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294764969 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294764969 AND published='1' LIMIT 1

124 (584.12551879883): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294764969 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294764969 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 966698.16970825): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (!!!!! 1292477.8461456): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (495.91064453125): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (108.00361633301): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (441.07437133789): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (90.122222900391): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (375.98609924316): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (92.983245849609): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (580.0724029541): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294764969 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (508.06999206543): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294764969 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (216.00723266602): SELECT name FROM jos_deeppockets WHERE id=212

136 (60.081481933594): SELECT name FROM jos_deeppockets WHERE id=212

137 (669.95620727539): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (637.05444335938): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (!!!!! 1944.0650939941): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294764969 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294764969 AND published='1' LIMIT 1

140 (180.00602722168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294764969 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294764969 AND published='1' LIMIT 1

141 (!!!!! 9665.9660339355): TRUNCATE TABLE jos_trademed_module

142 (160.93254089355): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294764969 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (627.99453735352): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294764969 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (665.90309143066): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294764969 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (518.0835723877): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294764969 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (79.870223999023): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294764969 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294764969 AND published='1' LIMIT 1

147 (59.843063354492): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294764969 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294764969 AND published='1' LIMIT 1

148 (!!!!! 1209.9742889404): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (97.990036010742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294764969 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294764969 AND published='1' LIMIT 1

150 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294764969 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294764969 AND published='1' LIMIT 1

151 (545.97854614258): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294764969 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294764969 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (65.088272094727): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

153 (37.908554077148): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

154 (61.03515625): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (147.10426330566): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294764969 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294764969 AND published='1' LIMIT 1

156 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294764969 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294764969 AND published='1' LIMIT 1

157 (132.08389282227): select jos_twitters.link from jos_twitters where cat=10

158 (29.087066650391): select jos_facebook.link from jos_facebook where cat=10

159 (26.941299438477): select jos_google_plus.link from jos_google_plus where cat=10

160 (27.179718017578): select jos_linkedin.link from jos_linkedin where cat=10

161 (264.16778564453): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 1389.0266418457): insert into jos_banners_delta values (14615,'2025-06-20 17:21:10','216.73.216.120','view'),(14202,'2025-06-20 17:21:10','216.73.216.120','view'),(14203,'2025-06-20 17:21:10','216.73.216.120','view')

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