Fusion of dynamic contrast-enhanced magnetic resonance mammography at 3.0 T with X-ray mammograms: Pilot study evaluation using dedicated semi-automatic registration software

Rationale and objectives: To evaluate the semi-automatic image registration accuracy of X-ray-mammography (XR-M) with high-resolution high-field (3.0T) MR-mammography (MR-M) in an initial pilot study. Material and methods: MR-M was acquired on a high-field clinical scanner at 3.0T (T1-weighted 3D VIBE +/- Gd). XR-M was obtained with state-of-the-art full-field digital systems. Seven patients with clearly delineable mass lesions >10 mm both in XR-M and MR-M were enrolled (exclusion criteria: previous breast surgery; surgical intervention between XR-M and MR-M). XR-M and MR-M were matched using a dedicated image-registration algorithm allowing semiautomatic non-linear deformation of MR-M based on finite-element modeling. To identify registration errors (RE) a virtual craniocaudal 2D mammogram was calculated by the software from MR-M (with and w/o Gadodiamide/Gd) and matched with corresponding XR-M. To quantify REs the geometric center of the lesions in the virtual vs. conventional mammogram were subtracted. The robustness of registration was quantified by registration of X-MRs to both MR-Ms with and w/o Gadodiamide. Results: Image registration was performed successfully for all patients. Overall RE was 8.2 mm (1 min after Gd; confidence interval/CI: 2.0-14.4 mm, standard deviation/SD: 6.7 mm) vs. 8.9 mm (no Gd; CI: 4.0-13.9 mm, SD: 5.4 mm). The mean difference between pre-vs. post-contrast was 0.7 mm(SD: 1.9 mm). Conclusion: Image registration of high-field 3.0 T MR-mammography with X-ray-mammography is feasible. For this study applying a high-resolution protocol at 3.0 T, the registration was robust and the overall registration error was sufficient for clinical application. (C) 2011 Elsevier Ireland Ltd. All rights reserved.