8 Questions to Ask Before Your Breast mri

8 Questions to Ask Before Your Breast MRI:

Since there is no nationally required criteria for breast mri, we wanted all patients to know what to look for in a high quality breast mri center. The problem is that radiology center operators don’t know what they don’t know. Just because they can take image slices of the breast, does not mean the images being performed are done correctly. You have the right to ask the radiologist or the technologist performing the study the following questions. We suggest you do this when you are scheduling the exam.  Right now they can do a poor quality study and still get paid.

(By January 1, 2012, all centers doing Breast MRI will be required to be ACR breast exam accredited, or they will not qualify for Medicare or insurance reimbursement, which means they will not get paid. Currently, there is no governing criteria to monitor the quality of breast MRI. A center doing breast MRI to the highest standards will be able to answer these questions without hesitation.) So here are 8 Questions to Ask Before Your Breast mri…

(1) Is their facility ACR (American College of Radiology) accredited? Is the accreditation current or has it expired?

If a radiology center has an ACR accreditation, they are interested in providing the highest quality care available. (By the way, we have found that just because a center is ACR accredited, does not necessarily mean they are doing breast mri exams correctly.) Continue to ask the rest of the questions.

_____Yes ____No (Run!)

2) Do they use a dedicated breast MRI coil (antenna)?

There are manufacturers that have designed breast mri antenna so that when the patient lies on their stomach, the breasts can drop into the coil. These antenna coils are specifically designed to see the best quality images of the breast. We recommend radiology centers using dedicated breast mri antenna coils.

_____Yes ____No (If no, find another center.)

3) Are their technologists ARRT registered for Magnetic Resonance and will a woman be positioning you and performing the exam? (American Registry of Radiologic Technologists who have taken and passed the MRI national board exam.)

Your right as a patient is to be comfortable with  your imaging provider? Your breasts may take a little pulling and positioning to reduce fatty wrinkles when you lie prone.  If you would prefer a female technologist, ask for it.

The amount of experience the technologist has is usually directly proportional to the level of competence practiced. There are educational programs available to these technologists that are specific to the exams they perform. By the way, if the technologist you question is a member of the ISMRM/SMRT, then they are usually the cream of the crop in their industry. These individuals take their profession seriously enough to belong to the international educational organization and continue learning more about their profession. MRI is constantly being updated and procedures are changing. Those in the know usually initiate updated and current practices.

_____Yes _____No

4) What is the slice thickness they use for the dynamic breast MRI study portion? (The thinner the better, but 2mm is maximum slice thickness. Anything under 1mm is very good.)

We think this is very important, because the interpretation will most likely not reveal a very small (1mm lesion) if the slice thicknesses are 3mm. In order to get the earliest detection possible, it is important that these be done to the standards setup by the experts. The thinner the slices for your dynamic breast mri portion,very often the better the exam will be.  (Specificity and signal weigh over mri image beauty.) Another key point during this part of the exam, is the patient must hold very still and the breasts should be immobilized and not allowed to vibrate and jiggle during the scanning process vibration.

_____Yes _____No

5) Does the imaging center use a 3D post processing system, (such as Confirma, DynaCad, Aurora 3D post processing or Sentinelle Medical’ s Aegis BRIGHT?)

The centers that acquire these systems take their reading and interpretation very seriously. The right tools for the job are important.

_____Yes _____No

6) Is the breast MRI exam being performed on a 1.5T field strength system or stronger?

We mention 1.5T because it is the lowest field strength we think that should be allowed to do breast mri. The signal to noise ratio is significantly more on higher field strength scanners, such as 1.5T and often more on 3T systems.

_____Yes _____No

7) Is the radiologist reading the exam “experienced” with reading dynamic breast MRI exams? (In other words, have they completed a breast MRI preceptor-ship, do they have another radiologist available for MRI breast over-reads, and do they average at least 10 MRI breast studies a month?)

_____Yes_____No

Can you get copies and discuss your results with the radiologist a few days after the exam?

_____Yes_____No

If the answer is “no”, sometimes the radiologist wants you to see the referring doctor first.  But after you’ve seen your referring physician, most breast radiologists are practiced and familiar with explaining breast results to patients.

If you get an answer of YES to all the questions above, the center you are having your breast exam done at is most likely using the latest procedures, products, and methods available. If you get an answer of NO to 2 out of the 7 questions, it is probably in your best interest to find a different center, and get the best study you can get for your money elsewhere. This is what we would recommend to our families and friends.

As a point of fact; Mammograms, x-rays of the breasts, actually adhere to a federally mandated criteria. If they don’t pass the test, they don’t get to collect and charge for the exam.   This is not the case for breast mri. As the patient, you have a choice to choose where you go for your study, but check with your insurance carrier as well.