Effect of breast tissue marker on MRI evaluation for breast lesions and clinical significance

Objective This study compares the magnetic resonance imaging (MRI) appearance of two types of breast tissue markers to investigate the appropriate clinical application of the markers. Methods Breast MRI of 69 patients (78 masses) with breast tissue markers had been placed were analyzed retrospectively from November 2015 to August 2018 in our hospital. The sizes and shapes of breast tissue markers were assessed in axial fat-suppressed T2-weighted images, T1-weighted images and contrast-enhanced T1-weighed images. Results The length of the coil nickel-free stainless steel markers were greater than ribbon titanium markers, with statistical difference in fat-suppressed T2-weighted images (P=0.039). In contrast-enhanced T1-weighted images, all coil nickel-free stainless steel markers showed >6 mm diameter and round shape, and ribbon titanium markers showed >6 mm diameter (n=20) or ≤6 mm diameter (n=8), and round (n=20), dot (n=7) or band (n=1) shapes. The categories of sizes and shapes in two types of breast tissue markers both had statistical significance (P<0.001, P<0.001). Conclusions Small breast lesions with breast tissue markers are not suitable for MRI evaluation. The artifact of ribbon titanium markers is smaller than coil nickel-free stainless steel markers, so they have less impact for lesions. The choice of the breast tissue markers and image evaluation methods should depend on the different clinical conditions. Key words: Magnetic resonance imaging; Breast neoplasms; Fiducial markers; Titanium; Stainless steel