Cardiac Connection > Tests & Procedures

No radiation. Noninvasive. Capable of constructing detailed pictures of the body quickly. MRI has a lot going for it. And now with advances in technology and the expertise of doctors at Doylestown Hospital, MRI is revealing even more information to help doctors detect, diagnose, and ultimately treat serious disease.

Breast MRI
Doylestown Hospital radiologist Richard Patt, MD, has been working in the field of breast MRI for more than a decade � shortly after radiologists first began to investigate its potential benefits in the early 1990s. As Chief of MRI at Georgetown University Hospital, he participated in the evolution of this remarkable technology as it was used to improve the detection and diagnosis of breast cancer. When he arrived at Doylestown Hospital in 2004, he set about expanding the capabilities of the hospital�s breast MRI program. �MRI can play an important role in all aspects of breast cancer care,� says Dr. Patt. �For certain women at high risk for breast cancer, it can even be a valuable screening tool.�

Specifically, breast MRI may be used:

Following a diagnosis of breast cancer but before surgery to detect tumors � even very small ones � at other sites in the breast or in the other breast. MRI often demonstrates the size of tumors better than mammography, enabling a surgeon to better decide whether breast conservation therapy or mastectomy is more appropriate.

To examine the surgical area more carefully when the margins of tissue removed are found to be not �clear� (i.e., they still contain cancer cells).

To monitor the effects of chemotherapy used to shrink a breast tumor prior to surgery.

For screening women with multiple risk factors for breast cancer including, for example, women who have been diagnosed with the breast cancer gene.

For women with breast implants, either from augmentation or reconstruction, to provide a better image than a mammogram.

As a �problem solver,� providing important information when suspicions remain even after mammogram and ultrasound.

CardiacMRI
Radiologists at Doylestown Hospital have been doing cardiac MRI for about six years, a fact that Doylestown Hospital radiologist William Corse, DO, calls �extraordinary.� �CardiacMRI looks at the heart structure and function in a unique way,� he says, �providing information that in some cases cannot be obtained by any other test available. It is the most difficult type of MR imaging to master, but we have had the good fortune to assemble here at Doylestown Hospital a dedicated team of radiologists and technologists well versed in the use of this modality. In fact,� continues Dr. Corse, who presented a paper in Beijing on the subject, �many teaching hospitals still are not able to perform cardiac MRI.�

Dr. Corse, who along with Doylestown Hospital radiologist Craig Kesack, MD, conducts cardiac MRI exams, describes cardiac MRI as a sophisticated, highlevel problem-solving technique � a technique that often cannot be replicated by any other means. For example, cardiac MRI can be used:

To assess left heart function and determine who will respond to various types of surgical and nonsurgical therapy. In many cases, no other diagnostic test can do this.

To assess heart function during types of chemotherapy that may be harmful to the heart.

To evaluate patients who may be at risk for a lethal heart arrhythmia and whose lives can be saved by implanting a defibrillator device.

To evaluate heart valve function and anatomy, masses of the heart, and different types of cardiomyopathies (diseases of the heart muscle).

To measure abnormal blood flow between heart chambers.

To evaluate patients after corrective surgery for congenital heart abnormalities.

MRA gives a different perspective
Another magnetic resonance technique is called MRA, or magnetic resonance angiography. With MRA, the physician can get high-resolution, 3-D images of blood vessels anywhere in the body, without having to insert a catheter into an artery or vein. �One of the big advantages of MRA over other scanning technologies is that we can rotate the images and look at them from any angle,� explains Dr. Corse. �We can see plaque clinging to just one area of a vessel, for example, that might not be visible with a scan that gives us only one perspective. It�s a wonderful tool.�

CardiacMRI and MRA are just part... but a very important part... of comprehensive cardiac care. Concludes Dr. Corse, �With the radiologists, cardiologists, and cardiothoracic surgeons at Doylestown Hospital, the community has access to the most advanced diagnosis and treatment of virtually any disease of the heart and vascular system.�

Appropriate use of MRI � in all its applications � is having a tremendous impact on patient care. Whether it�s used to detect or diagnose disease, evaluate or monitor treatment, or even to screen patients at high risk for a particular disease, MRI continues to prove itself to be a safe, accurate, and very valuable component of quality care.

Dr. Richard Patt, Dr.William Corse, and Dr. Craig Kesack are with Parlee and Tatem Radiologic Associates.