Evidence map›Paper›PMID 40019360›Full record

ArticleRadiology. Imaging cancer2025

Intraoperative Supine Breast MRI for Residual Tumor Assessment after Breast-Conserving Therapy in Early-Stage Breast Cancer.

Jirarat Jirarayapong, Leah H Portnow, Jayender Jagadeesan, Dylan C Kwait, Zhou Lan, Thanh U Barbie, Melissa A Mallory, Leah Kim, Mehra Golshan, Eva C Gombos

Abstract read
In one paragraph

Article in Radiology. Imaging cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Jirarat JirarayapongDepartment of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115.ORCID 0000-0001-9687-9205
Leah H PortnowDepartment of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115.ORCID 0000-0001-5146-7135
Jayender JagadeesanDepartment of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115.ORCID 0000-0002-3308-3012
Dylan C KwaitDepartment of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115.
Zhou LanDepartment of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115.ORCID 0000-0001-5881-2827
Thanh U BarbieDepartment of Surgery, Brigham and Women's Hospital, Boston, Mass.
Melissa A MalloryDepartment of Breast Oncology, H. Lee Moffitt Cancer Center, Tampa, Fla.
Leah KimDepartment of Surgery, Yale University School of Medicine, New Haven, Conn.
Mehra GolshanDepartment of Surgery, Yale University School of Medicine, New Haven, Conn.
Eva C GombosDepartment of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115.ORCID 0000-0002-8744-2471

Funding

TRD 3 - Enabling Technologies for Intraprocedural GuidanceP41EB028741 · NIBIB · BRIGHAM AND WOMEN'S HOSPITAL · PI Carl-Fredrik Westin · 2021 to 2026
$10.7M
NIBIB NIH HHS P41 EB028741
6 · The paper itself

Abstract

Purpose To evaluate the diagnostic performance of intraoperative supine MRI (isMRI) in identifying residual tumor burden immediately after breast-conserving therapy (BCT). Materials and Methods This single-institution prospective study (April 2012-December 2022) included 43 consecutive participants with stage 0-II breast cancer. Three participants with multicentric disease were excluded from the final analysis. Preoperative supine MRI was performed after standard preoperative prone MRI to compare tumor sizes and distances to the nipple, chest wall, and skin. After lumpectomy, the saline-filled surgical cavity was assessed for residual tumor at 3-T isMRI in the operating suite. Diagnostic accuracy of isMRI findings in identifying residual tumor at resection margins was assessed using histopathology of shave margin specimens as the reference standard. Performance metrics of isMRI and re-excision rates were analyzed at per-participant and per-margin levels. Results Forty participants (median age, 58.5 years; range, 40-76 years) with 44 breast cancers (36 unifocal and four multifocal) underwent BCT, all with a single lumpectomy site. Margin assessment using isMRI yielded accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 80%, 50%, 93%, 75%, and 81% per participant, respectively; and 93%, 52%, 97%, 65%, and 96% per margin. Second re-excision was avoided in two of six (33%) participants with true-positive isMRI readings, decreasing the final re-excision rate from 18% to 13%. Histopathology of six false-negative isMRI cases revealed residual invasive carcinomas, all smaller than 0.3 cm, or intermediate-to-high grade ductal carcinoma in situ. Conclusion Intraoperative assessment for residual tumor after BCT using isMRI demonstrated promising accuracy to guide targeted margin clearance within the same operation.

Indexed as

Breast NeoplasmsMagnetic Resonance ImagingMastectomy, SegmentalNeoplasm, ResidualAdultAgedBreastFemaleHumansMargins of ExcisionMiddle AgedNeoplasm StagingProspective StudiesSupine PositionBreastMR-Dynamic Contrast EnhancedMR-ImagingOncology

Identifiers

PMID40019360
PMCPMC11966566

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.