A Novel Approach to Contrast-Enhanced Breast Magnetic Resonance Imaging for Screening

Mann, Ritse M.; Mus, Roel; Zelst, Jan van; Geppert, Christian; Karssemeijer, Nico; Platel, Bram

doi:10.1097/rli.0000000000000057

Cited by 181 publications

(168 citation statements)

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“…Thus, several authors published on this popular topic and confirmed the ability of an abbreviated MRI protocol to detect breast cancer in screening of high-risk populations as well as in women with proven breast cancers. However, few studies have evaluated the specificity of an abbreviated protocol outside of a high-risk population (13).…”

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confidence: 99%

Impact of an abbreviated protocol for breast MRI in diagnostic accuracy

Oldrini¹,

Derraz²,

Salleron³

et al. 2018

Diagn Interv Radiol

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Breast magnetic resonance imaging (MRI) has a dominant and increasingly important role in breast imaging, particularly for screening of women at high risk of developing breast cancer, staging of breast cancers, follow-up after neoadjuvant chemotherapy, and evaluating axillary lymph nodes when a primary site cannot be found by mammography (1-3). At present, it takes about 30 to 40 minutes to perform a breast MRI in accordance with the good practice guidelines of the European Society of Breast Cancer Specialists (EU-SOMA) (4). This length of time is relatively long, and the examination presents high direct and indirect costs that limit its wider use (5-11).Recently, Kuhl et al. (4) has shown that in high-risk women, the use of an abbreviated protocol is a suitable option that does not compromise the sensitivity or the specificity relative to the conventional complete protocol, thanks to specific characteristics of breast cancers that occur in high-risk women. PURPOSEWe aimed to compare the diagnostic accuracy and interpretation time of an abbreviated protocol relative to the complete protocol of breast magnetic resonance imaging (MRI) with the use of breast imaging reporting and data system (BI-RADS). Between-reader and between-protocol variability for BI-RADS classification and influence of reader expertise on diagnostic accuracies were also evaluated. METHODSWe conducted a retrospective reader study in 90 women who underwent breast MRI: 30 benign examinations (graded as American College of Radiology [ACR] 1 or 2), 30 examinations graded as ACR 3 and 30 examinations requiring a histologic proof (graded as ACR 4 or 5). Two radiologists independently reviewed the protocols. The reference standard was 24 months of imaging follow-up (66.6%, n=60), percutaneous biopsy at the12th month imaging follow-up (5.5%, n=5), and breast surgery (27.9%, n=25). Analysis was done on a per-breast basis. There were 26 cancers in 168 breasts (15.1%) RESULTSInterpretation time was higher for the complete protocol (mean difference: 84 s, 95% CI [67;101] for senior and 83 s, 95% CI [70;95] for junior reader; P < 0.001). The reliability of BI-RADS classification between both protocols was very good with intraclass correlation coefficient of 0.89 for junior reader and 0.98 for senior reader; the inter-reader reliability was 0.94 and 0.90 for the complete and abbreviated protocols, respectively. For senior reader, the abbreviated and complete protocols yielded 95.1% and 94.4% specificity and 100% sensitivity. CONCLUSIONOur data provide corroborating evidence that abbreviated protocols decrease interpretation time without compromising sensitivity or specificity. There was a high level of concordance between the abbreviated and complete protocols and between the two readers.

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confidence: 99%

Impact of an abbreviated protocol for breast MRI in diagnostic accuracy

Oldrini¹,

Derraz²,

Salleron³

et al. 2018

Diagn Interv Radiol

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“…Recently, it was reported that the maximum curve slope in an ultrafast protocol performed even better in the differentiation of benign and malignant lesions compared to BI-RADS curve types [25]. This study reported that the initial phase of the enhancement curve was more important compared to late-phase characteristics.…”

Section: Discussionmentioning

confidence: 54%

“…With these criteria, breast MRI has a sensitivity of about 85 % to 99 % in detecting malignant breast lesions, as has been shown in several studies [1, 2, 16 -24]. Recently, the implementation of MRI exams in regular screening settings has been discussed as well [19,25,26]. If MRI of the breast is to be used under screening conditions, the shortening of protocols would be preferable.…”

Section: Introductionmentioning

confidence: 99%

Breast MRI at Very Short TE (minTE): Image Analysis of minTE Sequences on Non-Fat-Saturated, Subtracted T1-Weighted Images

Wenkel

Janka

Geppert

et al. 2017

Fortschr Röntgenstr

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Purpose?The aim was to evaluate a minimum echo time (minTE) protocol for breast magnetic resonance imaging (MRI) in patients with breast lesions compared to a standard TE (nTE) time protocol. Methods?Breasts of 144 women were examined with a 1.5 Tesla MRI scanner. Additionally to the standard gradient-echo sequence with nTE (4.8?ms), a variant with minimum TE (1.2?ms) was used in an interleaved fashion which leads to a better temporal resolution and should reduce the scan time by approximately 50?%. Lesion sizes were measured and the signal-to-noise ratio (SNR) as well as the contrast-to-noise ratio (CNR) were calculated. Subjective confidence was evaluated using a 3-point scale before looking at the nTE sequences (1?=?very sure that I can identify a lesion and classify it, 2?=?quite sure that I can identify a lesion and classify it, 3?=?definitely want to see nTE for final assessment) and the subjective image quality of all examinations was evaluated using a four-grade scale (1?=?sharp, 2?=?slight blur, 3?=?moderate blur and 4?=?severe blur/not evaluable) for lesion and skin sharpness. Lesion morphology and contrast enhancement were also evaluated. Results?With minTE sequences, no lesion was rated with ?definitely want to see nTE sequences for final assessment?. The difference of the longitudinal and transverse diameter did not differ significantly (p?>?0.05). With minTE, lesions and skin were rated to be significantly more blurry (p?

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“…Our preliminary study showed that the TWIST-Dixon-Flex technique produces high spatial resolution images at the peak enhancement and afterward with image quality that is superior to A recent study by Mann et al (5) found that the detected maximum slope during the rapid contrast wash-in provides important information for lesion detection and classification.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, Time-resolved Angiography with Stochastic Trajectories (TWIST), an acceleration technique based on view sharing, has been receiving increasing attention in breast DCE-MRI applications (1)(2)(3)(4)(5). When combined with the dual-echo Dixon fat and water separation technique, TWIST-Dixon provides superior fat suppression and higher SNR efficiency to allow better overall image quality for breast DCE-MRI applications (4).…”

Section: Introductionmentioning

confidence: 99%

Initial Experience of Applying TWIST-Dixon With Flexible View Sharing in Breast DCE-MRI

Kipfer

Nickel

et al. 2016

Clinical Breast Cancer

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Abstract:Objective: To develop a new fast imaging technique with flexible TWIST view sharing to achieve variable temporal resolution and with flexible echo time Dixon to achieve robust fat suppression and to evaluate its application in breast DCE-MRI. Materials and Conclusion:The new TWIST Dixon Flex technique provides potentially valuable information of the early tumor enhancement, while maintaining excellent image quality at peak and post-contrast enhancement. This technique could allow us to overcome the compromise on spatial over temporal resolution in clinical breast imaging.

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A Novel Approach to Contrast-Enhanced Breast Magnetic Resonance Imaging for Screening

Abstract: Ultrafast dynamic breast MRI allows detection of breast lesions and classification with high accuracy using MS. This allows substantial shortening of scan protocols and hence reduces imaging costs, which is beneficial especially for screening.

Cited by 181 publications

References 50 publications

Impact of an abbreviated protocol for breast MRI in diagnostic accuracy

Impact of an abbreviated protocol for breast MRI in diagnostic accuracy

Breast MRI at Very Short TE (minTE): Image Analysis of minTE Sequences on Non-Fat-Saturated, Subtracted T1-Weighted Images

Initial Experience of Applying TWIST-Dixon With Flexible View Sharing in Breast DCE-MRI

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