Abbreviated Breast MRI for Screening High-risk Women: Comparison with the Full Clinical Protocol

Abstract

Objective To compare cancer detection rate (CDR), patient recall, and interpretation time of a full protocol MRI (fpMRI) to an abbreviated MRI protocol (abMRI) in high-risk women. Methods This retrospective study was approved by the IRB. All sequential high-risk screening MRI examinations performed between January 1, 2013, and December 31, 2016, were included. Breast radiologists reviewed patient history, prior images, and abMRI images and recorded their interpretation. Time for interpretation reflected review of the MRI study but not dictation or report generation. Following a minimum 30-day washout period, radiologists interpreted the fpMRI, with interpretation and timing recorded. Data collected included CDR, interpretation time, and patient recall rate. Statistical analyses utilized were Cohen’s kappa coefficient, Student’s t-test, and McNemar’s test. Results Included were 334 MRI examinations of 286 women. Interpretation time was 60.7 seconds for the abMRI compared to 99.4 seconds for the fpMRI, with an average difference of 38.7 ± 5.4 seconds per patient (P < 0.0001). Recall rates were comparable: the abMRI recall rate was 82/334 (24.6%) and the fpMRI 81/334 (24.3%). All five cancers included were detected by both protocols with equal recall rate. However, there were more recommendations for biopsy with the fpMRI, although this difference was not statistically significant. Conclusion The abMRI demonstrated comparable CDR to fpMRI, with shortened interpretation time and similar recall rates. Implementing an abMRI to screen high-risk women reduces imaging and interpretation time, thereby improving cost-effectiveness and the patient experience without reduction in cancer detection.

MRI Screening of BRCA Mutation Carriers: Comparison of Standard Protocol and Abbreviated Protocols With and Without T2-Weighted Images

“…Harvey et al [26] reported mean interpretation times of 1.55 minutes for the abbreviated protocol compared with 6.43 minutes for the full protocol, with no difference in the number of cancers detected in a high-risk screening setting. Osei et al [27] reported mean interpretation times of 60.7 seconds for the abbreviated protocol compared with 99.4 seconds for the full protocol, with comparable compared cancer detection rates and recall rates. The interpretation times for abbreviated and standard protocols in our study are shorter than in the earlier studies.…”

Current and Future Directions of Breast MRI

“…The abMRI negative predictive value was 99.8% [ 69 ]. Osei et al found comparable cancer detection and patient recall rates for abMRI vs. fpMRI, while abMRI significantly decreased the radiologist’s time for interpretation [ 70 ]. Weinstein et al demonstrated screening abMRI resulted in a CDR of 27.4/1000 in women with dense breasts after a negative digital breast tomosynthesis [ 71 ].…”