Comparison of Abbreviated MRI and Full Diagnostic MRI in Distinguishing between Benign and Malignant Lesions Detected by Breast MRI: A Multireader Study

Abstract

Objective: To compare the performance of simulated abbreviated breast MRI (AB-MRI) and full diagnostic (FD)-MRI in distinguishing between benign and malignant lesions detected by MRI and investigate the features of discrepant lesions of the two protocols. Materials and Methods: An AB-MRI set with single first postcontrast images was retrospectively obtained from an FD-MRI cohort of 111 lesions (34 malignant, 77 benign) detected by contralateral breast MRI in 111 women (mean age, 49.8. ± 9.8; range, 28-75 years) with recently diagnosed breast cancer. Five blinded readers independently classified the likelihood of malignancy using Breast Imaging Reporting and Data System assessments. McNemar tests and area under the receiver operating characteristic curve (AUC) analyses were performed. The imaging and pathologic features of the discrepant lesions of the two protocols were analyzed. Results: The sensitivity of AB-MRI for lesion characterization tended to be lower than that of FD-MRI for all readers (58.8-82.4% vs. 79.4-100%), although the findings of only two readers were significantly different (p < 0.05). The specificity of AB-MRI for lesion characterization was higher than that of FD-MRI for 80% of readers (39.0-74.0% vs. 19.5-45.5%, p ≤ 0.001). The AUC of AB-MRI was comparable to that of FD-MRI for all readers (p > 0.05). Fifteen percent (5/34) of the cancers were false-negatives on AB-MRI. More suspicious margins or internal enhancement on the delayed phase images were related to the discrepancies. Conclusion: The overall performance of AB-MRI was similar to that of FD-MRI in distinguishing between benign and malignant lesions. AB-MRI showed lower sensitivity and higher specificity than FD-MRI, as 15% of the cancers were misclassified compared to FD-MRI.

Evaluating the effectiveness of abbreviated breast MRI (abMRI) interpretation training for mammogram readers: a multi-centre study assessing diagnostic performance, using an enriched dataset

“…A previous single-centre study, of 8 readers from the UK National Health Service Breast Screening Programme (NHSBSP), suggested that NHSBSP mammogram readers could be effectively trained to interpret abMRI with a single day’s one-to-one training [ 21 , 27 ]. Other international publications describe specific abMRI interpretation training for radiologists reading abMRI [ 1 , 28 , 29 ], but there is little published evidence evaluating abMRI interpretation training. To address this knowledge gap with formal evaluation of abMRI small-group training, our previous study’s one-to-one training [ 21 ] was adapted to create an electronic training package, delivered as single-day, small-group, in-person, hands-on workstation training.…”

Assessment of Enhancement Kinetics Improves the Specificity of Abbreviated Breast MRI: Performance in an Enriched Cohort

“…Subsequently, Kuhl et al [6] proposed the concept of abbreviated MRI (AB-MRI), which consists of one pre-and one post-contrast acquisition and their derived images (first post-contrast-subtracted and maximum-intensity projection [MIP]). Following these initial studies, multiple studies have reported that the diagnostic accuracy of AB-MRI is equivalent to that of the conventional full diagnostic protocol of MRI (FDP-MRI), with shorter acquisition and reading times, thereby making it more cost-effective as a screening tool [7][8][9][10][11][12][13][14][15][16].…”

Implementation of abbreviated breast MRI in diagnostic and screening settings

“…We also included second post-contrast images to our abbreviated protocol for detecting low-grade cancers. Kim et al also showed that using only the first post-contrast images could miss 15% of cancers (20).…”