Diagnostic Accuracy of Abbreviated MRI Protocol (ABB-MRI) For Detection of Breast Cancer in Women With Dense Breast: A Systematic Review And Meta-Analysis

Abstract

Background 2D and 3D mammography are less accurate than MRI for breast cancer diagnosis. ABB-MRI is a solution to the constraints of full diagnostic protocol MRI (FDP-MRI). This study synthesizes the evidence on the diagnostic effectiveness of ABB-MRI for screening women with dense breast tissue. Methods Using PRISMA guidelines, we conducted a systematic review and meta-analysis on multiple databases in August 2022. This review included studies that enrolled women with dense breast for screening, evaluated the diagnostic accuracy of ABB-MRI, and included a reference standard (histopathology). Students with all risk evaluation categories (mixed risk) were included in the study. We assessed the quality of included studies using QUADAS-2 in terms of bias concerns and applicability concerns. We synthesized the data by using a bivariate random-effects model and characterized overall values with forest plots. ABB-MRI performance was shown in the analysis with a 95% confidence region using a SROC plot. In a ROC analysis, the average true positive rate over a range of false positives was calculated. Results After reviewing 25 articles, 7 studies were included for quality assessment and quantitative analysis. In terms of bias and applicability, all studies exhibited low-risk. The meta-analysis includes 7 studies (plus one reader) that compared the sensitivity and specificity of an abbreviated MRI protocol (index test) to histology or follow-up. The pooled overall accuracy values of ABB-MRI for all included studies were sensitivity = 0.96 [0.91– 0.98] and specificity = 0.88 [0.85–0.91]. The SROC curve indicated an area under the curve (AUC) of 0.98 [0.96–0.99]. Conclusions Abbreviated Breast MRI Protocol (ABB-MRI) provides good specificity and sensitivity for identifying breast lesions in women with dense breasts. More research is needed to answer the broader questions raised by this study about the efficacy, safety, cost, and practicality of using this technique among this population.