FAST <scp>MRI</scp> breast screening revisited

Jain, Manish; Jain, Arushi; Hyzy, M. D.; Werth, Graziella

doi:10.1111/1754-9485.12502

Cited by 23 publications

(32 citation statements)

References 6 publications

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“…The abbreviated breast MRI protocol is an excellent solution for these issues. Our study confirms prior findings which show that using an abbreviated protocol performs similar to a full MRI protocol for lesion detection and can be used as a less costly and faster alternative to supplemental screening.…”

Section: Discussionsupporting

confidence: 90%

“…[18][19][20][21][22] which show that using an abbreviated protocol performsF I G U R E 2 Cancers detected by all five readers on post-contrast T1-weighted dynamic images [Color figure can be viewed at wileyonlinelibrary.com] F I G U R E 3 Maximum intensity projection (MIP) images showing the cancers detected by all five readers [Color figure can be viewed at wileyonlinelibrary.com] TA B L E 3 Details of the seven cancers including 3 y outcome Cancer undetected by two readers. Maximum intensity projection (MIP) image (A) and a subtraction image (B) on the bottom showing linear subtle clumped enhancement.…”

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confidence: 99%

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Potential role of abbreviated MRI for breast cancer screening in an academic medical center

et al. 2019

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The purpose is to determine whether an abbreviated MRI protocol (ABMR) is ready to be used for breast cancer screening in an academic practice setting. Two hundred and fifty nine breast MRIs from 1/1/2012 to 6/30/2012 were retrospectively reviewed using ABMR (MIP, Pre‐contrastT1, single dynamic post‐contrastT1, and subtraction). Five breast radiologists (4‐28 year‐expr) participated in this reader study performed in two phases: Phase1 ‐ radiologist's privy to clinical history but not to comparison imaging. Phase2 ‐ radiologists provided comparison imaging. For phase1, studies were reviewed using three steps: (a) MIP only (positive/negative/intermediate); (b) ABMR (recall/no recall) and (c) With T2 (for changes in recommendations). Radiologist also recorded total time for interpretation. In Phase2 the MRIs coded as "recall” were re‐reviewed with available comparison studies, noting changes in final recommendation. The abnormal interpretation rates (AIRs) were calculated for phase1 and phase2 results with comparison to the original full protocol. Of the 259 patients (avg. age‐52 years; range 26‐78), there were seven cancers (three invasive, three DCIS and one breast lymphoma). Acquisition time for ABMR was 3 minutes, ABMR + T2‐8 minutes, and original full protocol 16 minutes. Average MIP was positive or indeterminate in 86% (6/7) and negative in 14% (1/7) cancers. The average AIR for MIP only was 20.8% (sens‐77.1%; spec‐80.8%. The AIR w/o comparisons was 25.6% (sens‐91.4%; spec‐ 76.2%); however the average AIR decreased in phase 2 with comparisons to 13.7% (sens‐91.4%; spec‐88.5%). The AIR of the original full protocol read was 16.2% (sens‐100%; spec‐85.7%). Addition of T2 changed assessment in only 3% (1.2%‐6.5%). Avg. read time for ABMR including T2 was 2.5 minutes (1.6‐4.0 minutes). ABMR is reliable for breast cancer screening, with acceptable interpretation time and acceptable AIR.

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Section: Discussionsupporting

confidence: 90%

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confidence: 99%

Potential role of abbreviated MRI for breast cancer screening in an academic medical center

et al. 2019

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“…To improve access, tolerance, and reduce cost, Kuhl and colleagues [112] introduced the ultrafast, 3-min, breast MRI for screening and demonstrated that abbreviated breast MRI maintained comparable sensitivity and specificity to the full diagnostic protocol. Table 3 summarizes results of abbreviated MRI to date [112][113][114][115][116][117]. Incremental cancer detection rate following abbreviated screening breast MRI ranges between 8.9 and 36.5 cancers per 1000 screens.…”

Section: Magnetic Resonance Imaging (Mri)mentioning

confidence: 99%

Breast density implications and supplemental screening

2018

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Digital breast tomosynthesis (DBT) has been widely implemented in place of 2D mammography, although it is less effective in women with extremely dense breasts. Breast ultrasound detects additional early-stage, invasive breast cancers when combined with mammography; however, its relevant limitations, including the shortage of trained operators, operator dependence and small field of view, have limited its widespread implementation. Automated breast sonography (ABS) is a promising technique but the time to interpret and false positive rates need to be improved. Supplemental screening with contrast-enhanced magnetic resonance imaging (MRI) in high-risk women reduces late-stage disease; abbreviated MRI protocols may reduce cost and increase accessibility to women of average risk with dense breasts. Contrast-enhanced digital mammography (CEDM) and molecular breast imaging improve cancer detection but require further validation for screening and direct biopsy guidance should be implemented for any screening modality. This article reviews the status of screening women with dense breasts.

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“…AB-MRI reduces the MRI examination and interpretation time and allows faster throughput, leading to reduced cost and increased availability of breast MRI screening to intermediate-risk women (1,(4)(5)(6). In several studies involving different populations, AB-MRI screening has consistently shown cancer detection rates and diagnostic accuracy comparable to those of FD-MRI (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). AB-MRI with first postcontrast images preferentially detects invasive cancers and high-grade ductal carcinoma in situ (DCIS) due to their neoangiogenesis and rapid wash-in of contrast compared with fibrocystic change and low-grade DCIS (7).…”

Section: Study Populationmentioning

confidence: 99%

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

et al. 2021

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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.

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FAST MRI breast screening revisited

Abstract: Given the absence of statistically significant difference in the FPR and recall rates in comparison with FD, FAST scans can replace FD for screening of breast cancer.

Cited by 23 publications

References 6 publications

Potential role of abbreviated MRI for breast cancer screening in an academic medical center

Potential role of abbreviated MRI for breast cancer screening in an academic medical center

Breast density implications and supplemental screening

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

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