Implementation of abbreviated breast MRI in diagnostic and screening settings

Abstract

Background Abbreviated magnetic resonance imaging (MRI) includes fewer sequences than standard MRI, which could be utilized for breast cancer detection. Purpose To evaluate the diagnostic accuracy of abbreviated MRI protocol in screening and diagnostic settings. Material and Methods All women with screening and diagnostic (problem-solving and preoperative staging) MRI examination were recruited from 2017 to 2020. Two expert radiologists assessed designed abbreviated protocol (fat-saturated T1-weighted [T1W] pre-contrast and two first fat-saturated T1W post-contrast series with reconstruction of their subtraction) including maximum intensity projection (MIP) and then evaluated standard protocol of breast MRI. Associated findings, including axillary lymphadenopathy and invasion to nipple, skin, or pectoralis muscle were also evaluated. The concordance rate of abbreviated with standard protocol in screening and diagnostic settings were also compared, based on BI-RADS classification. Diagnostic accuracy, sensitivity, specificity, and positive and negative predictive value were calculated. Results A total of 108 (26.5%) of 408 patients (mean age = 43 ± 9 years) were classified as BI-RADS 4–5 and considered positive findings based on suspicious enhancement (mass or non-mass enhancement). Compared to standard protocol, abbreviated protocol revealed >98% accuracy in the diagnostic setting as well as 100% accuracy in the screening setting. Concordance rates in screening and diagnostic settings were 99.6% and 98.1%, respectively. There was no discordance between abbreviated and standard protocol in the evaluation of associated findings. Conclusion Abbreviated MRI protocol possesses substantial diagnostic accuracy in both screening and diagnostic settings. Additional information provided by standard protocol might not require for cancer detection.

Screening and Diagnosis Imagery in Breast Cancer: Classical and Emergent Techniques

“…In contrast to a full diagnostic MRI study, which takes 15-20 minutes, an abbreviated breast MRI (ultrafast) (Figures 5 and 6) for breast cancer screening involves a shorter imaging protocol (with fewer sequences) that allows patients to spend no more than 5 to 10 minutes within the MRI scanner. Compared to a full MRI, this abbreviated protocol revealed >98% accuracy in the diagnostic setting as well as 100% accuracy in the screening setting [20].…”

Abbreviated breast MRI for evaluating breast cancer before initiation of neoadjuvant chemotherapy: A cross-sectional study

“…All MRI examinations were performed using a GE Discovery MR750 3 T MRI scanner (GE Healthcare, Waukesha, WI, USA) with dedicated multichannel 16-row breast coil. We used the sequences of both abbreviated and standard protocols the same as our previous study [15] .…”

Environmental Sustainability and MRI: Challenges, Opportunities, and a Call for Action

“…For example, abbreviated breast MRI protocols, where unnecessary sequences are omitted, can reduce scan times by 30%-50% while maintaining high diagnostic accuracy. [14][15][16] Mango et al demonstrated that a shortened breast MRI exam that removed sequences such as T2-weighted imaging, redundant post-contrast T1-weighted imaging, and DWI reduced scan time from 30 to 40 minutes to 15 minutes. 16 For musculoskeletal MRI, Ross et al demonstrated a 20 minute reduction in scan time for an abbreviated protocol to assess occult hip and pelvis fractures in the elderly compared to a complete standard MRI exam, with high sensitivity (92%-100%) and specificity (97%-98%).…”

“…There have been several studies demonstrating that abbreviated protocols, tailored to the specific needs of the exam indication, can significantly reduce scan length, reducing overall energy use and GHG emissions. For example, abbreviated breast MRI protocols, where unnecessary sequences are omitted, can reduce scan times by 30%–50% while maintaining high diagnostic accuracy 14–16 . Mango et al demonstrated that a shortened breast MRI exam that removed sequences such as T2‐weighted imaging, redundant post‐contrast T1‐weighted imaging, and DWI reduced scan time from 30 to 40 minutes to 15 minutes 16 .…”