Performance of abbreviated protocols versus unenhanced MRI in detecting occult breast lesions of mammography in patients with dense breasts

Abstract

To assess the diagnostic ability of abbreviated protocols of MRI (AP-MRI) compared with unenhanced MRI (UE-MRI) in mammographically occult cancers in patients with dense breast tissue. The retrospective analysis consisted of 102 patients without positive findings on mammography who received preoperative MRI full diagnostic protocols (FDP) between January 2015 and December 2018. Two breast radiologists read the UE, AP, and FDP. The interpretation times were recorded. The comparisons of the sensitivity, specificity and area under the curve of each MRI protocol, and the sensitivity of these protocols in each subgroup of different size tumors used the Chi-square test. The paired sample t-test was used for evaluating the difference of reading time of the three protocols. Among 102 women, there were 68 cancers and two benign lesions in 64 patients and 38 patients had benign or negative findings. Both readers found the sensitivity and specificity of AP and UE-MRI were similar (p > 0.05), whereas compared with FDP, UE had lower sensitivity (Reader 1/Reader 2: p = 0.023, 0.004). For different lesion size groups, one of the readers found that AP and FDP had higher sensitivities than UE-MRI for detecting the lesions ≤ 10 mm in diameter (p = 0.041, p = 0.023). Compared with FDP, the average reading time of UE-MRI and AP was remarkably reduced (p < 0.001). AP-MRI had more advantages than UE-MRI to detect mammographically occult cancers, especially for breast tumors ≤ 10 mm in diameter.

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

“…In the current systematic review, three of seven the studies followed the negative cases for two years (6,16,17). Three of the studies followed for less than two years(7, 9, 10) and one study did not state the follow-up time(8).…”

“…We found that the total acquisition time and reading time for ABB-MRI (AP protocol) is by farm shorter than previously known full protocol MRI. In the AP protocol, the time to perform ranges between 3-20 minutes (9,17) which are shorter than 20-45 minutes in full protocol breast MRI (19). The reading time for ABB-MRI ranges between 28-54 seconds(6, 16) compared to the previous reports on full protocol which is 6.43 minutes(3).…”

“…Comstock et al enrolled average risk patients based on the BCSC risk calculator (10). Kennard et al and Chen et al (2022) included patients with mixed risk (9,17), the two remaining studies did not mention anything about the risk assessment(8, 16).…”

New Approaches and Recommendations for Risk‐Adapted Breast Cancer Screening

“…153 Detection performance between unenhanced DWI, T1W, T2W, AB-MRI and full MRI protocols has also been compared demonstrating almost equivalent performance. 154,155 Although DWI as a stand-alone technique has demonstrated high performance, its sensitivity is still inferior to that of DCE-MRI (Fig. 7).…”

“…Likewise, due to the limited spatial resolution of DWI, small lesions (<10 mm) are not easily detectable, thus increasing the false-negatives. 155 This is of utmost importance, as many lesions may not be detected as early as with DCE-MRI and/or AB-MRI when performing only Research has focused on developing more robust DWI acquisition strategies such as readout segmented echo planar imaging (rsEPI) and reduced field-of-view (rFOV), as well as advanced reconstruction and postprocessing (correction and optimization) algorithms, to improve spatial resolution, image quality, and reduce artifacts. 150,152 In parallel, efforts to standardize DWI acquisition parameters and interpretation have recently been suggested for lesion classification.…”