Abbreviated screening protocol for breast MRI: a feasibility study

• Published in: Academic radiology Vol. 22; no. 9; p. 1157
• Main Authors: Grimm, Lars J, Soo, Mary S, Yoon, Sora, Kim, Connie, Ghate, Sujata V, Johnson, Karen S
• Format: Journal Article
• Language: English
• Published: United States 01.09.2015
• Subjects: Biopsy, Large-Core Needle - methods; Breast - diagnostic imaging; Breast Cyst - diagnostic imaging; Breast Neoplasms - diagnostic imaging; Carcinoma, Ductal, Breast - diagnostic imaging; Carcinoma, Intraductal, Noninfiltrating - diagnostic imaging; Carcinoma, Lobular - diagnostic imaging; Clinical Protocols; Cohort Studies; Contrast Media - administration & dosage; Feasibility Studies; Female; Gadolinium DTPA - administration & dosage; Humans; Magnetic Resonance Imaging - methods; Magnetic Resonance Imaging - statistics & numerical data; Mass Screening - methods; Mass Screening - statistics & numerical data; Meglumine - administration & dosage; Meglumine - analogs & derivatives; Middle Aged; Organometallic Compounds - administration & dosage; Pilot Projects; Sensitivity and Specificity; Time Factors; abbreviated protocol; specificity; screening; sensitivity; Magnetic resonance imaging
• ISSN: 1878-4046
• DOI: 10.1016/j.acra.2015.06.004

To compare the performance of two shortened breast magnetic resonance imaging (MRI) protocols to a standard MRI protocol for breast cancer screening. In this Health Insurance Portability and Accountability Act compliant, institutional review board-approved pilot study, three fellowship-trained breast imagers evaluated 48 breast MRIs (24 normal, 12 benign, and 12 malignant) selected from a high-risk screening population. MRIs were presented in three viewing protocols, and a final Breast Imaging-Reporting and Data System assessment was recorded for each case. The first shortened protocol (abbreviated 1) included only fat-saturated precontrast T2-weighted, precontrast T1-weighted, and first pass T1-weighted postcontrast sequences. The second shortened protocol (abbreviated 2) included the abbreviated 1 protocol plus the second pass T1-weighted postcontrast sequence. The third protocol (full), reviewed after a 1-month waiting period, included a nonfat-saturated T1-weighted sequence, fat-saturated T2-weighted, precontrast T1-weighted, and three or four dynamic postcontrast sequences. Interpretation times were recorded for the abbreviated 1 and full protocols. Sensitivity and specificity were compared via a chi-squared analysis. This pilot study was designed to detect a 10% difference in sensitivity with a power of 0.8. There was no significant difference in sensitivity between the abbreviated 1 (86%; P = .22) or abbreviated 2 (89%; P = .38) protocols and the full protocol (95%). There was no significant difference in specificity between the abbreviated 1 (52%; P = 1) or abbreviated 2 (45%; P = .34) protocols and the full protocol (52%). The abbreviated 1 and full protocol interpretation times were similar (2.98 vs. 3.56 minutes). In this pilot study, reader performance comparing two shortened breast MRI protocols to a standard protocol in a screening cohort were similar, suggesting that a shortened breast MRI protocol may be clinically useful, warranting further investigation.