High-temporal/high-spatial resolution breast magnetic resonance imaging improves diagnostic accuracy compared with standard breast magnetic resonance imaging in patients with high background parenchymal enhancement Journal Article
| Authors: | Eskreis-Winkler, S.; Sung, J. S.; Dixon, L.; Monga, N.; Jindal, R.; Simmons, A.; Thakur, S.; Sevilimedu, V.; Sutton, E.; Comstock, C.; Feigin, K.; Pinker, K. |
| Article Title: | High-temporal/high-spatial resolution breast magnetic resonance imaging improves diagnostic accuracy compared with standard breast magnetic resonance imaging in patients with high background parenchymal enhancement |
| Abstract: | PURPOSE: To compare breast magnetic resonance imaging (MRI) diagnostic performance using a standard high-spatial resolution protocol versus a simultaneous high-temporal/high-spatial resolution (HTHS) protocol in women with high levels of background parenchymal enhancement (BPE). MATERIALS AND METHODS: We conducted a retrospective study of contrast-enhanced breast MRIs performed at our institution before and after the introduction of the HTHS protocol. We compared diagnostic performance of the HTHS and standard protocol by comparing cancer detection rate (CDR) and positive predictive value of biopsy (PPV3) among women with high BPE (ie, marked or moderate). RESULTS: Among women with high BPE, the HTHS protocol demonstrated increased CDR (23.6 per 1,000 patients v 7.9 per 1,000 patients; P = 0. 013) and increased PPV3 (16.0% v 6.3%; P = .021) compared with the standard protocol. This corresponded to a 9.8% (95% CI, 1.29 to 18.3) decrease in the proportion of unnecessary biopsies among high-BPE patients and an additional cancer yield of 15.7 per 1,000 patients (95% CI, 1.3 to 18.3). CONCLUSION: Among women with high BPE, HTHS MRI improved diagnostic performance, leading to an additional cancer yield of 15.7 cancers per 1,000 women and concomitantly decreasing unnecessary biopsies by 9.8%. A multisite prospective trial is warranted to confirm these findings and to pave the way for more widespread clinical implementation. |
| Keywords: | adult; controlled study; major clinical study; nuclear magnetic resonance imaging; cancer diagnosis; diagnostic accuracy; prospective study; retrospective study; diagnostic value; contrast enhancement; predictive value; breast magnetic resonance imaging; diagnostic test accuracy study; human; female; article |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 41 |
| Issue: | 30 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2023-10-20 |
| Start Page: | 4747 |
| End Page: | 4755 |
| Language: | English |
| DOI: | 10.1200/jco.22.00635 |
| PUBMED: | 37561962 |
| PROVIDER: | scopus |
| PMCID: | PMC10602549 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF. Corresponding MSK author is Sarah Eskreis-Winkler -- Source: Scopus |
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