Abbreviated protocol for breast MRI: Are multiple sequences needed for cancer detection? Journal Article

Authors: Mango, V. L.; Morris, E. A.; David Dershaw, D.; Abramson, A.; Fry, C.; Moskowitz, C. S.; Hughes, M.; Kaplan, J.; Jochelson, M. S.
Article Title: Abbreviated protocol for breast MRI: Are multiple sequences needed for cancer detection?
Abstract: Objective: To evaluate the ability of an abbreviated breast magnetic resonance imaging (MRI) protocol, consisting of a precontrast T1 weighted (T1W) image and single early post-contrast T1W image, to detect breast carcinoma. Materials and methods: A HIPAA compliant Institutional Review Board approved review of 100 consecutive breast MRI examinations in patients with biopsy proven unicentric breast carcinoma. 79% were invasive carcinomas and 21% were ductal carcinoma in situ. Four experienced breast radiologists, blinded to carcinoma location, history and prior examinations, assessed the abbreviated protocol evaluating only the first post-contrast T1W image, post-processed subtracted first post-contrast and subtraction maximum intensity projection images. Detection and localization of tumor were compared to the standard full diagnostic examination consisting of 13 pre-contrast, post-contrast and post-processed sequences. Results: All 100 cancers were visualized on initial reading of the abbreviated protocol by at least one reader. The mean sensitivity for each sequence was 96% for the first post-contrast sequence, 96% for the first post-contrast subtraction sequence and 93% for the subtraction MIP sequence. Within each sequence, there was no significant difference between the sensitivities among the 4 readers (p = 0.471, p = 0.656, p = 0.139). Mean interpretation time was 44 s (range 11-167 s). The abbreviated imaging protocol could be performed in approximately 10-15 min, compared to 30-40 min for the standard protocol. Conclusion: An abbreviated breast MRI protocol allows detection of breast carcinoma. One pre and post-contrast T1W sequence may be adequate for detecting breast carcinoma. These results support the possibility of refining breast MRI screening protocols.
Keywords: adult; human tissue; aged; nuclear magnetic resonance imaging; cancer diagnosis; tumor volume; cancer screening; breast carcinoma; cancer size; invasive carcinoma; intraductal carcinoma; breast biopsy; breast mri; nuclear magnetic resonance scanner; breast cancer screening; human; female; article; abbreviated mri protocol
Journal Title: European Journal of Radiology
Volume: 84
Issue: 1
ISSN: 0720-048X
Publisher: Elsevier Ireland Ltd.  
Date Published: 2015-01-01
Start Page: 65
End Page: 70
Language: English
DOI: 10.1016/j.ejrad.2014.10.004
PROVIDER: scopus
PUBMED: 25454099
Notes: Export Date: 2 January 2015 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Jennifer Kaplan
    24 Kaplan
  2. Mary Catherine Hughes
    3 Hughes
  3. D David Dershaw
    177 Dershaw
  4. Elizabeth A Morris
    247 Morris
  5. Chaya S. Moskowitz
    173 Moskowitz
  6. Victoria Lee Mango
    18 Mango
  7. Charles Walker Fry
    3 Fry