Abbreviated breast dynamic contrast-enhanced MR imaging for lesion detection and characterization: the experience of an Italian oncologic center

Abstract

Abbreviated approach to breast MRI examination reduces the image acquisition and the reading time associated with MR substantially without influencing the diagnostic accuracy (high sensitivity and NPV >99.5%). AP could translate into cost-savings and could enable a higher number of examinations within the same MR session.

Abbreviated MRI of the Breast: Does It Provide Value?

“…A shared finding in almost all abbreviated MRI studies is that the cancers detected were mainly early‐stage invasive cancers, with percentages ranging from 64–97%. The ductal carcinomas in situ (DCIS) detected with abbreviated MRI screening were predominately intermediate or high‐grade DCIS . This is in good agreement with a recent study by Sung et al, who found that in women at high breast cancer risk who underwent screening with both mammography and MRI, invasive cancers were more likely to be detected with MRI, while most cancers found with mammography were DCIS .…”

“…Whereas the above‐mentioned studies included T 2 ‐weighted or STIR sequences in their protocols, others solely relied on DCE‐MRI. Petrillo et al investigated an abbreviated protocol including one precontrast T 1 ‐weighted and the first postcontrast T 1 ‐weighted series in 508 patients, yielding similar results with comparable diagnostic accuracy of the abbreviated and the full protocols . Romeo et al used a protocol that included localizer, precontrast, and three timepoint postcontrast sequences to enable the assessment of the delayed enhancement.…”

“…In efforts to overcome these limitations and facilitate increased access to screening breast MRI, Kuhl et al initially introduced an abbreviated breast MRI protocol for screening that substantially shortened examination and reading times; at the same time, this protocol maintained a diagnostic accuracy equivalent to a full diagnostic protocol . Thereafter, several other studies have investigated different abbreviated and high‐temporal resolution MRI protocols for breast cancer diagnosis and screening, with similar results . This review will provide an overview of the current published literature on abbreviated breast MRI and its potential clinical applications and challenges.…”

Visibility of mammographically occult breast cancer on diffusion-weighted MRI versus ultrasound

“…However, high cost and lengthy exam time contributes to limited DCE-MRI utilization, even among women who meet criteria for high-risk screening (40,41). To decrease scan time, abbreviated MRI protocols have been explored with promising preliminary results (42,43). However, both DCE and abbreviated MRI protocols are dependent on the use of intravenous gadolinium, which accounts for additional cost and time associated with obtaining intravenous access and the gadolinium agent itself.…”

Abbreviated MRI Protocols in Breast Cancer Diagnostics

“…Commonly, contrast‐enhanced abbreviated breast MRI protocols consist of a localizer and a native as well as a single early postcontrast T 1 ‐weighted sequence . By subtracting the native from the enhanced scan, a subtraction mask is calculated that solely displays contrast‐enhancing areas .…”