Short first-pass MRI of the breast

Fischer, Uwe; Korthauer, Annette; Baum, Friedemann; Luftner-Nagel, Susanne; Heyden, D. von; Marten-Engelke, K.

doi:10.1258/ar.2012.110638

Cited by 20 publications

(22 citation statements)

References 4 publications

(8 reference statements)

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“…To enable wider use of breast MRI and improve cost‐effectiveness, the use of shorter and less costly MRI protocols is mandatory. The concept of abbreviated breast MRI was introduced to enable this, reducing the acquisition time to 3 minutes and making reading much faster. Many studies evaluating this concept have been published in recent years, showing that abbreviated protocols provide virtually equal cancer detection performance compared with more extended multiparametric protocols .…”

Section: Future Perspectivesmentioning

confidence: 99%

Contrast‐enhanced MRI for breast cancer screening

Mann

Kuhl²,

Moy

2019

Magnetic Resonance Imaging

227

154

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Multiple studies in the first decade of the 21st century have established contrast‐enhanced breast MRI as a screening modality for women with a hereditary or familial increased risk for the development of breast cancer. In recent studies, in women with various risk profiles, the sensitivity ranges between 81% and 100%, which is approximately twice as high as the sensitivity of mammography. The specificity increases in follow‐up rounds to around 97%, with positive predictive values for biopsy in the same range as for mammography. MRI preferentially detects the more aggressive/invasive types of breast cancer, but has a higher sensitivity than mammography for any type of cancer. This performance implies that in women screened with breast MRI, all other examinations must be regarded as supplemental. Mammography may yield ~5% additional cancers, mostly ductal carcinoma in situ, while slightly decreasing specificity and increasing the costs. Ultrasound has no supplemental value when MRI is used. Evidence is mounting that in other groups of women the performance of MRI is likewise superior to more conventional screening techniques. Particularly in women with a personal history of breast cancer, the gain seems to be high, but also in women with a biopsy history of lobular carcinoma in situ and even women at average risk, similar results are reported. Initial outcome studies show that breast MRI detects cancer earlier, which induces a stage‐shift increasing the survival benefit of screening. Cost‐effectiveness is still an issue, particularly for women at lower risk. Since costs of the MRI scan itself are a driving factor, efforts to reduce these costs are essential. The use of abbreviated MRI protocols may enable more widespread use of breast MRI for screening. Level of Evidence: 1 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2019;50:377–390.

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Section: Future Perspectivesmentioning

confidence: 99%

Contrast‐enhanced MRI for breast cancer screening

Mann

Kuhl²,

Moy

2019

Magnetic Resonance Imaging

227

154

View full text Add to dashboard Cite

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“…Limitations for implementing MRI are high costs and availability. Costs and examination time can be reduced using ''short first-pass MRI'' technique (11). Neither HHUS nor MRI are realistic alternatives as adjuncts to mammography in population-based screening.…”

Section: Introductionmentioning

confidence: 99%

Interpretation of automated breast ultrasound (ABUS) with and without knowledge of mammography: a reader performance study

et al. 2015

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Background: Automated breast ultrasonography (ABUS) has the potential to be an important adjunct to mammography in women with dense breasts. Purpose: To compare reader performance and inter-observer variation of ABUS alone and in combination with mammography. Material and Methods: This retrospective study had ethical committee approval. All women gave written informed consent. One hundred and fourteen breasts in 90 women examined by digital mammography and ABUS were interpreted by five radiologists using BI-RADS categories. The 114 breasts included 38 cancers and 76 normal or benign findings. In the first reading session ABUS only was interpreted, and in the second ABUS plus digital mammography. Image interpretations were done without knowledge of clinical or imaging results. A consensus panel analyzed false negative and false positive interpretations. Reading time was recorded for one radiologist. AUC was used for performance measurement, and kappa statistic for inter-observer variability. Results: Mean size for cancers was 16.2 mm; area under the curve (AUC) values for ABUS alone and for combined reading were, respectively: reader A, 0.592-0.744; reader B, 0.740-0.947; reader, C 0.759-0.823; reader D, 0.670-0.688; reader E, 0.904-0.923; and all readers combined 0.730-0.823. The higher AUC for combined reading was statistically significant (P < 0.05) for reader B and for all readers. There was a considerable inter-observer variability. Observer agreement revealed following kappa values for ABUS alone and combined reading, respectively: reader A, 0. 22-0.30; reader B, 0.33-0.44; reader C, 0.32-0.39; reader D, 0.07-0.14; and reader E, 0.34-0.43. Shadowing from dense parenchyma was the most common cause of false positive ABUS interpretations. Mean interpretation time for a bilateral normal ABUS examination was 9 min. Conclusion: Observer agreement was higher and all radiologists improved diagnostic performance using combined ABUS and mammography interpretation. Combined reading should be standard if ABUS is implemented in screening of women with dense breasts.

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“…Eine Kombination von 3 Techniken in axialer Schnittführung, wahlweise T2w-oder Short-Tau-Inversion-Recovery(STIR)-Sequenzen, diffusionsgewichtete Bildgebung (DWI) in Echo-Planar-Imaging(EPI)-Technik sowie eine Gradientenecho(GRE)-Kontrastmitteldynamik ermöglichen eine sichere Detektion und akkurate Dignitätseinschätzung kontrastmittelaffiner Läsionen [17]. Varianten für verkürzte Protokolle sind die kontrastmittelfreie MRT durch Kombination von T2w/STIR-und DWI-Aufnahmen ([20]; blaues Rechteck) sowie die durch Fischer und Kollegen vorgeschlagene und durch Kuhl und Kollegen aufgenommene First-pass-Variante [18,19] klinische Erkrankung manifest werden [3]. Andererseits bleibt Brustkrebs auch nach Jahrzehnten der Mammographie-Früherkennung die bedeutendste tumorbedingte Todesursache bei Frauen.…”

Section: Gdunclassified

“…Ein durch Fischer und Kollegen vorgestellter Ansatz verzichtet auf alle Sequenzen außer die frühe kontrastmittelverstärkte Darstellung und ist so in der Lage, das Untersuchungsprotokoll auf etwa 3 min Messzeit zu verkürzen ( [18]; . Abb.…”

Section: Aktuelle Evidenz Und Entwicklung Verkürzter Protokolleunclassified

Kontrastmittelfreie Mamma-MRT

et al. 2019

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Die kontrastmittelverstärkte MRT der Mamma gilt als das sensitivste Verfahren zum Nachweis von Brustkrebs. Rezente Arbeiten belegen der Methode eine herausragende Sensitivität sowie einen sehr hohen negativen Vorhersagewert. Gegen eine breite Anwendung als Früherkennungsverfahren werden regelhaft hohe Kosten und die limitierte Verfügbarkeit der Methode angeführt. In den letzten Jahren wurden verkürzte Untersuchungsprotokolle vorgeschlagen, darunter auch die vollständige Substitution der Kontrastmittelgabe mittels Diffusionsbildgebung (DWI). Kann diese tatsächlich die kontrastmittelverstärkte MRT der Mamma ersetzen und somit u. a. als Screeningverfahren Anwendung finden?

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Short first-pass MRI of the breast

Abstract: To reduce examination time and costs, a new concept for MRI of the breast is presented. This short first-pass MRI takes 4-5 minutes and could be applied to approximately three-quarters of all women.

Cited by 20 publications

References 4 publications

Contrast‐enhanced MRI for breast cancer screening

Contrast‐enhanced MRI for breast cancer screening

Interpretation of automated breast ultrasound (ABUS) with and without knowledge of mammography: a reader performance study

Kontrastmittelfreie Mamma-MRT

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