Highlights
- •Novel breast MRI protocols include abbreviated DCE MRI, Ultrafast breast MRI, and DWI.
- •Abbreviated MRI protocols have shown similar sensitivities and specificities to a full MRI protocol.
- •Ultrafast DCE MRI significantly reduced acquisition and reading times compared to a full MRI protocol.
- •Ultrafast DCE MRI showed increased specificity and similar sensitivity compared to a full MRI protocol.
- •DWI provided additional non-invasive characterization of breast tumors compared to DCE MRI.
- •The Fast MRI screening program has potential to increase the number of breast cancers detected.
Abstract
Objective
The manuscript discusses landmark studies using abbreviated MRI for breast cancer
screening. This includes abbreviated dynamic contrast enhanced MRI and diffusion weighted
imaging. Our institutional experience with abbreviated MR protocol for breast cancer
screening is also described.
Conclusion
Abbreviated MRI protocols were found to demonstrate value for screening of breast
cancer. It has been shown that abbreviated protocol MRI provides similar diagnostic
sensitivities to full protocol MRI for breast cancer in women with increased lifetime
risk. Our institutional abbreviated MRI protocol for breast cancer offers improved
time and workflow efficiencies and has the potential to increase the number of breast
cancers detected and the detection of pathologically relevant invasive breast cancer
at earlier stages.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Clinical ImagingAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Cancer statistics, 2018.CA Cancer J Clin. 2018; 68: 7-30https://doi.org/10.3322/caac.21442
- American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography.CA Cancer J Clin. 2007; 57: 75-89
- Screening for breast Cancer: U.S. preventive services task force recommendation statement.Ann Intern Med. 2016; 164: 279-296https://doi.org/10.7326/M15-2886
- Breast cancer screening for women at average risk: 2015 guideline update from the American Cancer Society.JAMA. 2015; 314: 1599-1614https://doi.org/10.1001/jama.2015.12783
- Comparison of the performance of screening mammography, physical examination, and breast US and evaluation of factors that influence them: an analysis of 27,825 patient evaluations.Radiology. 2002; 225: 165-175
- Breast density as a predictor of mammographic detection: comparison of interval- and screen-detected cancers. JNCI.J Natl Cancer Inst. 2000; 92: 1081-1087
- Breast cancer detection using automated whole breast ultrasound and mammography in radiographically dense breasts.Eur Radiol. 2010; 20: 734-742https://doi.org/10.1007/s00330-009-1588-y
- Breast-cancer tumor size, overdiagnosis, and mammography screening effectiveness.N Engl J Med. 2016; 375: 1438-1447
- Abbreviated breast MRI for screening women with dense breast: The EA1141 Trial.Br J Radiol. 2017; (20170441)https://doi.org/10.1259/bjr.20170441
- Magnetic resonance imaging in breast cancer: a literature review and future perspectives.World J Clin Oncol. 2014; 5: 61-70https://doi.org/10.5306/wjco.v5.i2.61
- Meta-analysis of MR imaging in the diagnosis of breast lesions.Radiology. 2008; 246: 116-124
- Mammography, breast ultrasound, and magnetic resonance imaging for surveillance of women at high familial risk for breast cancer.J Clin Oncol. 2005; 23: 8469-8476
- Dynamic contrast-enhanced MRI in the diagnosis and management of breast cancer.NMR Biomed. 2009; 22: 28-39https://doi.org/10.1002/nbm.1273
- Preoperative assessment of breast cancer: sonography versus MR imaging.AJR Am J Roentgenol. 2002; 179: 1493-1501
- Patterns of breast magnetic resonance imaging use in community practice.JAMA Intern Med. 2014; 174: 125-132
- Cost-effectiveness of alternating magnetic resonance imaging and digital mammography screening in BRCA1 and BRCA2 gene mutation carriers..Cancer. 2013; 119: 1266-1276https://doi.org/10.1002/cncr.27864
- An abbreviated protocol for high-risk screening breast magnetic resonance imaging: impact on performance metrics and BI-RADS assessment.Acad Radiol. 2017; 24: 1132-1138https://doi.org/10.1016/j.acra.2017.03.014
- Feasibility and potential limitations of abbreviated breast MRI: an observer study using an enriched cohort.Breast Cancer. 2017; 24: 411-419
- Abbreviated MRI protocols for detecting breast cancer in women with dense breasts.Korean J Radiol. 2017; 18: 470-475
- Application of abbreviated protocol of magnetic resonance imaging for breast cancer screening in dense breast tissue.Acad Radiol. 2017; 24: 316-320
- Abbreviated combined MR protocol: a new faster strategy for characterizing breast lesions.Clin Breast Cancer. 2016; 16: 207-211
- Abbreviated screening protocol for breast MRI: a feasibility study.Acad Radiol. 2015; 22: 1157-1162
- Abbreviated breast magnetic resonance imaging (MRI): first postcontrast subtracted images and maximum-intensity projection—a novel approach to breast cancer screening with MRI.J Clin Oncol. 2014; 32: 2304-2310https://doi.org/10.1200/JCO.2013.52.5386
- Systematic development of an abbreviated protocol for screening breast magnetic resonance imaging.Breast Cancer Res Treat. 2017; 162: 283-295
- An abbreviated protocol for high-risk screening breast MRI saves time and resources.J Am Coll Radiol. 2016; 13: R74-R80
- Evaluation of a known breast cancer using an abbreviated breast MRI protocol: correlation of imaging characteristics and pathology with lesion detection and conspicuity.Eur J Radiol. 2016; 85: 815-823
- Abbreviated protocol for breast MRI: are multiple sequences needed for cancer detection?.Eur J Radiol. 2015; 84: 65-70
- Apparent diffusion coefficient values for discriminating benign and malignant breast MRI lesions: effects of lesion type and size.AJR Am J Roentgenol. 2010 Jun; 194: 1664-1673
- Novel approach to contrast-enhanced breast magnetic resonance imaging for screening.Invest Radiol. 2014; 49: 579-585
- Multireader study on the diagnostic accuracy of ultrafast breast magnetic resonance imaging for breast cancer screening.Invest Radiol. 2018; 53: 579-586
- Kinetic analysis of benign and malignant breast lesions with ultrafast dynamic contrast-enhanced MRI: comparison with standard kinetic assessment.Am J Roentgenol. 2016; 207: 1159-1166
- Performance of DWI as a rapid unenhanced technique for detecting mammographically occult breast cancer in elevated-risk women with dense breasts.Am J Roentgenol. 2016; 207: 205-216
What to Expect n.d. https://stanfordhealthcare.org/medical-tests/m/mri/what-to-expect.html [accessed June 27, 2019].
Magnetic Resonance Imaging - Special Subjects - Merck Manuals Professional Edition. Merck Manuals Professional Edition n.d. https://www.merckmanuals.com/professional/special-subjects/principles-of-radiologic-imaging/magnetic-resonance-imaging [accessed June 27, 2019].
- Radiologic and pathologic findings in breast tumors with high signal intensity on T2-weighted MR images.Radiographics. 2010; 30: 533-548https://doi.org/10.1148/rg.302095044
- Dynamic breast MR imaging: are signal intensity time course data useful for differential diagnosis of enhancing lesions?.Radiology. 1999; 211: 101-110https://doi.org/10.1148/radiology.211.1.r99ap38101
- Supplemental breast MR imaging screening of women with average risk of breast cancer.Radiology. 2017; 283: 361-370
- Breast MRI: guidelines from the European Society of Breast Imaging.Eur Radiol. 2008; 18: 1307-1318
- Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging.Radiology. 1988 Aug; 168: 497-505
- Diffusion weighted MRI of the breast: protocol optimization, guidelines for interpretation, and potential clinical applications.Magn Reson Imaging Clin N Am. 2013; 21: 601-624
- ADC mapping of benign and malignant breast tumors.Magn Reson Med Sci. 2005; 4: 35-42
- Characterization of ductal carcinoma in situ on diffusion weighted breast MRI.Eur Radiol. 2011 Sep; 21: 2011-2019
- Sensitivity and specificity of unenhanced MR mammography (DWI combined with T2-weighted TSE imaging, ueMRM) for the differentiation of mass lesions.Eur Radiol. 2010 May; 20: 1101-1110
- Meta-analysis of quantitative diffusion-weighted MR imaging in the differential diagnosis of breast lesions.BMC Cancer. 2010; 10: 693https://doi.org/10.1186/1471-2407-10-693
- Diffusion-weighted imaging with apparent diffusion coefficient mapping for breast cancer detection as a stand-alone parameter: comparison with dynamic contrast-enhanced and multiparametric magnetic resonance imaging.Invest Radiol. 2018; 53: 587-595
- Accuracy of diffusion kurtosis imaging in characterization of breast lesions.Br J Radiol. 2017; 90: 20160873https://doi.org/10.1259/bjr.20160873
- Contribution of diffusion-weighted imaging to dynamic contrast-enhanced MRI in the characterization of breast tumors.AJR Am J Roentgenol. 2011; 196: 210-217
- Radiomics based on adapted diffusion kurtosis imaging helps to clarify most mammographic findings suspicious for cancer.Radiology. 2018; 287: 761-770
- Breast cancer: diffusion kurtosis MR imaging-diagnostic accuracy and correlation with clinical-pathologic factors.Radiology. 2015; 277: 46-55
- Evidence-based guideline: the role of diffusion and perfusion MRI for the diagnosis of acute ischemic stroke: report of the therapeutics and technology assessment Subcommittee of the American Academy of Neurology.Neurology. 2010; 75: 177-185
- Accuracy of diffusion-weighted imaging in the diagnosis of stroke in patients with suspected cerebral infarct.Stroke. 2013; 44: 1169-1171
- Sensitivity of diffusion- and perfusion-weighted imaging for diagnosing acute ischemic stroke is 97.5%.Stroke. 2015; 46: 98-101
- Detection of breast cancer with addition of annual screening ultrasound or a single screening MRI to mammography in women with elevated breast cancer risk.JAMA. 2012; 307: 1394-1404https://doi.org/10.1001/jama.2012.388
- Breast cancer screening using tomosynthesis in combination with digital mammography.JAMA. 2014; 311: 2499-2507
- EA1141—educational materials.(Available from:)
- Abbreviated MRI of the breast: does it provide value?.J Magn Reson Imaging. 2019; 49: e85-100
- Preliminary Results of a Simplified Breast MRI Protocol to Characterize Breast Lesions: Comparison with a Full Diagnostic Protocol and a Review of the Current Literature.Acad Radiol. 2017; 24: 1387-1394
Article info
Publication history
Published online: November 30, 2019
Accepted:
October 29,
2019
Received in revised form:
October 14,
2019
Received:
April 8,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
