A study of a breast MRI abbreviated protocol for breast neoplasm screening / 中华健康管理学杂志

ABSTRACT

Objective:This study aimed to evaluate the performance of breast magnetic resonance imaging (MRI) abbreviated protocol (AP) in diagnosing breast neoplasms.Methods:We retrospectively analyzed the data of 86 patients who had undergone breast MRI examinations and compared the images using an AP and full diagnostic protocol (FDP). The AP consisted of axial T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and four-phase dynamic enhancement sequences. The FDP consisted of sagittal T2WI, axial T2WI, T1-weighted imaging, DWI, and seven-phase dynamic enhancement sequences. All the images were analyzed using the Breast Imaging Reporting and Data System (BI-RADS). The consistencies between the different protocols were then calculated. With the pathological diagnosis as the gold standard, the diagnostic capabilities of the two protocols were compared.Result:Two radiologists analyzed the AP and FDP images. The consistencies in the BI-RADS between the different protocols were 0.856 and 0.900, and those in time-signal intensity curves (TICs) were 0.822 and 0.922. Within the same protocol, the consistencies in the BI-RADS between different radiologists were 0.744 and 0.822, and those in TICs were 0.889 and 0.878. No significant differences were found ( P>0.05). In terms of diagnosing malignant neoplasms using the BI-RADS, the sensitivities of the AP and FDP were 89.8% (95 %CI 0.785-0.958) and 91.5% (95 %CI 0.806-0.968), respectively; their specificities were 71.0% (95 %CI 0.518-0.851) and 77.4% (95 %CI 0.585-0.897), respectively; and the areas under the curves (AUCs) were 0.804 (95 %CI 0.698-0.910) and 0.845 (95 %CI 0.748-0.941), respectively. Diagnosing malignant neoplasms using TICs, the sensitivities of the AP and FDP were 86.4% (95 %CI 0.745-0.936) and 89.8% (95 %CI 0.785-0.958), respectively; their specificities were 61.3% (95 %CI 0.423-0.776) and 67.7% (95 %CI 0.485-0.827), respectively, and the AUCs were 0.739 (95 %CI 0.623-0.855) and 0.788 (95 %CI 0.679-0.897), respectively. There was no significant difference between the AP and FDP ( P>0.05). The MRI acquisition times of the AP and FDP were 11.97±0.94 min and 21.25±1.12 min, respectively, with a significant difference ( P<0.001). The average reading time was reduced by 13.5% using the AP compared with that using the FDP. Conclusion:Compared with the FDP, the AP reduced the acquisition time and maintained the diagnostic accuracy, which can be used as an improved pattern for MRI screening in high-risk populations of breast neoplasms.