Korean J Radiol.  2017 Jun;18(3):470-475. 10.3348/kjr.2017.18.3.470.

Abbreviated MRI Protocols for Detecting Breast Cancer in Women with Dense Breasts

• Chen SQ
• Huang M
• Shen YY
• Liu CL
• Xu CX

• KMID: 2427302
• DOI: http://doi.org/10.3348/kjr.2017.18.3.470

Abstract

OBJECTIVE
To evaluate the validity of two abbreviated protocols (AP) of MRI in breast cancer screening of dense breast tissue.
MATERIALS AND METHODS
This was a retrospective study in 356 participants with dense breast tissue and negative mammography results. The study was approved by the Nanjing Medical University Ethics Committee. Patients were imaged with a full diagnostic protocol (FDP) of MRI. Two APs (AP-1 consisting of the first post-contrast subtracted [FAST] and maximum-intensity projection [MIP] images, and AP-2 consisting of AP-1 combined with diffusion-weighted imaging [DWI]) and FDP images were analyzed separately, and the sensitivities and specificities of breast cancer detection were calculated.
RESULTS
Of the 356 women, 67 lesions were detected in 67 women (18.8%) by standard MR protocol, and histological examination revealed 14 malignant lesions and 53 benign lesions. The average interpretation time of AP-1 and AP-2 were 37 seconds and 54 seconds, respectively, while the average interpretation time of the FDP was 3 minutes and 25 seconds. The sensitivities of the AP-1, AP-2, and FDP were 92.9, 100, and 100%, respectively, and the specificities of the three MR protocols were 86.5, 95.0, and 96.8%, respectively. There was no significant difference among the three MR protocols in the diagnosis of breast cancer (p > 0.05). However, the specificity of AP-1 was significantly lower than that of AP-2 (p = 0.031) and FDP (p = 0.035), while there was no difference between AP-2 and FDP (p > 0.05).
CONCLUSION
The AP may be efficient in the breast cancer screening of dense breast tissue. FAST and MIP images combined with DWI of MRI are helpful to improve the specificity of breast cancer detection.

Keyword

Breast cancer; Magnetic resonance imaging; Abbreviated protocol; Diffusion-weighted imaging; Full diagnostic protocol; Screening; Dense breast

MeSH Terms

Adult
Breast/*diagnostic imaging
Breast Neoplasms/*diagnosis/diagnostic imaging/pathology
Female
Humans
Magnetic Resonance Imaging/*methods
Medical History Taking
Middle Aged
Retrospective Studies
Sensitivity and Specificity

Figure

• 

  Fig. 1 40-year-old woman with dense breast tissue.FAST (A) and MIP (B) of MRI show 11-mm homogeneously enhancing mass with circumscribed margins in left breast, which was classified as probably benign (BI-RADS 3). However, DWI (C) shows high signal (low signal on apparent diffusion coefficient), which was classified as malignant (BI-RADS 4), and biopsy yielded invasive ductal carcinoma.BI-RADS = Breast Imaging-Reporting and Data System, DWI = diffusion-weighted imaging, FAST = first post-contrast subtracted, MIP = maximum-intensity projection

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