Added value of ultrafast sequence in abbreviated breast MRI surveillance in women with a personal history of breast cancer: A multireader study.

Abstract

PURPOSE:

To evaluate the added value of ultrafast MRI in abbreviated breast MRI (AB-MRI) surveillance in women with a personal history of breast cancer (PHBC).

METHOD:

Between September 2017 and November 2019, consecutive postoperative surveillance AB-MRIs with ultrafast MRIs (20 images with a 4.0-second temporal resolution using 4D time-resolved angiography with keyhole technique) were retrospectively collected. Four blinded radiologists independently classified the Breast Imaging Reporting and Data System (BI-RADS) category for AB-MRI alone versus the combined protocol (AB-MRI + ultrafast MRI). Readers were recommended to change BI-RADS category according to the time to enhancement cut-off of 12 s in ultrafast MRI. McNemar test and generalized estimation equation model were used to compare the diagnostic performances.

RESULTS:

A total of 867 MRI examinations in 867 women (mean age ± standard deviation, 51 years ± 8) were evaluated. The sensitivity of both protocols among all readers was the same, at 90% (9/10). Addition of ultrafast MRI improved the specificity (a mean of 95.3% vs. 88.6 %, p < 0.001 for all readers) and positive predictive value 1 (PPV1) (a mean of 21% vs. 10%, p < 0.001 for all readers) compared to AB-MRI alone. Downgrading BI-RADS category 3 to 2 in four readers in a mean of 6.7% (57 of 857) of negative or benign findings was the main reason for the improved specificity and PPV1.

CONCLUSION:

Addition of ultrafast MRI to AB-MRI improved the specificity and PPV1 by reducing unnecessary short-term follow-ups without compromising sensitivity in postoperative surveillance.

• Authors: Eun Sil Kim, Nariya Cho, Soo-Yeon Kim, Su Hyun Lee, Jung Min Chang, Yeon Soo Kim, Su Min Ha, Woo Kyung Moon
• Journal: European journal of radiology (Eur J Radiol) Vol. 151 Pg. 110322 (Jun 2022) ISSN: 1872-7727 [Electronic] Ireland
• PMID: 35462271 (Publication Type: Journal Article)
• Copyright: Copyright © 2022. Published by Elsevier B.V.

Chemical References

• Contrast Media

Topics

• Breast Neoplasms (diagnostic imaging)
• Contrast Media
• Female
• Humans
• Magnetic Resonance Imaging (methods)
• Radiologists
• Retrospective Studies
• Sensitivity and Specificity