Aims and objectives
Breast cancer is second to lung cancer as the leading cause of death among women in the United States.
Over 40,000 women were estimated to die of breast cancer in 2016.
[1] Since the 5-year survival rates for breast cancer depend on the stage at the time of diagnosis (figure 1) Fig. 1 ,
hence early detection is the key to improved survival.
[2]
Breast magnetic resonance imaging (MRI) offers the highest known sensitivity for diagnosing and detecting abnormalities in the breast.
[3], however it...
Methods and materials
Patient population:
A retrospective review of 143 breast MRI examinations performed at our institution in the last three years and present at the department workstation,
was performed by two radiologists (with 7 and 5 years of experience in breast imaging).
Two sets of images were reviewed separately and blindly.
The first set consisted of the proposed abbreviated protocol consisting of the first post-contrast subtracted images [FAST] and its maximum-intensity projection [MIP] (figure 2) Fig. 2 .
The second set consisted of the full diagnostic protocol...
Results
Review of the abbreviated protocol revealed 15 malignant lesions (figure 3) Fig. 3 and 66 benign lesions (figure 4) with perfect inter-rater agreement on the malignant lesions.
Review of the full protocol revealed 15 malignant lesions and 68 benign lesions and 68 normal scans.
Significant reduction of the scan acquisition time was noted when comparing the full diagnostic protocol to the suggested abbreviated protocol (about 83% reduction in time).
The reporting time also showed significant reduction with the detection of lesions in the abbreviated protocol...
Conclusion
The purpose of this study was to evaluate an abbreviated breast MRI protocol formed of the first subtracted post-contrast image and its MIP as an alternative to the full diagnostic protocol in screening for malignancy in order to make breast MRI a cost-effective tool since it has the highest sensitivity for cancer detection.
The proposed abbreviated protocol was able to detect all the malignant lesions in the study with a PPV of 100% and with 83% reduction in scan time as well as significant reduction...
References
American Cancer Society website.
Cancer facts and figures 2016.
www.cancer.org/acs/groups/content/@research/documents/document/acspc 047079.pdf.
Accessed September 18,
2016
Noone AM,
Howlader N,
Krapcho M,
Miller D,
Brest A,
Yu M,
Ruhl J,
Tatalovich Z,
Mariotto A,
Lewis DR,
Chen HS,
Feuer EJ,
Cronin KA (eds).
SEER Cancer Statistics Review,
1975-2015,
National Cancer Institute.
Bethesda,
MD,https://seer.cancer.gov/csr/1975_2015/,
based on November 2017 SEER data submission,
posted to the SEER web site,
April 2018.
O’Flynn EA,
Ledger AE,
DeSouza NM. Alternative Screening for Dense Breasts: MRI.
AJR,
February 2015,
204: W141–W149
Sardanelli...