School of Medicine and Health Sciences Poster Presentations

Title

Comparing Abbreviated Versus Full Breast MRI Protocol for Breast Cancer Screening

Document Type

Poster

Abstract Category

Cancer/Oncology

Keywords

Breast imaging, MRI, Breast cancer, High-risk screening, Abbreviated MRI

Publication Date

Spring 5-1-2019

Abstract

Background: MRI is the most sensitive imaging modality currently available for the detection of breast cancer, but it is costly, time consuming, and uncomfortable for the patient. A full breast MRI protocol requires 45 to 60 minutes and results in several thousand images for interpretation. Recent studies have suggested that fewer imaging sequences, termed an abbreviated protocol, may be sufficient for interpretation. Resulting in a more cost-effective examination with an improved patient experience. The lower cost and shorter time would make MRI a more available and cost-effective examination, particularly in the screening or surveillance environment. Purpose: The purpose of this study was to compare an abbreviated and a full breast MRI protocol for screening high-risk women, comparing the average reading time for the two protocols and their impact on patient recall rates for additional evaluation following the MRI examination. Methods: An abbreviated imaging protocol using five of the twelve traditional sequence types was tested in this retrospective study. The study population consisted of patients deemed high-risk between January 1, 2013 and December 31, 2016. Radiologists with a specialization in breast imaging reviewed patient history and prior images (mammograms, ultrasounds, etc.), then reviewed the abbreviated protocol images and recorded an interpretation. Timing of the abbreviated protocol consisted only of the review of the abbreviated MRI sequences and did not include dictation or report generation. Following a 30-day washout period, the radiologist interpreted the entire full protocol with their interpretations and timing again recorded. Results: Three metrics were obtained and compared for the 2 different protocols: accuracy of cancer detection, reading time, and callback rate. Preliminary data of 217 patient were classified using the ‘Breast Imaging Reporting and Data System’ (BIRADS). There were no significant changes in the callback rate nor in the diagnostic interpretations. On average, the interpretation time was 67.94 seconds for the abbreviated protocol compared to 102.05 seconds for the full protocol, with an average difference of 33.90 ± 5.7 seconds per patient. Our study revealed no difference in cancer detection, with all cancers found using both protocols. Conclusions: We conclude that future use of an abbreviated MRI protocol can increase breast MRI accessibility by reducing the amount of imaging time with improved cost effectiveness, patient satisfaction, and efficiency of the radiologist, with no reduction in cancer detection. Further studies across the country would aid in diversifying the patient cohort and develop a wider representation of the general population.

Open Access

1

Comments

Presented at Research Days 2019.

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Comparing Abbreviated Versus Full Breast MRI Protocol for Breast Cancer Screening

Background: MRI is the most sensitive imaging modality currently available for the detection of breast cancer, but it is costly, time consuming, and uncomfortable for the patient. A full breast MRI protocol requires 45 to 60 minutes and results in several thousand images for interpretation. Recent studies have suggested that fewer imaging sequences, termed an abbreviated protocol, may be sufficient for interpretation. Resulting in a more cost-effective examination with an improved patient experience. The lower cost and shorter time would make MRI a more available and cost-effective examination, particularly in the screening or surveillance environment. Purpose: The purpose of this study was to compare an abbreviated and a full breast MRI protocol for screening high-risk women, comparing the average reading time for the two protocols and their impact on patient recall rates for additional evaluation following the MRI examination. Methods: An abbreviated imaging protocol using five of the twelve traditional sequence types was tested in this retrospective study. The study population consisted of patients deemed high-risk between January 1, 2013 and December 31, 2016. Radiologists with a specialization in breast imaging reviewed patient history and prior images (mammograms, ultrasounds, etc.), then reviewed the abbreviated protocol images and recorded an interpretation. Timing of the abbreviated protocol consisted only of the review of the abbreviated MRI sequences and did not include dictation or report generation. Following a 30-day washout period, the radiologist interpreted the entire full protocol with their interpretations and timing again recorded. Results: Three metrics were obtained and compared for the 2 different protocols: accuracy of cancer detection, reading time, and callback rate. Preliminary data of 217 patient were classified using the ‘Breast Imaging Reporting and Data System’ (BIRADS). There were no significant changes in the callback rate nor in the diagnostic interpretations. On average, the interpretation time was 67.94 seconds for the abbreviated protocol compared to 102.05 seconds for the full protocol, with an average difference of 33.90 ± 5.7 seconds per patient. Our study revealed no difference in cancer detection, with all cancers found using both protocols. Conclusions: We conclude that future use of an abbreviated MRI protocol can increase breast MRI accessibility by reducing the amount of imaging time with improved cost effectiveness, patient satisfaction, and efficiency of the radiologist, with no reduction in cancer detection. Further studies across the country would aid in diversifying the patient cohort and develop a wider representation of the general population.