Abbreviated Combined MR Protocol: A New Faster Strategy for Characterizing Breast Lesions

作者：Moschetta Marco^*; Telegrafo Michele; Rella Leonarda; Ianora Amato Antonio Stabile; Angelelli Giuseppe

来源：Clinical Breast Cancer, 2016, 16(3): 207-211.

DOI：10.1016/j.clbc.2016.02.008

• Abbreviated protocol
• Breast
• Breast lesions
• Carcinoma
• MRI

The use of an abbreviated magnetic resonance protocol consisting of 1 pre- and post-contrast T1 weighted sequence has been proposed in order to screen for breast cancer. We propose an abbreviated magnetic resonance protocol combining short TI inversion recovery, turbo spin echo-T2 sequences, a pre-contrast fat saturation T1 weighted, and a single intermediate post-contrast fat saturation T1 weighted sequence with the corresponding subtracted series. It represents a time-saving tool with the same diagnostic potential as the standard protocol for characterizing breast lesions.
Background: The use of an abbreviated magnetic resonance (MR) protocol has been recently proposed for cancer screening. The aim of our study is to evaluate the diagnostic accuracy of an abbreviated MR protocol combining short TI inversion recovery (STIR), turbo-spin-echo (TSE)-T2 sequences, a pre-contrast T1, and a single intermediate (3 minutes after contrast injection) post-contrast T1 sequence for characterizing breast lesions. Materials and Methods: A total of 470 patients underwent breast MR examination for screening, problem solving, or preoperative staging. Two experienced radiologists evaluated both standard and abbreviated protocols in consensus. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy for both protocols were calculated (with the histological findings and 6-month ultrasound follow-up as the reference standard) and compared with the McNemar test. The post-processing and interpretation times for the MR images were compared with the paired t test. Results: In 177 of 470 (38%) patients, the MR sequences detected 185 breast lesions. Standard and abbreviated protocols obtained sensitivity, specificity, diagnostic accuracy, PPV, and NPV values respectively of 92%, 92%, 92%, 68%, and 98% and of 89%, 91%, 91%, 64%, and 98% with no statistically significant difference (P < .0001). The mean post-processing and interpretation time were, respectively, 7 +/- 1 minutes and 6 +/- 3.2 minutes for the standard protocol and 1 +/- 1.2 minutes and 2 +/- 1.2 minutes for the abbreviated protocol, with a statistically significant difference (P < .01). Conclusion: An abbreviated combined MR protocol represents a time-saving tool for radiologists and patients with the same diagnostic potential as the standard protocol in patients undergoing breast MRI for screening, problem solving, or preoperative staging.

• 出版日期2016-6