Can the abbreviated MRI protocol replace the standard full protocol in the detection and characterization of breast non-mass enhancement?

Abstract

BackgroundBreast MRI full diagnostic protocol (FDP) showed great value in detecting and characterizing non-mass enhancement (NME); however, it is costly and time-consuming. MRI abbreviated protocol (AP) showed comparable accuracy to FDP in various indications but has not been specifically tested in NME. Our study purpose is to assess the accuracy of the AP in the detection and characterization of breast NME in comparison with the FDP and to perform time analysis of the AP.MethodsPatients who demonstrated NME in dynamic contrast-enhanced MRI were included to be assessed using AP and FDP. Image analysis was performed blindly and independently. Firstly, reconstructed images from the pre- and first post-contrast T1WI (first maximum intensity projection and subtraction) were made available as AP. Later, the time/signal intensity curve and remaining images of the FDP were added to the assessment. Both protocols were compared regarding acquisition time, interpretation time, BI-RADS scores and accuracy in the detection and characterization of NME in correlation to histopathology and/or follow-up. Validity statistics, Cohen-Kappa and ROC curve were used.ResultsFifty-nine NME lesions were identified. AP acquisition and interpretation times were significantly shorter than those of the FDP (3.3 vs. 35 min) and (45 “25–75 s” vs. 108 “80–150 s”) (P < 0.001), respectively. There was almost perfect agreement between the two protocols in the BIRADS grading of NME (k = 0.950, P < 0.001). In ROC curve analysis, the FDP was insignificantly more accurate than the AP (84.8% vs. 81.4%, P = 0.144).ConclusionsBreast MRI–AP is comparable to the FDP in the detection and characterization of breast NME with advantageous time saving.