Abbreviated Breast MRI Protocols in the Screening of High-Risk Females

Abstract

Background: Standard MRI breast more often than not, have lengthy protocols that make them much more expensive and time-consuming. And in spite its great potential for early detection of breast cancer, its wide application remains difficult. Aim of the Work: This study aims to decrease scanning time with the abbreviated MRI protocol and to achieve the same high level of cancer detection while providing greater efficiency, improved patient tolerance of the examination, and substantial resource savings. Patients and Methods: The study was conducted in the department of Radio-diagnosis – Ain Shams University Hospital in Cairo, Egypt. It was conducted on 30 female patients, their ages mainly comprising of the adult group. All are high-risk females defined by the ACR appropriateness criteria and were referred to the Radiology department of Ain Shams University hospital for MRI examination. Results: This study was done on high-risk women with a lifetime risk of over 20%. The majority of the examinations were performed on women with previous history of breast cancer (63.3%), while 36.7% had moderate to high family history, and 10% had both personal breast cancer history as well as high familial risk. An abbreviated protocol was created form the sequences obtained from the full diagnostic protocol, which consisted of a pre-contrast T1, post-contrast T1, subtraction and MIP images. On MRI examination using the conventional protocol, 36% of the women in our study were diagnosed with breast mass lesions, of which 20% were malignant masses. Benign findings, whether mass or non-mass lesions constitutes of a total of 50.1%, and about 26.7% were normal. All the malignant lesions were identified on the abbreviated protocol by the designated reader after review of the clinical history. So, the cancer detection rate in our study using the abbreviated MRI protocols revealed a Kappa agreement test of 1.000, i.e., perfect agreement with the conventional protocols for the participant females, with a highly significant. Conclusion: The use of abbreviated MRI breast is feasible without compromising the cancer detection rate compared to a full protocol. It also achieved a significant reduction in scanning time, interpretation time, and total cost of the study. Proving its efficacy and making a more accessible first line of screening high-risk females.