Abbreviated Protocol Feasible in Breast Cancer MRI Screening

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Abbreviated Protocol Feasible in Breast Cancer MRI Screening
Abbreviated Protocol Feasible in Breast Cancer MRI Screening

(HealthDay News) -- An abbreviated protocol (AP) can accurately establish the absence of breast cancer and has diagnostic accuracy similar to that of a full diagnostic protocol (FDP) in breast magnetic resonance imaging (MRI) screening, according to a study published online in the Journal of Clinical Oncology.

Christiane K. Kuhl, MD, from the University Hospital of Aachen in Germany, and colleagues conducted a prospective observational reader study in 443 women who underwent 606 screening MRIs.

Radiologists searched for significant enhancement by reviewing the maximum-intensity projection (MIP) images. They then characterized enhancement and established diagnosis by reviewing the complete AP (first postcontrast subtracted and MIP images). The FDP was analyzed thereafter.

The researchers found that MRI acquisition time was 17 minutes for the FDP and 3 minutes for AP. The average time taken to read a single MIP was 2.8 seconds, and the complete AP took 28 seconds.

RELATED: Breast Cancer Resource Center

Eleven breast cancers were diagnosed (additional cancer yield, 18.2 per 1,000), with MIP readings positive in 10 of these cancers (90.9%). MIP allowed establishment of the absence of breast cancer in 418 of 419 cases (negative predictive value, 99.8%).

All cancers were diagnosed with interpretation of the complete AP and FDP. The specificity and positive predictive values were equivalent for AP versus FDP (94.3% vs. 93.9% and 24.4% vs. 23.4%, respectively).

"With a reading time <30 seconds for the complete AP, diagnostic accuracy was equivalent to that of the FDP and resulted in an additional cancer yield of 18.2 per 1,000," the researchers wrote.

We are not picking up some of the biologically relevant cancers with mammography. Another test that builds on the success of mammography and that relies more on tumor biology and functionality, not just anatomy, is called for," the author of an accompanying editorial wrote.

"Abbreviated FAST breast MRI is a huge step forward in breast cancer screening and may pave the way for future tests based on functionality rather than anatomy, and with better patient access, such as contrast-enhanced digital mammography."


  1. Kuhl CK, Schrading S, Strobel K et al. Abbreviated Breast Magnetic Resonance Imaging (MRI): First Postcontrast Subtracted Images and Maximum-Intensity Projection—A Novel Approach to Breast Cancer Screening With MRI. J Clin Oncol. 2014;doi:10.1200/JCO.2013.52.5386.
  2. Morris EA. Rethinking Breast Cancer Screening: Ultra FAST Breast Magnetic Resonance Imaging. J Clin Oncol. 2014;doi:10.1200/JCO.2014.56.1514.

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