Diagnostic validity of abbreviated breast MRI in the diagnosis of breast cancer: a comparative study to the full breast MRI protocol using BI-RADS.

Abstract

Purpose: This work aimed to determine the diagnostic performance of the magnetic resonance imaging (MRI) breast abbreviated protocol (AP) in diagnosing malignant breast lesions using BI-RADS compared with the diagnostic accuracy of the full diagnostic protocol (FDP).

Material and methods: A prospective single-centre study was conducted. A total of 125 female patients with suspicious breast masses underwent MRI with the AP and the FDP. The images of AP and FDP were independently interpreted by 2 radiologists with 10 years of experience in breast imaging, and any disagreement was resolved with a third one. Using the histopathological examination as a reference test, the diagnostic effectiveness of both FDP and AP in breast cancer screening was calculated. ROC curve was utilised to estimate the optimal BI-RADS cut-off for prediction of malignancy. The difference in image interpretation time between both protocols was estimated using the Mann-Whitney test. Moreover, the inter-test agreement between both protocols was assessed using Cohen's κ test.

Results: The study included 83 malignant and 42 benign lesions. AP indicated a specificity, sensitivity, and accuracy of 90.5%, 96.4%, and 94.4%, while the FDP showed a specificity, sensitivity, and accuracy of 92.9%, 100%, and 97.6%, respectively. BI-RADS 3 category was the best cut-off for prediction of malignancy. There was a significant difference between both protocols concerning the interpretation time (p < 0.001). There was excellent agreement between both protocols, with a κ of 0.915.

Conclusions: Breast MRI AP may be employed instead of FDP to identify breast cancer with similar diagnostic performance. Moreover, it reduces the interpretation time and the scan cost.