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Clinical usefulness of abbreviated MRI protocol in breast cancer detection

Background: The use of breast MRI for screening has increased over the past decade, mostly in women with a high risk of breast cancer. Abbreviated breast MRI (AB-MR) is introduced to make MRI a more accessible screening modality. AB-MR decreases scanning and reporting time and the overall cost of MR...

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Main Authors: Hamid, Marlina Tanty Ramli, Loi, Kai Seng, Chan, Wai Yee, Mumin, Nazimah Ab, Hamid, Shamsiah Abdul, Rozalli, Faizatul Izza, Rahmat, Kartini
Format: Article
Published: Bentham Science Publishers 2024
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R Medicine
Online Access:http://eprints.um.edu.my/44999/
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spelling my.um.eprints.449992024-04-15T08:26:30Z http://eprints.um.edu.my/44999/ Clinical usefulness of abbreviated MRI protocol in breast cancer detection Hamid, Marlina Tanty Ramli Loi, Kai Seng Chan, Wai Yee Mumin, Nazimah Ab Hamid, Shamsiah Abdul Rozalli, Faizatul Izza Rahmat, Kartini R Medicine Background: The use of breast MRI for screening has increased over the past decade, mostly in women with a high risk of breast cancer. Abbreviated breast MRI (AB-MR) is introduced to make MRI a more accessible screening modality. AB-MR decreases scanning and reporting time and the overall cost of MRI. Objective: This study aims to evaluate the diagnostic efficacy of abbreviated MRI protocol in detecting breast cancer in screening and diagnostic populations, using histopathology as the reference standard. Materials and Methods: This is a single-centre retrospective cross-sectional study of 134 patients with 198 histologically proven breast lesions who underwent full diagnostic protocol contrast-enhanced breast MRI (FDP-MR) at the University Malaya Medical Centre (UMMC) from 1st January 2018 to 31st December 2019. AB-MR was pre-determined and evaluated with regard to the potential to detect and exclude malignancy from 3 readers of varying radiological experiences. The sensitivity of both AB-MR and FDP-MR were compared using the McNemar test, where both protocols' diagnostic performances were assessed via the receiver operating characteristic (ROC) curve. Inter-observer agreement was analysed using Fleiss Kappa. Results: There were 134 patients with 198 lesions. The average age was 50.9 years old (range 27 – 80). A total of 121 (90) MRIs were performed for diagnostic purposes. Screening accounted for 9.4 of the cases, 55.6 (n=110) lesions were benign, and 44.4 (n=88) were malignant. The commonest benign and malignant lesions were fibrocystic change (27.3) and invasive ductal carcinoma (78.4). The mean sensitivity, specificity, positive predictive value, and negative predictive value for AB-MR were 0.96, 0.57, 0.68 and 0.94, respectively. Both AB-MR and FDP-MR showed excellent diagnostic performance with AUC of 0.88 and 0.96, respectively. The general inter-observer agreement of all three readers for AB-MR was substantial (k=0.69), with fair agreement demonstrated between AB-MR and FDP-MR (k=0.36). Conclusion: The study shows no evidence that the diagnostic efficacy of AB-MR is inferior to FDP-MR. AB-MR, with high sensitivity, has proven its capability in cancer detection and exclusion, especially for biologically aggressive cancers. © 2024 The Author(s). Published by Bentham Science Publisher. Bentham Science Publishers 2024 Article PeerReviewed Hamid, Marlina Tanty Ramli and Loi, Kai Seng and Chan, Wai Yee and Mumin, Nazimah Ab and Hamid, Shamsiah Abdul and Rozalli, Faizatul Izza and Rahmat, Kartini (2024) Clinical usefulness of abbreviated MRI protocol in breast cancer detection. Current Medical Imaging, 20. ISSN 1573-4056, DOI https://doi.org/10.2174/1573405620666230829150218 <https://doi.org/10.2174/1573405620666230829150218>. 10.2174/1573405620666230829150218
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic R Medicine
spellingShingle R Medicine
Hamid, Marlina Tanty Ramli
Loi, Kai Seng
Chan, Wai Yee
Mumin, Nazimah Ab
Hamid, Shamsiah Abdul
Rozalli, Faizatul Izza
Rahmat, Kartini
Clinical usefulness of abbreviated MRI protocol in breast cancer detection
description Background: The use of breast MRI for screening has increased over the past decade, mostly in women with a high risk of breast cancer. Abbreviated breast MRI (AB-MR) is introduced to make MRI a more accessible screening modality. AB-MR decreases scanning and reporting time and the overall cost of MRI. Objective: This study aims to evaluate the diagnostic efficacy of abbreviated MRI protocol in detecting breast cancer in screening and diagnostic populations, using histopathology as the reference standard. Materials and Methods: This is a single-centre retrospective cross-sectional study of 134 patients with 198 histologically proven breast lesions who underwent full diagnostic protocol contrast-enhanced breast MRI (FDP-MR) at the University Malaya Medical Centre (UMMC) from 1st January 2018 to 31st December 2019. AB-MR was pre-determined and evaluated with regard to the potential to detect and exclude malignancy from 3 readers of varying radiological experiences. The sensitivity of both AB-MR and FDP-MR were compared using the McNemar test, where both protocols' diagnostic performances were assessed via the receiver operating characteristic (ROC) curve. Inter-observer agreement was analysed using Fleiss Kappa. Results: There were 134 patients with 198 lesions. The average age was 50.9 years old (range 27 – 80). A total of 121 (90) MRIs were performed for diagnostic purposes. Screening accounted for 9.4 of the cases, 55.6 (n=110) lesions were benign, and 44.4 (n=88) were malignant. The commonest benign and malignant lesions were fibrocystic change (27.3) and invasive ductal carcinoma (78.4). The mean sensitivity, specificity, positive predictive value, and negative predictive value for AB-MR were 0.96, 0.57, 0.68 and 0.94, respectively. Both AB-MR and FDP-MR showed excellent diagnostic performance with AUC of 0.88 and 0.96, respectively. The general inter-observer agreement of all three readers for AB-MR was substantial (k=0.69), with fair agreement demonstrated between AB-MR and FDP-MR (k=0.36). Conclusion: The study shows no evidence that the diagnostic efficacy of AB-MR is inferior to FDP-MR. AB-MR, with high sensitivity, has proven its capability in cancer detection and exclusion, especially for biologically aggressive cancers. © 2024 The Author(s). Published by Bentham Science Publisher.
format Article
author Hamid, Marlina Tanty Ramli
Loi, Kai Seng
Chan, Wai Yee
Mumin, Nazimah Ab
Hamid, Shamsiah Abdul
Rozalli, Faizatul Izza
Rahmat, Kartini
author_facet Hamid, Marlina Tanty Ramli
Loi, Kai Seng
Chan, Wai Yee
Mumin, Nazimah Ab
Hamid, Shamsiah Abdul
Rozalli, Faizatul Izza
Rahmat, Kartini
author_sort Hamid, Marlina Tanty Ramli
title Clinical usefulness of abbreviated MRI protocol in breast cancer detection
title_short Clinical usefulness of abbreviated MRI protocol in breast cancer detection
title_full Clinical usefulness of abbreviated MRI protocol in breast cancer detection
title_fullStr Clinical usefulness of abbreviated MRI protocol in breast cancer detection
title_full_unstemmed Clinical usefulness of abbreviated MRI protocol in breast cancer detection
title_sort clinical usefulness of abbreviated mri protocol in breast cancer detection
publisher Bentham Science Publishers
publishDate 2024
url http://eprints.um.edu.my/44999/
_version_ 1797906867372949504
score 13.211869

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