For women with extremely dense breasts, new research suggests that abbreviated breast magnetic resonance imaging (MRI) facilitates significant reductions in scanning and reading time in comparison to multiparametric MRI (mpMRI) without sacrificing accuracy in breast cancer detection.
In a secondary analysis from the Dense Tissue and Early Breast Neoplasm Screening (DENSE) trial, published earlier today in Radiology, researchers compared abbreviated breast MRI versus mpMRI in 518 women (median age of 53) who had extremely dense breasts and negative mammograms. The abbreviated MRI protocol included dual high-temporal low-spatial and low-temporal high-spatial dynamic T1-weighted MRI obtained immediately prior to and up to 120 seconds after injection of contrast material, according to the study.
The study authors found that the abbreviated MRI protocol offered 84.3 percent sensitivity and 73.9 percent specificity in comparison to 85.9 percent sensitivity and 75.8 percent specificity for mpMRI.
Researchers also noted a pooled reading time of 49.7 seconds for abbreviated breast MRI in contrast to 96.4 seconds for mpMRI. There was also an 81 percent reduction in approximate scan time for abbreviated breast MRI (3.5 minutes vs. 18.5 minutes), according to the study authors.
“In our study, we show that the most abbreviated MRI protocol … maintained diagnostic accuracy while reducing reading and scanning times in MRI from a population-screening setting,” wrote lead study author Sophie E.L. van Grinsven, Ph.D.(c), who is affiliated with the Julius Center for Health Sciences and Primary Care at the University Medical Center Utrecht and Utrecht University in Utrecht, the Netherlands, and colleagues.
In addition to enhanced workflow efficiencies, the researchers suggested that abbreviated breast MRI could significantly improve patient comfort and adherence to breast cancer screening.
“Both the time spent in the MRI unit and high noise levels have been identified as sources of discomfort and reasons for discontinuing full-protocol MRI screening. Therefore, reducing the examination time and noise levels could potentially improve the patient experience and may contribute to higher attendance rates,” added van Grinsven and colleagues.
Three Key Takeaways
1. Comparable diagnostic accuracy. Abbreviated breast MRI achieved similar sensitivity (84.3 percent) and specificity (73.9 percent) to full multiparametric MRI (85.9 percent and 75.8 percent, respectively), indicating that it maintains diagnostic accuracy for breast cancer detection in women with extremely dense breasts.
2. Substantial time savings. Abbreviated MRI reduced scan time by 81 percent (3.5 vs. 18.5 minutes) and cut reading time nearly in half (49.7 vs. 96.4 seconds), enhancing workflow efficiency for screening programs.
3. Improved patient experience. The shorter exam duration and reduced noise may increase patient comfort and adherence, potentially leading to higher participation rates in breast cancer screening among women with dense breasts.
(Editor’s note: For related content, see “Emerging AI Algorithm Shows Promise for Abbreviated Breast MRI in Multicenter Study,” “Study Questions Utility of Ultrafast Breast MRI for Challenging Lesions and Moderate/Marked BPE” and “Can Abbreviated Breast MRI Have an Impact in Assessing Post-Neoadjuvant Chemotherapy Response?”)
In an accompanying editorial, Masako Kataoka, M.D., Ph.D., and Maya Honda, M.D., Ph.D,, cautioned that the incremental reading approach utilized in the study didn’t include basic abbreviated MRI with T2-weighted imaging. They also expressed concern that the sensitivity and specificity in the study were lower than those reported in the DENSE trial. However, Drs. Kataoka and Honda also pointed out the substantially reduced reading and acquisition time as well as the likely benefits for patients with the abbreviated MRI protocol.
“The core result of the study — that the simplest abbreviated MRI sequence consisting of DCE MRI performed within 120 seconds of contrast material injection yields comparable sensitivity and specificity to a full protocol in an extremely dense breast screening environment — carries substantial impact if reproduced by other studies. From the perspective of a patient, the benefits of a shorter examination time are improved willingness to participate in the examination and better images with less discomfort,” noted Drs. Kataoka and Honda, who are both affiliated with the Pre-emptive Medicine and Lifestyle-related Disease Research Center at Kyoto University Hospital in Kyoto, Japan.
In regard to study limitations, the authors conceded the use of BI-RADS scores for each incremental step to MRI acquisition may not reflect the accuracy of interpreting a full multiparametric MRI. They also cautioned that the combination of case mix complexity and retrospective reading is not comparable to real-world breast cancer screening despite the use of prospective screening data from the DENSE trial.
