Abbreviated protocol of magnetic resonance imaging for breast non-mass enhancement: do we only need the first postcontrast images?

Abstract

BackgroundAbbreviated protocol (AP) of magnetic resonance imaging (MRI) possesses substantial diagnostic accuracy in detecting breast cancer; however, multiple studies have found that the sensitivity of original AP is reduced in non-mass enhancement (NME) lesions.PurposeTo evaluate the diagnostic value of the different AP protocols of MRI for detecting breast cancer with different morphologic patterns.Material and MethodsA retrospective study was performed on 193 lesions from 186 patients who underwent breast MRI with pathological confirmation. The lesions were divided into mass and NME groups. Three protocols were used for interpretation, including standard full diagnostic protocol (FDP), AP1 and AP2 (AP1 using the first-phase enhancement, AP2 using the first- and second-phase enhancements). The scan and interpretation time, sensitivity, specificity, and area under the curve (AUC) of three protocols in two groups were compared.ResultsThere were 124 and 69 lesions in the mass and NME groups, respectively. The scan and interpretation time of AP1 and AP2 were shorter than those of FDP (all P <0.001). In the mass group, the sensitivity and specificity of the three protocols did not significantly differ (all P >0.05); however, in the NME group, the sensitivity of AP1 was lower than that of FDP and AP2 (P1 = 0.007, P2 = 0.000). The AUC did not significantly differ among three protocols in two groups (all P >0.05), but the NME group had the lowest mean AUC for API (0.864 ± 0.049).ConclusionThe application of the second-phase post-enhancement scan as the AP2 can reduce the missed diagnoses of breast cancer with NME.