The Diagnostic Accuracy of an Abbreviated vs. a Full MRI Breast Protocol in Detecting Breast Lobular Carcinoma: A Single-Center ROC Study.

IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Francis Zarb, Deborah Mizzi, Paul Bezzina, Leanne Galea
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引用次数: 0

Abstract

Background/Objectives: Abbreviated breast MRI protocols have been proposed as a faster and more cost-effective alternative to standard full protocols for breast cancer detection. This study aimed to compare the diagnostic accuracy of an abbreviated protocol with that of a full protocol in identifying lobular breast carcinoma using Breast Imaging Reporting and Data System (BI-RADS) classification. The diagnostic performance was evaluated against a gold standard comprising biopsy-proven lobular carcinoma or negative follow-up imaging, using Receiver Operating Characteristic (ROC) analysis and performance metrics such as sensitivity and specificity. Methods: A retrospective analysis was conducted on 35 breast MRI examinations performed between January 2019 and December 2021. Of these, 20 cases had biopsy-confirmed lobular carcinoma, and 15 were determined to be normal based on at least 12 months of negative follow-up imaging. Two radiologists independently reviewed the images using only the abbreviated protocol, blinded to the original reports. Their findings were then compared with the initial full-protocol MRI reports. BI-RADS categories 1 and 2 were considered negative for malignancy, while BI-RADS categories 3, 4, and 5 were considered positive. Results: The area under the ROC curve (AUC) was 1.0 for the full protocol and 0.920 and 0.922 for Radiologists A and B, respectively, using the abbreviated protocol. All malignant lesions were correctly identified by both radiologists across both protocols, resulting in a sensitivity of 100%. However, the abbreviated protocol demonstrated significantly lower specificity (73.3% for Radiologist A and 53.5% for Radiologist B) compared to 100% specificity with the full protocol (p < 0.05). Lymph node involvement was correctly identified in 6-7 of 7 cases, though Radiologist A reported four false positives. Lesion laterality and count matched histopathology in 75-90% of cancer cases depending on protocol. Lesion localization was accurate in 60-80% of cases using the abbreviated protocol, though size comparisons were limited due to the incomplete radiological documentation of dimensions. Conclusions: While the abbreviated MRI protocol achieved diagnostic accuracy and sensitivity comparably to the full protocol, it demonstrated reduced specificity. These findings suggest that abbreviated MRI breast protocol may be a viable screening tool, although the higher false-positive rate should be considered in clinical decision-making.

一项单中心的ROC研究:在检测乳腺小叶癌时,简短与完整的MRI乳房方案的诊断准确性。
背景/目的:缩短乳房MRI方案被认为是乳腺癌检测标准完整方案的一种更快、更具成本效益的替代方案。本研究旨在比较使用乳腺成像报告和数据系统(BI-RADS)分类识别小叶型乳腺癌的简化方案和完整方案的诊断准确性。诊断表现根据金标准进行评估,包括活检证实的小叶癌或阴性随访成像,使用受试者工作特征(ROC)分析和灵敏度和特异性等性能指标。方法:回顾性分析2019年1月至2021年12月期间进行的35例乳腺MRI检查。其中,20例活检证实为小叶癌,15例根据至少12个月的阴性随访影像确定为正常。两名放射科医生仅使用简化的方案独立审查图像,对原始报告视而不见。然后将他们的发现与最初的完整方案MRI报告进行比较。BI-RADS分类1和2被认为是恶性肿瘤阴性,而BI-RADS分类3、4和5被认为是阳性。结果:完整方案的ROC曲线下面积(AUC)为1.0,简化方案的放射科医师A、B分别为0.920、0.922。两种方案的放射科医生都能正确识别出所有恶性病变,灵敏度为100%。然而,与完整方案的100%特异性相比,简化方案的特异性明显较低(放射科医生A为73.3%,放射科医生B为53.5%)(p < 0.05)。7例中有6-7例淋巴结受累被正确识别,尽管放射科医生A报告了4例假阳性。根据不同的治疗方案,在75-90%的癌症病例中,病变侧边和计数与组织病理学相符。在使用简化方案的病例中,病变定位在60-80%的情况下是准确的,尽管由于尺寸的放射记录不完整,尺寸比较受到限制。结论:虽然与完整方案相比,简化的MRI方案具有诊断准确性和敏感性,但其特异性降低。这些发现表明,尽管在临床决策中应考虑较高的假阳性率,但缩短MRI乳房方案可能是一种可行的筛查工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Diagnostics
Diagnostics Biochemistry, Genetics and Molecular Biology-Clinical Biochemistry
CiteScore
4.70
自引率
8.30%
发文量
2699
审稿时长
19.64 days
期刊介绍: Diagnostics (ISSN 2075-4418) is an international scholarly open access journal on medical diagnostics. It publishes original research articles, reviews, communications and short notes on the research and development of medical diagnostics. There is no restriction on the length of the papers. Our aim is to encourage scientists to publish their experimental and theoretical research in as much detail as possible. Full experimental and/or methodological details must be provided for research articles.
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