Abbreviated breast MRI for evaluating breast cancer before initiation of neoadjuvant chemotherapy: A cross-sectional study

Background

Although, there are accumulating evidence about diagnostic role of abbreviated breast magnetic resonance imaging (MRI) in screening setting, the implementation of abbreviated MRI in staging of breast cancer has been poorly elucidated.

Objective

To evaluate the diagnostic performance of abbreviated breast MRI in estimating extent of disease before initiation of neoadjuvant chemotherapy.

Methods

A total of 54 patients with biopsy-proven main lesion referred to evaluate by standard protocol breast MRI before initiation of neoadjuvant chemotherapy were retrospectively enrolled. From a standard protocol, a data set of abbreviated protocol consisting fat-saturated T1-weighted (T1W) pre-contrast and first two fat-saturated T1W post-contrast series with reconstruction of their subtraction including maximum intensity projection (MIP) were obtained and interpreted. The concordance rate of abbreviated with standard protocol (as a reference standard) were compared. Diagnostic accuracy, sensitivity, specificity, and positive and negative predictive value were calculated, as well.

Results

The maximum size of the main mass was 38.6 ± 17.3 and 40.7 ± 17.9 for abbreviated and standard protocol, respectively. All of the main mass was detected by abbreviated protocol with 100% concordance. Concordance was 98.1% and 94.4% in terms of multifocal/multicentric status and for estimating of NME, respectively. The abbreviated protocol has high sensitivity and specificity with more than 90% value regarding main mass detection, measurement of the maximum size of the main mass, determination of multifocal/multicenter status and NAC involvement.

Conclusion

Abbreviated protocol may be a reliable surrogate for standard protocol breast MRI in evaluating extent of breast cancer.