Breast MRI for cancer detection and characterization: A review of evidence-based clinical applications
Breast MRI for cancer detection and characterization: A review of evidence-based clinical applications
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DOI：
10.1016/j.acra.2007.11.006
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发表时间：
2008-04-01
影响因子：
4.8
通讯作者：
Partridge, Savannah
中科院分区：
文献类型：
--
作者：
DeMartini, Wendy;Lehman, Constance;Partridge, Savannah
理由和目标。乳腺MRI是一种重要的新工具，在成像设备的检测和表征乳腺癌。了解证据支持的好处和潜在的危害乳腺MRI是很重要的，以确保适当利用这一医疗资源。本文综述了MRI用于乳腺癌评估的临床环境已被证明是有利的。关于MRI的诊断准确性和这种成像工具对临床结果的影响的证据进行了描述。新型乳腺MRI技术，可能会导致未来的性能改进进行了讨论。多项研究表明，乳腺MRI有利于筛查高风险患者、评价新诊断乳腺癌的患者、监测接受新辅助化疗的患者的治疗反应以及评价原发部位未知的转移性腋窝腺癌患者。MRI的局限性之一是其高成本和低特异性，导致假阳性检查。当在证据支持的临床环境中使用时，与现有的乳腺癌检测相比，MRI的高灵敏度导致早期癌症检测或更高的检测准确性。进一步的科学努力对于优化乳腺MRI的未来性能和应用至关重要。
Rationale and Objectives. Breast MRI is an important new tool in the imaging armamentarium for the detection and characterization of breast carcinoma. Understanding the evidence-supported benefits and potential harms of breast MRI is important to ensure the appropriate utilization of this medical resource.Materials and Methods. This article reviews the clinical settings in which MRI for breast cancer assessment has been shown to be advantageous. The evidence regarding the diagnostic accuracy of MRI and the impact of this imaging tool on clinical outcomes are described. Novel breast MRI techniques which may lead to future improvements in performance are discussed.Results. Breast MRI has been shown in multiple studies to be advantageous for screening patients at high risk, evaluating patients with a new breast cancer diagnosis, monitoring treatment response in patients undergoing neoadjuvant chemotherapy and evaluating patients with metastatic axillary adenocarcinoma and unknown primary site. Among the limitations of MRI are its high cost and modest specificity resulting in false positive examinations.Conclusions. When used in evidence-supported clinical settings, the high sensitivity of MRI results in earlier cancer detection or greater accuracy of detection compared to existing tests for breast carcinoma. Further scientific endeavors are crucial to optimize the future performance and application of breast MRI.