Abbreviated protocol for breast MRI: Are multiple sequences needed for cancer detection?
Abbreviated protocol for breast MRI: Are multiple sequences needed for cancer detection?
复制标题
DOI：
10.1016/j.ejrad.2014.10.004
复制
发表时间：
2015-01-01
影响因子：
3.3
通讯作者：
Jochelson, Maxine S.
中科院分区：
文献类型：
--
作者：
Mango, Victoria L.;Morris, Elizabeth A.;Jochelson, Maxine S.
目的：评价一种由平扫T1加权(T1W)图像和早期增强后T1W图像组成的简化乳腺磁共振成像(MRI)方案诊断乳腺癌的能力。材料和方法：符合HIPAA标准的机构审查委员会批准了对100例经活检证实的单中心性乳腺癌患者的连续乳腺MRI检查。79%为浸润性癌，21%为导管原位癌。四位经验丰富的乳腺放射科医生对癌的位置、病史和先前的检查视而不见，评估了简化的方案，仅评估第一次增强后T1W图像、后处理减影第一次增强后图像和减影最大密度投影图像。将肿瘤的检测和定位与标准的全面诊断检查进行比较，该检查包括13个增强前、增强后和后处理序列。结果：100例肿瘤在最初阅读简化方案时至少有一个阅读器可以看到。每个序列的平均灵敏度分别为：第一次增强后序列96%、第一次增强后减影序列96%和减影MIP序列93%。在每个序列中，4种读取器之间的敏感性无显著差异(p=0.471，p=0.656，p=0.139)。平均口译时间44s(S 11~167s)。简化的成像方案可以在大约10-15分钟内完成，而标准方案为30-40分钟。一个增强前后的T1W序列可能足以检出乳腺癌。这些结果支持完善乳腺MRI筛查方案的可能性。(C)2014爱思唯尔爱尔兰有限公司。保留所有权利。
Objective: To evaluate the ability of an abbreviated breast magnetic resonance imaging (MRI) protocol, consisting of a precontrast T1 weighted (T1W) image and single early post-contrast T1W image, to detect breast carcinoma.Materials and methods: A HIPAA compliant Institutional Review Board approved review of 100 consecutive breast MRI examinations in patients with biopsy proven unicentric breast carcinoma. 79% were invasive carcinomas and 21% were ductal carcinoma in situ. Four experienced breast radiologists, blinded to carcinoma location, history and prior examinations, assessed the abbreviated protocol evaluating only the first post-contrast T1W image, post-processed subtracted first post-contrast and subtraction maximum intensity projection images. Detection and localization of tumor were compared to the standard full diagnostic examination consisting of 13 pre-contrast, post-contrast and post-processed sequences.Results: All 100 cancers were visualized on initial reading of the abbreviated protocol by at least one reader. The mean sensitivity for each sequence was 96% for the first post-contrast sequence, 96% for the first post-contrast subtraction sequence and 93% for the subtraction MIP sequence. Within each sequence, there was no significant difference between the sensitivities among the 4 readers (p = 0.471, p = 0.656, p = 0.139). Mean interpretation time was 44s (range 11-167 s). The abbreviated imaging protocol could be performed in approximately 10-15 min, compared to 30-40 min for the standard protocol.Conclusion: An abbreviated breast MRI protocol allows detection of breast carcinoma. One pre and postcontrast T1W sequence may be adequate for detecting breast carcinoma. These results support the possibility of refining breast MRI screening protocols. (C) 2014 Elsevier Ireland Ltd. All rights reserved.