title: Abbreviated screening protocol for breast MRI: a feasibility study.
abstract: OBJECTIVE
  To compare the performance of two shortened breast magnetic resonance imaging (MRI) protocols to a standard MRI protocol for breast cancer screening.
  
  
  METHODS
  In this Health Insurance Portability and Accountability Act compliant, institutional review board-approved pilot study, three fellowship-trained breast imagers evaluated 48 breast MRIs (24 normal, 12 benign, and 12 malignant) selected from a high-risk screening population. MRIs were presented in three viewing protocols, and a final Breast Imaging-Reporting and Data System assessment was recorded for each case. The first shortened protocol (abbreviated 1) included only fat-saturated precontrast T2-weighted, precontrast T1-weighted, and first pass T1-weighted postcontrast sequences. The second shortened protocol (abbreviated 2) included the abbreviated 1 protocol plus the second pass T1-weighted postcontrast sequence. The third protocol (full), reviewed after a 1-month waiting period, included a nonfat-saturated T1-weighted sequence, fat-saturated T2-weighted, precontrast T1-weighted, and three or four dynamic postcontrast sequences. Interpretation times were recorded for the abbreviated 1 and full protocols. Sensitivity and specificity were compared via a chi-squared analysis. This pilot study was designed to detect a 10% difference in sensitivity with a power of 0.8.
  
  
  RESULTS
  There was no significant difference in sensitivity between the abbreviated 1 (86%; P = .22) or abbreviated 2 (89%; P = .38) protocols and the full protocol (95%). There was no significant difference in specificity between the abbreviated 1 (52%; P = 1) or abbreviated 2 (45%; P = .34) protocols and the full protocol (52%). The abbreviated 1 and full protocol interpretation times were similar (2.98 vs. 3.56 minutes).
  
  
  CONCLUSIONS
  In this pilot study, reader performance comparing two shortened breast MRI protocols to a standard protocol in a screening cohort were similar, suggesting that a shortened breast MRI protocol may be clinically useful, warranting further investigation.
authors.affiliation: Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710. Electronic address: Lars.grimm@duke.edu.
authors.forename: Lars J
authors.initials: LJ
authors.lastname: Grimm
authors.affiliation: Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710.
authors.forename: Mary S
authors.initials: MS
authors.lastname: Soo
authors.affiliation: Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710.
authors.forename: Sora
authors.initials: S
authors.lastname: Yoon
authors.affiliation: Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710.
authors.forename: Connie
authors.initials: C
authors.lastname: Kim
authors.affiliation: Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710.
authors.forename: Sujata V
authors.initials: SV
authors.lastname: Ghate
authors.affiliation: Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710.
authors.forename: Karen S
authors.initials: KS
authors.lastname: Johnson
mesh_terms: D062005:Biopsy, Large-Core Needle / Q000379:methods; D001940:Breast / Q000000981:diagnostic imaging*; D047688:Breast Cyst / Q000000981:diagnostic imaging; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging; D002985:Clinical Protocols; D015331:Cohort Studies; D003287:Contrast Media / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000706:statistics & numerical data; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data; D008536:Meglumine / Q000008:administration & dosage / Q000031:analogs & derivatives; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage; D010865:Pilot Projects; D012680:Sensitivity and Specificity; D013997:Time Factors
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine; D019786:Gadolinium DTPA
keywords: Magnetic resonance imaging; abbreviated protocol; screening; sensitivity; specificity