title: Evaluation of a known breast cancer using an abbreviated breast MRI protocol: Correlation of imaging characteristics and pathology with lesion detection and conspicuity.
abstract: OBJECTIVE
  This study evaluates use of an abbreviated magnetic resonance imaging protocol with T2-weighted imaging in detecting biopsy-proven unifocal breast cancer.
  
  
  METHODS
  This is an institutional review board approved retrospective study of patients with biopsy-proven unifocal breast cancer (88% invasive; 12% in situ) undergoing magnetic resonance imaging. In three separate sessions, three breast imagers evaluated (1) T1-weighted non-contrast, post-contrast and post-contrast subtracted images, (2) T1-weighted images with clinical history and prior imaging, and (3) T1-weighted images and T2-weighted images with clinical history and prior imaging. Protocols were compared for cancer detection, reading time and lesion conspicuity. An independent breast radiologist retrospectively analyzed initial enhancement ratio of cancers and retrospectively reviewed lesion morphology and final pathology.
  
  
  RESULTS
  All 107 cancers were identified at first protocol by at least one reader; five cancers were missed by either one or two readers. One cancer was missed by one reader at protocols two and three. Mean percentage detection for protocol one was 97.8%; protocol two, 99.4%, protocol three, 99.4%. T2-weighted images did not alter cancer detection but increased lesion conspicuity for 2/3 readers. 3/5 missed lesions were low grade cancers. Initial enhancement ratio was positively associated with increasing tumor grade (p=0.031) and pathology (p=0.002). Reader interpretation time decreased and lesion conspicuity increased as initial enhancement ratio increased.
  
  
  CONCLUSIONS
  Abbreviated magnetic resonance imaging has high rate of detection for known breast cancer and short interpretation time. T2 weighted imaging increased lesion conspicuity without altering detection rate. Initial enhancement ratio correlated with invasive disease and tumor grade.
authors.affiliation: Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, United States. Electronic address: Laura.Heacock@nyumc.org.
authors.forename: Laura
authors.initials: L
authors.lastname: Heacock
authors.affiliation: Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, United States. Electronic address: Amy.Melsaether@nyumc.org.
authors.forename: Amy N
authors.initials: AN
authors.lastname: Melsaether
authors.affiliation: Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, United States. Electronic address: Samantha.Heller@nyumc.org.
authors.forename: Samantha L
authors.initials: SL
authors.lastname: Heller
authors.affiliation: Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, United States. Electronic address: Yiming.Gao@nyumc.org.
authors.forename: Yiming
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, United States. Electronic address: Kristine.Pysarenko@nyumc.org.
authors.forename: Kristine M
authors.initials: KM
authors.lastname: Pysarenko
authors.affiliation: Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, United States. Electronic address: James.Babb@nyumc.org.
authors.forename: James S
authors.initials: JS
authors.lastname: Babb
authors.affiliation: Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, United States; Center for Advanced Imaging Innovation and Research (CAI(2)R), New York University School of Medicine, New York, NY 10016, United States. Electronic address: Gene.Kim@nyumc.org.
authors.forename: Sungheon G
authors.initials: SG
authors.lastname: Kim
authors.affiliation: Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY 10016, United States; Center for Advanced Imaging Innovation and Research (CAI(2)R), New York University School of Medicine, New York, NY 10016, United States. Electronic address: Linda.Moy@nyumc.org.
authors.forename: Linda
authors.initials: L
authors.lastname: Moy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis / Q000473:pathology; D003287:Contrast Media; D003951:Diagnostic Errors; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013382:Subtraction Technique; D013997:Time Factors
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA
keywords: Abbreviated MRI protocol; Breast MRI; Breast cancer screening