title: Systematic development of an abbreviated protocol for screening breast magnetic resonance imaging.
abstract: We sought to develop an abbreviated protocol (AP) for breast MRI that maximizes lesion detection by assessing each lesion not seen on mammography by each acquisition from a full diagnostic protocol (FDP).
  
  
  
  671 asymptomatic women (mean 55.7 years, range 40-80) with a negative mammogram were prospectively enrolled in this IRB approved study. All lesions on MRI not visualized on mammography were analyzed, reported, and suspicious lesions biopsied. In parallel, all FDP MRI acquisitions were scored by lesion to eventually create a high-yield AP.
  
  
  
  FDP breast MRI detected 452 findings not visible on mammography, including 17 suspicious lesions recommended for biopsy of which seven (PPV 41.2%) were malignant in six women. Mean size of the four invasive malignancies was 1.9 cm (range 0.7-4.1), all node negative; three lesions in two women were ductal carcinoma in situ. Nine biopsied lesions were benign, mean size 1.2 cm (range 0.6-2.0). All biopsied lesions were in women with dense breasts (heterogeneously or extremely dense on mammography, n = 367), for a cancer detection rate of 16.3/1000 examinations in this subpopulation. These data were used to identify four high-yield acquisitions: T2, T1-pre-contrast, T11.5, and T16to create the AP with a scan time of 7.5 min compared to 24 min for the FDP.
  
  
  
  Our analysis of a FDP MRI in a mammographically negative group identified four high-yield acquisitions that could be used for rapid screening of women for breast cancer that retains critical information on morphology, histopathology, and kinetic activity to facilitate detection of suspicious lesions.
authors.affiliation: Regional Medical Imaging, PC, 2486 Nerredia Street, Flint, MI, 48532, USA. dstrahle@rmipc.net.|Department of Radiology, Michigan State University College of Human Medicine, 3346 Lennon Road, Flint, MI, 48507, USA. dstrahle@rmipc.net.
authors.forename: David A
authors.initials: DA
authors.lastname: Strahle
authors.affiliation: Department of Epidemiology and Biostatistics, Michigan State University College of Human Medicine, 909 Fee Road, Room B601, East Lansing, MI, 48824, USA.
authors.forename: Dorothy R
authors.initials: DR
authors.lastname: Pathak
authors.affiliation: Michigan State University College of Osteopathic Medicine, 965 Fee Road, East Lansing, MI, 48824, USA.|Department of Radiology, Michigan State University College of Human Medicine, 846 Service Road, East Lansing, MI, 48824, USA.
authors.forename: Arlene
authors.initials: A
authors.lastname: Sierra
authors.affiliation: Department of Surgery, Drexel University College of Medicine, 3101 Emrick Boulevard, Suite 310, Bethlehem, PA, 18020, USA.
authors.forename: Sukamal
authors.initials: S
authors.lastname: Saha
authors.affiliation: Michigan State University College of Osteopathic Medicine, 965 Fee Road, East Lansing, MI, 48824, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Strahle
authors.affiliation: Department of Radiology, Michigan State University College of Human Medicine, 4100 Beecher Road, Suite A, Flint, MI, 48532, USA.|Department of Radiation Oncology, Karmanos Cancer Institute at McLaren Flint, 4100 Beecher Road, Suite A, Flint, MI, 48532, USA.|Department of Oncology, Wayne State University, 4100 Beecher Road, Suite A, Flint, MI, 48532, USA.
authors.forename: Kiran
authors.initials: K
authors.lastname: Devisetty
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000071060:Breast Density; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000473:pathology; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods; D008327:Mammography; D008403:Mass Screening; D008875:Middle Aged; D009367:Neoplasm Staging; D012680:Sensitivity and Specificity
keywords: Breast cancer; Cancer screening; Dense breast; Magnetic resonance imaging; Mammography