The research included 518 women with extremely dense breasts, a group known to have a higher risk of breast cancer and for whom mammography is often less reliable. Because dense tissue can obscure tumors on mammograms, MRI is sometimes used as a supplemental screening tool. However, full MRI scans are time-consuming and costly, limiting their use in large-scale screening.
This study examined whether an abbreviated MRI protocol could offer a faster, cost-effective alternative without compromising diagnostic accuracy. All participants had negative mammogram results and were part of a larger screening trial.
Seven experienced radiologists reviewed 518 MRI scans. They were analyzed in four steps, each adding imaging sequences. The first step—the abbreviated protocol—included dynamic T1-weighted images acquired within 2 minutes of contrast injection. The fourth step represented the full protocol, which included additional sequences for lesion classification.
The abbreviated protocol had a sensitivity of 84.3%, compared with 85.9% for the full protocol. Specificity was 73.9% for the abbreviated version and 75.8% for the full. These differences were not statistically significant, indicating comparable performance.
“The abbreviated protocol had a pooled reading time (49.7 seconds; 95% CI: 48.5, 50.9) that was almost 50% shorter than the full protocol (96.4 seconds; 95% CI: 94.3, 98.5; P < .001) with 70%–80% shorter scanning time, depending on hospital and scanner vendor,” reported senior co-authors Carla H. van Gils and Wouter B. Veldhuis of Utrecht University, the Netherlands, and their team.
The shorter protocol maintained diagnostic accuracy across readers and showed moderate agreement, similar to the full protocol. Of the 83 cancers detected, 68 were invasive and 15 were ductal carcinoma in situ, all confirmed through biopsy or follow-up.
A multicenter trial to validate these findings in real-world screening began enrolling participants in 2024.
Full author disclosures and additional methodology details are available in the published study.
Source: RSNA Radiology
