Variation in Technical Quality of Breast MRI

Area of Science:

• Radiology
• Medical Imaging
• Oncology

Background:

• Breast MRI quality can differ significantly across healthcare facilities in the United States.
• The American College of Radiology (ACR) Breast MRI Accreditation Program was implemented to standardize quality.
• Assessing the quality of external breast MRIs is essential for patient care.

Purpose of the Study:

• To evaluate the technical quality of outside breast MRIs submitted for second opinions at a tertiary cancer center.
• To determine if quality has improved after the implementation of the ACR Breast MRI Accreditation Program.

Main Methods:

• Retrospective review of 100 consecutive outside breast MRI cases presented for second opinion.
• Blind review of image quality by fellowship-trained breast radiologists and a breast imaging fellow.
• Assessment of technical quality based on ACR Breast MRI Accreditation Program criteria.

Main Results:

• 68% of 88 US-referred cases had at least one technical deficiency.
• Common deficiencies included artifacts (74%), shimming issues (17), and motion (16).
• Significant deficiencies were noted in T2-weighted (38%) and postcontrast T1-weighted sequences (27% delayed, 23% early), often due to low signal-to-noise ratio.

Conclusions:

• Breast MRI quality demonstrates variability across the United States.
• Radiologists need to be aware of and adhere to ACR Breast MRI accreditation standards.
• Meeting accreditation standards is vital for improving patient quality and safety in breast MRI.