Breast MRI: Simplifying Protocol and BI-RADS Categories.

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Breast magnetic resonance imaging (MRI) is a valuable diagnostic tool.
• Abbreviated MRI protocols offer potential for reduced time and cost with maintained accuracy.
• Assessing the concordance between abbreviated and full breast MRI protocols is crucial for clinical adoption.

Purpose of the Study:

• To evaluate the agreement between abbreviated and full breast MRI protocols in breast cancer assessment.
• To determine the diagnostic accuracy of abbreviated breast MRI compared to standard protocols.

Main Methods:

• Retrospective cross-sectional study of 419 women undergoing breast MRI between June 2019 and May 2020.
• Evaluation by 3 board-certified radiologists using abbreviated (MIP, subtraction, T1W pre/post-contrast) and full MRI protocols.
• Findings categorized using a simplified BI-RADS classification adapted from the BI-RADS 5th edition.

Main Results:

• Very good agreement observed between abbreviated and full protocols for the total population (weighted kappa: 0.95) and subgroups (weighted kappa: 0.86-1.00).
• High diagnostic accuracy of 97.6% for abbreviated breast MRI compared to full diagnostic MRI.
• Significant agreement (P <.001) across all analyses.

Conclusions:

• Abbreviated breast MRI protocols demonstrate comparable performance to full diagnostic protocols for breast cancer screening and diagnosis.
• The proposed simplified BI-RADS classification can assist physicians in clinical decision-making.
• Abbreviated breast MRI is a viable alternative to full protocols, enhancing efficiency without compromising accuracy.