Chen Shuang-Qing, Huang Min, Shen Yu-Ying, Liu Chen-Lu, Xu Chuan-Xiao
Department of Radiology, The Affiliated Suzhou Hospital, Nanjing Medical University, No.16, Bai-Ta-Xi Road, Suzhou 215001, China.
Breast Imaging Screening Center, The Affiliated Suzhou Hospital, Nanjing Medical University, Suzhou, China.
Acad Radiol. 2017 Mar;24(3):316-320. doi: 10.1016/j.acra.2016.10.003. Epub 2016 Dec 1.
The study aimed to evaluate the usefulness of an abbreviated protocol (AP) of magnetic resonance imaging (MRI) in comparison to a full diagnostic protocol (FDP) of MRI in the breast cancer screening with dense breast tissue.
There are 478 female participants with dense breast tissue and negative mammography results, who were imaged with MRI using AP and FDP. The AP and FDP images were analyzed separately, and the sensitivity and specificity of breast cancer detection were calculated. The chi-square test and receiver operating characteristics curves were used to assess the breast cancer diagnostic capabilities of the two protocols.
Sixteen cases of breast cancer from 478 patients with dense breasts were detected using the FDP method, with pathologic confirmation of nine cases of ductal carcinoma in situ, six cases of invasive ductal carcinoma, and one case of mucinous carcinoma. Fifteen cases of breast cancer were successfully screened using the AP method. The sensitivity showed no obvious significant difference between AP and FDP (χ = 0.592, P = 0.623), but the specificity showed a statistically significant difference (χ = 4.619, P = 0.036). The receiver operating characteristics curves showed high efficacy of both methods in the detection of breast cancer in dense breast tissue (the areas under the curve were 0.931 ± 0.025 and 0.947 ± 0.024, respectively), and the ability to diagnose breast cancer was not statistically significantly different between the two methods.
The AP of MRI may improve the detection rate of breast cancer in dense breast tissue, and it may be useful in efficient breast cancer screening.
本研究旨在评估磁共振成像(MRI)的简化方案(AP)与完整诊断方案(FDP)在致密乳腺组织乳腺癌筛查中的实用性。
478名乳腺组织致密且乳腺X线摄影结果为阴性的女性参与者接受了MRI的AP和FDP检查。分别分析AP和FDP图像,并计算乳腺癌检测的敏感性和特异性。采用卡方检验和受试者工作特征曲线评估两种方案的乳腺癌诊断能力。
采用FDP方法在478例乳腺致密患者中检测出16例乳腺癌,其中9例导管原位癌、6例浸润性导管癌和1例黏液癌经病理证实。采用AP方法成功筛查出15例乳腺癌。AP和FDP之间的敏感性无明显显著差异(χ = 0.592,P = 0.623),但特异性有统计学显著差异(χ = 4.619,P = 0.036)。受试者工作特征曲线显示两种方法在致密乳腺组织乳腺癌检测中均具有较高效能(曲线下面积分别为0.931±0.025和0.947±0.024),且两种方法在乳腺癌诊断能力上无统计学显著差异。
MRI的AP可能提高致密乳腺组织中乳腺癌的检出率,并可能有助于高效的乳腺癌筛查。