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用于筛查的简化乳腺 MRI 的实施:专家小组叙述性综述。

Implementation of Abbreviated Breast MRI for Screening: Expert Panel Narrative Review.

机构信息

Department of Radiology, Duke University Medical Center, 2301 Erwin Rd, Box 3808, Durham, NC 27710.

Evelyn H. Lauder Breast Center, New York, NY.

出版信息

AJR Am J Roentgenol. 2022 Feb;218(2):202-212. doi: 10.2214/AJR.21.26349. Epub 2021 Aug 11.

DOI:10.2214/AJR.21.26349
PMID:34378397
Abstract

Abbreviated breast MRI (AB-MRI) is being rapidly adopted to harness the high sensitivity of screening MRI while addressing issues related to access, cost, and workflow. The successful implementation of an AB-MRI program requires collaboration across administrative, operational, financial, technical, and clinical providers. Institutions must be thoughtful in defining patient eligibility for AB-MRI and providing recommendations for screening intervals, as existing practices are heterogeneous. Similarly, there is no universally accepted AB-MRI protocol, though guiding principles should harmonize abbreviated and full protocols while being mindful of scan duration and amount of time patients spend on the MRI table. The interpretation of AB-MRI will be a new experience for many radiologists and may require a phased rollout and a careful audit of performance metrics over time to ensure benchmark metrics are achieved. AB-MRI finances, which are driven by patient self-payment, will require buy-in from hospital administration with the recognition that downstream revenues will be needed to support initial costs. Finally, successful startup of an AB-MRI program requires active engagement with the larger community of patients and referring providers. As AB-MRI becomes more widely accepted and available, best practices and community standards will continue to evolve to ensure high-quality patient care.

摘要

缩短式乳腺磁共振成像(AB-MRI)正在被迅速采用,以充分利用筛查 MRI 的高灵敏度,同时解决与获取途径、成本和工作流程相关的问题。成功实施 AB-MRI 计划需要行政、运营、财务、技术和临床提供者之间的协作。医疗机构必须认真定义 AB-MRI 的患者资格,并提供筛查间隔的建议,因为现有的实践方法存在差异。同样,也没有普遍接受的 AB-MRI 协议,尽管指导原则应该协调缩短和完整的协议,同时注意扫描时间和患者在磁共振成像台上的时间。AB-MRI 的解读对许多放射科医生来说将是一种新的体验,可能需要分阶段推出,并随着时间的推移仔细审核绩效指标,以确保达到基准指标。AB-MRI 的财务状况由患者自付费用驱动,这将需要医院管理层的认可,并认识到需要下游收入来支持初始成本。最后,AB-MRI 计划的成功启动需要与更广泛的患者和转介提供者社区进行积极接触。随着 AB-MRI 被更广泛地接受和应用,最佳实践和社区标准将继续发展,以确保高质量的患者护理。

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