Kim Eun Sil, Cho Nariya, Kim Soo-Yeon, Lee Su Hyun, Chang Jung Min, Kim Yeon Soo, Ha Su Min, Moon Woo Kyung
Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Republic of Korea; Department of Radiology, Seoul National College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Republic of Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Republic of Korea; Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do 15355, Republic of Korea.
Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Republic of Korea; Department of Radiology, Seoul National College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Republic of Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Republic of Korea.
Eur J Radiol. 2022 Jun;151:110322. doi: 10.1016/j.ejrad.2022.110322. Epub 2022 Apr 18.
To evaluate the added value of ultrafast MRI in abbreviated breast MRI (AB-MRI) surveillance in women with a personal history of breast cancer (PHBC).
Between September 2017 and November 2019, consecutive postoperative surveillance AB-MRIs with ultrafast MRIs (20 images with a 4.0-second temporal resolution using 4D time-resolved angiography with keyhole technique) were retrospectively collected. Four blinded radiologists independently classified the Breast Imaging Reporting and Data System (BI-RADS) category for AB-MRI alone versus the combined protocol (AB-MRI + ultrafast MRI). Readers were recommended to change BI-RADS category according to the time to enhancement cut-off of 12 s in ultrafast MRI. McNemar test and generalized estimation equation model were used to compare the diagnostic performances.
A total of 867 MRI examinations in 867 women (mean age ± standard deviation, 51 years ± 8) were evaluated. The sensitivity of both protocols among all readers was the same, at 90% (9/10). Addition of ultrafast MRI improved the specificity (a mean of 95.3% vs. 88.6 %, p < 0.001 for all readers) and positive predictive value 1 (PPV) (a mean of 21% vs. 10%, p < 0.001 for all readers) compared to AB-MRI alone. Downgrading BI-RADS category 3 to 2 in four readers in a mean of 6.7% (57 of 857) of negative or benign findings was the main reason for the improved specificity and PPV.
Addition of ultrafast MRI to AB-MRI improved the specificity and PPV by reducing unnecessary short-term follow-ups without compromising sensitivity in postoperative surveillance.
评估超快磁共振成像（MRI）在有乳腺癌个人史（PHBC）女性的简化乳腺MRI（AB-MRI）监测中的附加价值。
回顾性收集2017年9月至2019年11月期间连续进行的术后监测AB-MRI及超快MRI（使用带钥孔技术的4D时间分辨血管造影术，20幅图像，时间分辨率为4.0秒）。四位盲法放射科医生独立对单独的AB-MRI与联合方案（AB-MRI + 超快MRI）进行乳腺影像报告和数据系统（BI-RADS）分类。建议读者根据超快MRI中12秒的强化截止时间改变BI-RADS分类。采用McNemar检验和广义估计方程模型比较诊断性能。
共评估了867名女性（平均年龄±标准差，51岁±8岁）的867次MRI检查。所有读者中两种方案的敏感性相同，均为90%（9/10）。与单独的AB-MRI相比，添加超快MRI提高了特异性（所有读者的平均值分别为95.3%和88.6%，p < 0.001）和阳性预测值1（PPV）（所有读者的平均值分别为21%和10%，p < 0.001）。在四位读者中，平均6.7%（857例中的57例）的阴性或良性结果从BI-RADS 3类降级为2类是特异性和PPV提高的主要原因。
在AB-MRI中添加超快MRI可通过减少不必要的短期随访提高特异性和PPV，且不影响术后监测的敏感性。
