Department of Medical Imaging, Division of Breast Imaging, Södersjukhuset, Stockholm, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Acta Radiol. 2024 Feb;65(2):195-201. doi: 10.1177/02841851231216552. Epub 2023 Dec 19.
Earlier studies have shown that abbreviated protocol magnetic resonance imaging (AB-MRI) has similar diagnostic accuracy as the full protocol (Full MRI).
To compare the diagnostic accuracy, reading time, and inter-rater agreement of AB-MRI to Full MRI among women without known increased familial risk of breast cancer or prior biopsy.
In total, 395 MRI examinations were included in this study. Three readers were blinded to all patient information. The AB-MRI and Full MRI were read separately and in a different random order for each of the readers. Scores 1-2 were considered test negative while scores 3-5 were test positive. A positive reference test was the diagnosis of malignancy; a negative reference test was the absence of a diagnosis of breast cancer within a two-year follow-up. We used a generalized estimating equations approach to compare sensitivity and specificity between the two protocols. We used -tests to compare the average reading time and Krippendorff's alpha to compare inter-rater agreement.
MRI examinations of 395 women (median age=56 years) were evaluated. For AB-MRI and Full MRI, respectively, the sensitivity was 93.0% (95% CI=90.6-95.0) vs. 92.0% (95% CI=89.4-94.1), the specificity was 91.7% (95% CI=90.3-92.9) vs. 94.3% (95% CI=93.2-95.3), average reading time was 67 vs. 126 s, and the inter-rater agreement 0.79 vs. 0.83. The difference in sensitivity was not statistically significant (=0.840), but the difference in specificity was significant (=0.003).
AB-MRI has similar sensitivity, but somewhat lower specificity. The average reading time for the abbreviated protocol is lower, as is inter-rater agreement.
早期的研究表明，缩短版协议磁共振成像（AB-MRI）与完整协议（Full MRI）具有相似的诊断准确性。
比较无已知家族性乳腺癌风险增加或既往活检史的女性中 AB-MRI 与 Full MRI 的诊断准确性、阅读时间和观察者间一致性。
本研究共纳入 395 例 MRI 检查。三位观察者均对所有患者信息设盲。AB-MRI 和 Full MRI 分别由三位观察者独立阅片，且每位观察者阅读顺序均为 AB-MRI 和 Full MRI 随机交替。评分 1-2 为阴性测试结果，评分 3-5 为阳性测试结果。阳性参考测试为恶性肿瘤诊断；阴性参考测试为在两年随访期间未诊断为乳腺癌。我们使用广义估计方程比较两种方案的敏感性和特异性。使用 t 检验比较平均阅读时间，使用 Krippendorff's alpha 检验比较观察者间一致性。
评估了 395 例女性的 MRI 检查（中位年龄=56 岁）。AB-MRI 和 Full MRI 的敏感性分别为 93.0%（95%CI=90.6-95.0）和 92.0%（95%CI=89.4-94.1），特异性分别为 91.7%（95%CI=90.3-92.9）和 94.3%（95%CI=93.2-95.3），平均阅读时间分别为 67s 和 126s，观察者间一致性分别为 0.79 和 0.83。敏感性的差异无统计学意义（=0.840），但特异性的差异有统计学意义（=0.003）。
AB-MRI 具有相似的敏感性，但特异性略低。缩短版协议的平均阅读时间较低，观察者间一致性也较低。
