Heacock Laura, Reig Beatriu, Lewin Alana A, Toth Hildegard K, Moy Linda, Lee Cindy S
New York University Langone Health, Department of Radiology, New York, NY.
New York University Langone, Center for Advanced Imaging Innovation and Research (CAI2R), New York, NY.
J Breast Imaging. 2020 Jun 3;2(3):201-214. doi: 10.1093/jbi/wbaa020.
Breast MRI offers high sensitivity for breast cancer detection, with preferential detection of high-grade invasive cancers when compared to mammography and ultrasound. Despite the clear benefits of breast MRI in cancer screening, its cost, patient tolerance, and low utilization remain key issues. Abbreviated breast MRI, in which only a select number of sequences and postcontrast imaging are acquired, exploits the high sensitivity of breast MRI while reducing table time and reading time to maximize availability, patient tolerance, and accessibility. Worldwide studies of varying patient populations have demonstrated that the comparable diagnostic accuracy of abbreviated breast MRI is comparable to a full diagnostic protocol, highlighting the emerging role of abbreviated MRI screening in patients with an intermediate and high lifetime risk of breast cancer. The purpose of this review is to summarize the background and current literature relating to abbreviated MRI, highlight various protocols utilized in current multicenter clinical trials, describe workflow and clinical implementation issues, and discuss the future of abbreviated protocols, including advanced MRI techniques.
乳腺磁共振成像(MRI)对乳腺癌检测具有高灵敏度,与乳腺X线摄影和超声相比,更易检测出高级别浸润性癌。尽管乳腺MRI在癌症筛查方面有明显优势,但其成本、患者耐受性及低利用率仍是关键问题。简化乳腺MRI仅采集选定数量的序列和增强后成像,利用了乳腺MRI的高灵敏度,同时减少扫描时间和阅片时间,以最大限度提高可及性、患者耐受性和可获得性。针对不同患者群体的全球研究表明,简化乳腺MRI的诊断准确性与完整诊断方案相当,凸显了简化MRI筛查在乳腺癌终生风险为中高的患者中的新兴作用。本综述的目的是总结与简化MRI相关的背景和当前文献,突出当前多中心临床试验中使用的各种方案,描述工作流程和临床实施问题,并讨论简化方案的未来,包括先进的MRI技术。