Lee-Felker Stephanie, Joines Melissa, Storer Lindsey, Li Bo, DeBruhl Nanette, Sayre James, Hoyt Anne
David Geffen School of Medicine at the University of California, Los Angeles, Department of Radiological Sciences, Los Angeles, CA.
University of California, Los Angeles, Fielding School of Public Health, Department of Biostatistics, Los Angeles, CA.
J Breast Imaging. 2020 Feb 4;2(1):43-49. doi: 10.1093/jbi/wbz071.
To evaluate extent of disease estimation of abbreviated protocol (ap) magnetic resonance imaging (MRI) compared with full protocol (fp) MRI in newly diagnosed breast cancer.
In this institutional review board-approved, Health Insurance Portability and Accountability Act-compliant, retrospective study of women with breast cancer who underwent pretreatment fpMRI on a 3 Tesla MRI in 2013, axial fat-saturated pre- and first postcontrast T1, maximum-intensity projection, and subtraction sequences were interpreted independently by three breast radiologists in two sessions, without and with prior imaging, respectively. Agreement was calculated using Cohen's kappa. Interpretations were compared with histology or clinical stability. Diagnostic performances were compared using Bennett's statistic. P < 0.05 was significant.
Eighty-one women (mean age 56 years, range 32-92 years), 116 lesions, and 95 cancers (mean size 27 mm, range 4-110 mm) were included. Agreement among radiologists for lesion assessment was excellent (0.83). apMRI cancer detection improved with prior imaging (mean sensitivity from 95% to 99%, specificity from 91% to 97%, positive predictive value [PPV] from 92% to 98%, and negative predictive value [NPV] from 95% to 99%) versus fpMRI (sensitivity 98% [93/95], specificity 94% [76/81], PPV 95% [93/98], and NPV 97% [76/78]). apMRI detected all multifocal, multicentric, and contralateral disease seen in 19% (15/81) of women to the same extent as fpMRI. apMRI axillary metastases detection improved with prior imaging (mean sensitivity from 78% to 86%, specificity from 90% to 92%, PPV from 76% to 82%, and NPV from 89% to 94%) versus fpMRI (sensitivity 71% [17/24], specificity 88% [51/58]), PPV 71% [17/24], and NPV 88% [51/58]).
apMRI may be acceptable for women with newly diagnosed cancer.
评估简化方案（ap）磁共振成像（MRI）与完整方案（fp）MRI对新诊断乳腺癌疾病评估的程度。
在这项经机构审查委员会批准、符合《健康保险流通与责任法案》的回顾性研究中，纳入了2013年在3特斯拉MRI上接受预处理fpMRI的乳腺癌女性患者。轴向脂肪饱和的 pre-和首次增强后T1、最大强度投影及减影序列由三位乳腺放射科医生在两个阶段分别独立解读，分别在无先前影像和有先前影像的情况下进行。使用科恩kappa系数计算一致性。将解读结果与组织学或临床稳定性进行比较。使用贝内特统计量比较诊断性能。P < 0.05具有统计学意义。
纳入81名女性（平均年龄56岁，范围32 - 92岁）、116个病灶和95例癌症（平均大小27毫米，范围4 - 110毫米）。放射科医生之间对病灶评估的一致性极佳（0.83）。与fpMRI相比，apMRI在有先前影像时癌症检测得到改善（平均敏感性从95%提高到99%，特异性从91%提高到97%，阳性预测值[PPV]从92%提高到98%，阴性预测值[NPV]从95%提高到99%）（敏感性98%[93/95]，特异性94%[76/81]，PPV 95%[93/98]，NPV 97%[76/78]）。apMRI在19%（15/81）的女性中检测到的所有多灶性、多中心性和对侧疾病与fpMRI的程度相同。与fpMRI相比，apMRI在有先前影像时腋窝转移检测得到改善（平均敏感性从78%提高到86%，特异性从90%提高到92%，PPV从76%提高到82%，NPV从89%提高到94%）（敏感性71%[17/24]，特异性88%[51/58]），PPV 71%[17/24]，NPV 88%[51/58]）。
apMRI对于新诊断癌症的女性可能是可接受的。
