Breast Imaging Division, IEO European Institute of Oncology IRCCS, Milan, Italy.
Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Milan, Italy.
Br J Radiol. 2024 Dec 1;97(1164):1915-1924. doi: 10.1093/bjr/tqae196.
This meta-analysis compares the efficacy, limitations, and clinical implications of abbreviated breast MRI (AB-MRI) and full protocol MRI (FP-MRI), focusing on diagnostic accuracy across diverse populations. It extends previous analyses by including studies conducted after 2019 in both screening and diagnostic contexts.
We conducted a systematic review (November 2019 to December 2022), using a bivariate model to calculate summary estimates of sensitivity and specificity. Random effect models were applied for summary area under the curve (AUC), and probability distributions for negative and positive predictive values were obtained. Subgroup analyses explored differences in sensitivity, specificity, and AUC between AB-MRI and FP-MRI.
From 11 eligible studies (1 prospective, 10 retrospective), statistical analysis revealed a significant difference in sensitivity between FP-MRI (95%) and AB-MRI (86%, P = .005), with no significant difference in specificity (P = .50). AB-MRI's shorter acquisition time suggests potential for higher patient throughput, but challenges remain in detecting small lesions and nonmass enhancements. Some studies recommend additional sequences, like diffusion-weighted imaging, to improve diagnostic performance.
While FP-MRI remains the gold standard in breast cancer detection, AB-MRI offers a quicker alternative, especially in high-risk screening. However, its lower sensitivity limits its use as a standalone diagnostic tool. Future research should optimize AB-MRI protocols and consider patient-specific factors to enhance breast cancer screening and diagnostic strategies.
This meta-analysis expands understanding of AB-MRI's role in breast cancer detection, highlighting its benefits and limitations compared to FP-MRI, particularly in terms of sensitivity and screening efficiency.
本荟萃分析比较了缩短式乳腺磁共振成像（AB-MRI）和全协议磁共振成像（FP-MRI）的疗效、局限性和临床意义，重点关注不同人群的诊断准确性。它通过纳入 2019 年后在筛查和诊断环境中进行的研究，扩展了之前的分析。
我们进行了系统评价（2019 年 11 月至 2022 年 12 月），使用双变量模型计算敏感性和特异性的汇总估计值。应用随机效应模型计算汇总曲线下面积（AUC），并获得阴性和阳性预测值的概率分布。亚组分析探索了 AB-MRI 和 FP-MRI 之间的敏感性、特异性和 AUC 差异。
从 11 项符合条件的研究（1 项前瞻性、10 项回顾性）中，统计分析显示 FP-MRI（95%）和 AB-MRI（86%，P=0.005）之间的敏感性存在显著差异，特异性无显著差异（P=0.50）。AB-MRI 较短的采集时间表明患者吞吐量可能更高，但在检测小病变和非肿块强化方面仍存在挑战。一些研究建议增加序列，如扩散加权成像，以提高诊断性能。
虽然 FP-MRI 仍然是乳腺癌检测的金标准，但 AB-MRI 提供了一种更快的替代方案，尤其是在高危筛查中。然而，其较低的敏感性限制了其作为独立诊断工具的使用。未来的研究应优化 AB-MRI 方案，并考虑患者的具体因素，以增强乳腺癌的筛查和诊断策略。
本荟萃分析扩展了对 AB-MRI 在乳腺癌检测中的作用的理解，强调了其与 FP-MRI 的优势和局限性，特别是在敏感性和筛查效率方面。
