Lopes da Silva Filho Agnaldo, Mitraud Ottoni Guedes Mariana, Paiva Moraes Thais, Moraes Campos Adriene, Braga de Paula Ivie, Marcondes de Oliveira Coelho Felipe, Silveira Santana Barbara, Andrade Coelho Bertha, Martins de Araújo Campos Linhares Letícia, Lima Couto Henrique
Obstetrics and Gynecology Department, Hospital das Clínicas, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil.
Breast Surgery Department, Rede Mater Dei de Saúde, Belo Horizonte, Brazil.
Breast Care (Basel). 2025 Mar 5:1-7. doi: 10.1159/000543958.
The optimized short breast MRI protocol for breast cancer screening was developed to address some limitations of the complete protocol, such as long examination duration and high cost. This study aimed to evaluate the intraobserver agreement between optimized short and complete protocols in the interpretation of breast MRI images. Specifically, we assessed the acquisition and reading times of the images, as well as the time required for report generation.
A cross-sectional study was conducted in asymptomatic women with high breast density, at moderate and high risk, who underwent breast MRI in private institutions in Belo Horizonte, MG, Brazil. An optimized short protocol was simulated on a computer by selecting images from the complete examination. The examinations were read independently, with BI-RADS categories assigned. Intraobserver agreement between this shorter protocol and the complete protocol was assessed.
A total of 170 women were included. A 100% BI-RADS agreement rate was observed in categories 1 and 2, an 80.95% agreement rate in category 3, and a 93.75% agreement rate in category 4 between the protocols. The unweighted kappa value was 0.955 (95% confidence interval [CI] 0.916-0.993), while the weighted kappa value was 0.969 (95% CI: 0.943-0.995). Furthermore, the optimized short protocol reduced examination duration by 21 min.
The optimized short breast MRI protocol provides a time-efficient alternative for breast cancer screening in moderate- to high-risk populations with dense breasts while maintaining strong agreement in BI-RADS classification. This protocol reduces costs and enhances patient tolerability, thereby improving accessibility to breast MRI.
为解决完整方案的一些局限性，如检查时间长和成本高，开发了用于乳腺癌筛查的优化短程乳腺MRI方案。本研究旨在评估优化短程方案与完整方案在乳腺MRI图像解读中的观察者内一致性。具体而言，我们评估了图像的采集和读取时间，以及生成报告所需的时间。
对巴西米纳斯吉拉斯州贝洛奥里藏特私立机构中乳房密度高、中度和高度风险的无症状女性进行了一项横断面研究。通过从完整检查中选择图像，在计算机上模拟了优化短程方案。独立读取检查结果，并分配BI-RADS类别。评估了该较短方案与完整方案之间的观察者内一致性。
共纳入170名女性。在1类和2类中观察到100%的BI-RADS一致率，3类中的一致率为80.95%，4类中的一致率为93.75%。未加权kappa值为0.955（95%置信区间[CI]0.916-0.993），加权kappa值为0.969（95%CI：0.943-0.995）。此外，优化短程方案将检查时间缩短了21分钟。
优化短程乳腺MRI方案为乳房致密的中高风险人群的乳腺癌筛查提供了一种省时的替代方案，同时在BI-RADS分类中保持高度一致。该方案降低了成本，提高了患者耐受性，从而改善了乳腺MRI的可及性。
