Screening programs with conventional X-ray mammography have been shown to reduce breast cancer deaths; however, conventional mammography has a high false-positive rate, leading to many unnecessary biopsies.
MR imaging could be a useful adjunct to mammography, but the examinations can be time-consuming and commonly require the injection of a contrast agent, which carries its own cost and potential complications.
For the new study, researchers evaluated an abbreviated MR breast imaging protocol that requires no contrast agent. The protocol uses only two short sequences: the first to show the shape and appearance of the lesion and the second to display its biophysiological properties with diffusion-weighted imaging with background suppression magnetic resonance mammography (DWIBS-MRM), a technique that works by assessing the diffusion, or movement, of water molecules through tissue. Areas of restricted diffusion may indicate malignancy.
The researchers compared DWIBS-MRM to an abbreviated contrast-enhanced MRI and full diagnostic breast MR protocol in 50 women with suspicious screening mammograms and indication for biopsy.
Twenty-four of the 50 participants had a breast carcinoma. DWIBS-MRM achieved a comparable accuracy to that of the full diagnostic and the abbreviated contrast-enhanced MRI protocols. The technique yielded an excellent negative predictive value of 92 percent. Negative predictive value represents the probability that a person with a negative test does not have the disease.
Only pure microcalcification related ductal carcinoma in-situ (DCIS) without solid tumor, a very early stage of breast cancer, was not detected by any of the MR techniques.
DWIBS-MRM has advantages over other MR approaches, author said. The MR images can be obtained in less than seven minutes, compared with more than 30 minutes for a full breast MR protocol. The mean reading time using the unenhanced DWIBS-MRM method is less than 30 seconds thanks to an innovative summation technique called maximum intensity projection, or MIP, that allows lesion assessment by reading one summation image instead of multiple single-slice images.
https://www2.rsna.org/timssnet/media/pressreleases/14_pr_target.cfm?ID=829
Edited
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