ISSN 1305-3825 | E-ISSN 1305-3612
Breast Imaging - Original Article
Does use of an abbreviated protocol for breast magnetic resonance imaging alter the BI-RADS classification?
1 Institut de cancérologie de Lorraine, service d'imagerie, Vandœuvre-lès-Nancy, France  
2 Institut de cancérologie de Lorraine, cellule data biostatistique, Vandœuvre-lès-Nancy,  
3 Institut de Cancérologie de Lorraine Alexis-Vautrin, Service de chirurgieVandœuvre-lès-Nancy, France; CRAN, UMR 7039, Université de Lorraine, CNRS  
Diagn Interv Radiol ; : -


Purpose: The purpose of this study was to compare the diagnostic accuracy and interpretation time of an abbreviated protocol relative to the complete protocol of breast magnetic resonance imaging (MRI) with the use of breast imaging reporting and data system (BI-RADS). Between-reader and between-protocol variability for BIRADS classification and influence of reader expertise on diagnostic accuracies were also evaluated.


Methods: We conducted a retrospective reader study in 90 women who underwent breast MRI: 30 benign examinations (American College of Radiology [ACR]1 or 2), 30 ACR3 and 30 examinations requiring a histological proof (ACR 4 or 5). Two radiologists independently reviewed the protocols. The reference standard was 24 months for imaging follow-up (66.6%, n=60), percutaneous biopsy at the 12 month imaging follow-up (5.5%, n=5), and breast surgery (27.9%, n=25). Analysis was done on a per-breast basis. There were 26 cancers in 168 breasts (15.1%).


Results: Interpretation time was higher for complete protocol (mean difference: 84sec, 95% CI [67;101] for senior and 83 sec, 95% CI [70;95] for junior reader; p<0.001) . The reliability of BI-RADS classification between both protocols was very good with intra-class correlation coefficient of 0.89 for junior and 0.98 for senior reader; the inter-reader reliability was respectively 0.94 and 0.90 for complete and abbreviated protocol. For senior reader, the specificities were 95.1% and 94.4% for abbreviated and complete protocols and sensitivities were 100 % for both.


Conclusion: Our data provide corroborating evidence that abbreviated protocols decrease interpretation time without compromising sensitivity or specificity. There was a high level of concordance between the abbreviated and the complete protocol and between the two readers.

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