Characterization of common breast MRI abnormalities: comparison between abbreviated and full MRI protocols

Abbreviated Breast MRI: State of the Art

Abbreviated MRI is an umbrella term, defined as a focused MRI examination tailored to answer a single specific clinical question. For abbreviated breast MRI, this question is: "Is there evidence of breast cancer?" Abbreviated MRI of the breast makes maximum use of the fact that the kinetics of breast cancers and of benign tissue differ most in the very early postcontrast phase; therefore, abbreviated breast MRI focuses on this period. The different published approaches to abbreviated MRI include the following three subtypes: (a) short protocols, consisting of a precontrast and either a single postcontrast acquisition (first postcontrast subtracted [FAST]) or a time-resolved series of postcontrast acquisitions with lower spatial resolution (ultrafast [UF]), obtained during the early postcontrast phase immediately after contrast agent injection; (b) abridged protocols, consisting of FAST or UF acquisitions plus selected additional pulse sequences; and (c) noncontrast protocols, where diffusion-weighted imaging replaces the contrast information. Abbreviated MRI was proposed to increase tolerability of and access to breast MRI as a screening tool. But its widening application now includes follow-up after breast cancer and even diagnostic assessment. This review defines the three subtypes of abbreviated MRI, highlighting the differences between the protocols and their clinical implications and summarizing the respective evidence on diagnostic accuracy and clinical utility.

Evaluation of Image Quality of Motion-Corrected Supine Breast MRI

Breast MRI is the most performant modality for breast cancer diagnosis and could be widespread in the future. The gold standard breast MRI is performed in the prone position, but comfort and correlation with surgery or biopsy positioning can be problematic, while supine MRI could be an interesting alternative. In this work, we evaluated the image quality of T2-weighted supine breast MRI in healthy volunteers after online correction of respiratory motion artifacts compared to standard vendor's reconstruction and to standard prone MRI. T2-weighted images were acquired in the prone and free-breathing supine position in 10 volunteers. Two types of reconstructions were evaluated for supine acquisitions: the standard vendor's reconstruction and an online version of a nonrigid motion correction technique (generalized reconstruction by inversion of coupled system). Image quality criteria, including overall quality, sharpness, uniformity, and different types of artifacts, were assessed and scored by 2 radiologists in a randomized fashion. Interobserver agreement was verified by Weighted Cohen's Kappa calculation and a comparison between the different acquisitions was made by Wilcoxon signed-rank test. Generalized Reconstruction by Inversion of Coupled Systems (GRICS) reconstruction method significantly increased image quality in comparison to the standard reconstruction of supine acquisition. It allows a comparable quality, slightly lower than the gold standard prone MRI in T2-weighted images but it needs to be assessed with more patients and with target lesions before it can be used in clinical practice.