Shorter MRI Exam Effectively Detects Cancer in Dense Breasts

Women with extremely dense breasts face a higher risk of missed breast cancer diagnoses, as dense glandular and fibrous tissue can obscure tumors on mammograms. While breast MRI is recommended for supplemental screening due to its higher accuracy, the lengthy procedure time and associated costs have limited its broader use. A new study now shows that abbreviated breast MRI significantly shortens exam time while retaining a high level of diagnostic accuracy, offering a faster, more accessible option for these high-risk patients.

The study by researchers at the University Medical Center at Utrecht University (Utrecht, Netherlandsl) builds on prior work from the Netherlands-based Dense Tissue and Early Breast Neoplasm Screening (DENSE) Trial, which investigated breast cancer screening in women with extremely dense breast tissue. In the latest study, the researchers performed a secondary analysis of a subset of MRI exams from the DENSE Trial to evaluate how much of the standard MRI protocol could be reduced without sacrificing diagnostic accuracy. Abbreviated MRI protocols reduce the typical 30–35 minute exam time of full-protocol breast MRI to as little as 10 minutes. This faster technique involves fewer imaging sequences while still allowing radiologists to assess the breast tissue for signs of cancer.

Image: Abbreviated axial MRI images show a 7-mm irregular mass with irregular margin (Photo courtesy of Radiology)

Seven experienced radiologists, each with at least 16 years of practice, read the same breast MRI exams with four sequences added one at a time, resulting in a total of 2,072 reads. After each step, the radiologists assigned Breast Imaging Reporting and Data System (BI-RADS) scores to determine whether a patient needed to be recalled for further testing. The study revealed that the abbreviated protocol offered sensitivity and specificity comparable to the full-protocol MRI. Importantly, adding more imaging sequences did not improve the radiologists’ ability to decide on recalls, confirming that the abbreviated protocol was sufficient. The findings, published in Radiology, demonstrated a dramatic reduction in both scan and reading times. The shortest scan time clocked in at under five minutes, with overall scan times reduced by up to 80% and reading times by 50%. This efficiency could allow more women to be screened in less time and improve the feasibility of incorporating breast MRI into national screening programs.

“Compared to mammography, breast MRI, whether abbreviated or full protocol, has a higher diagnostic accuracy for women with extremely dense breasts,” said study author Wouter B. Veldhuis, M.D., Ph.D. “Reducing the examination time and noise levels potentially improves patient experience. Moreover, shorter reading and scan times may allow implementation of MRI in national screening programs making it available for all women with extremely dense breasts.”

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