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Technical aspects of breast MRI—do they affect outcomes?

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Abstract

In a systematic review of breast MRI for assessing ipsilateral breast cancer to detect additional lesions, technical details were extracted from publications to assess their effect on diagnostic performance. Where technical parameters were complete, we examined their effect on summary ROC models, and the TP:FP ratio and PPV, using random-effects logistic regression. A total of 2,801 breasts in 19 publications underwent statistical analysis for year of study, slice thickness, and repetitions after contrast-medium injection. None were associated with TP/FP ratio. Summary ROC analysis provided weak evidence (P = 0.09) of an association between diagnostic performance and time period, however no trend over time. Tesla strength was reported in 2,801 cases. Other key information was omitted including whether both breasts were examined for 1683 (60%), position of the patient in 1,375 (49%), and imaging planes used in 688 (25%). Contrast agent and dose were reported for 2,646 (95%) breasts. Reporting technique was inconsistently reported. Single radiology reports were found in 1,637 (58%) cases, double in 347 (12.4%), and in 960 (34%) knowledge of mammography or ultrasound findings was not stated. Slice thickness, number of sequences after contrast medium, and year of study did not show significant performance differences. Other technical information was deficient. There is an urgent need to improve the quality of reporting of breast MRI studies.

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References

  1. Houssami N, Ciatto S, Macaskill P et al (2008) Accuracy and surgical impact of magnetic resonance imaging in breast cancer staging: systematic review and meta-analysis in detection of multifocal and multicentric cancer. J Clin Oncol 26:3248–3258

    Article  Google Scholar 

  2. Warren RM, Thompson D, Pointon LJ et al (2006) Evaluation of a prospective scoring system designed for a multicenter breast MR imaging screening study. Radiology 239:677–685

    Article  PubMed  Google Scholar 

  3. Kuhl C (2007) The current status of breast MR imaging. Part I. Choice of technique, image interpretation, diagnostic accuracy, and transfer to clinical practice. Radiology 244:356–378

    Article  PubMed  Google Scholar 

  4. American College of Radiology (2003) Breast imaging reporting and data system atlas. American College of Radiology, Radford, VA

  5. National Health and Medical Research Council (NHMRC) (2000) How to review the evidence: systematic identification and review of the scientific literature. NHMRC, Canberra

  6. Rutter C, Gatsonis C (2001) A hierarchical regression approach to meta-analysis of diagnostic test accuracy evaluations. Stat Med 20:2865–2884

    Article  PubMed  CAS  Google Scholar 

  7. Macaskill P (2004) Empirical Bayes estimates generated in a hierarchical summary ROC analysis agreed closely with those of a full Bayesian analysis. J Clin Epidemiol 59:925–932

    Article  Google Scholar 

  8. Kuhl CK, Mielcareck P, Klaschik S et al (1999) Dynamic breast MR imaging: are signal intensity time course data useful for differential diagnosis of enhancing lesions? Radiology 211:101–110

    PubMed  CAS  Google Scholar 

  9. Sardanelli F, Giuseppetti GM, Panizza P et al (2004) Sensitivity of MRI versus mammography for detecting foci of multifocal, multicentric breast cancer in fatty and dense breasts using the whole-breast pathologic examination as a gold standard. AJR Am J Roentgenol 183:1149–1157

    PubMed  Google Scholar 

  10. Hlawatsch A, Teifke A, Schmidt M, Thelen M (2002) Preoperative assessment of breast cancer: sonography versus MR imaging. AJR Am J Roentgenol 179:1493–1501

    PubMed  Google Scholar 

  11. Drew PJ, Chatterjee S, Turnbull LW et al (1999) Dynamic contrast enhanced magnetic resonance imaging of the breast is superior to triple assessment for the pre-operative detection of multifocal breast cancer. Ann Surg Oncol 6:599–603

    Article  PubMed  CAS  Google Scholar 

  12. Boetes C, Mus RD, Holland R et al (1995) Breast tumors: comparative accuracy of MR imaging relative to mammography and US for demonstrating extent. Radiology 197:743–747

    PubMed  CAS  Google Scholar 

  13. Esserman L, Hylton N, Yassa L, Barclay J, Frankel S, Sickles E (1999) Utility of magnetic resonance imaging in the management of breast cancer: evidence for improved preoperative staging. J Clin Oncol 17:110–119

    PubMed  CAS  Google Scholar 

  14. Deurloo EE, Peterse JL, Rutgers EJ, Besnard AP, Muller SH, Gilhuijs KG (2005) Additional breast lesions in patients eligible for breast-conserving therapy by MRI: impact on preoperative management and potential benefit of computerised analysis. Eur J Cancer 41:1393–1401

    Article  PubMed  Google Scholar 

  15. Berg WA, Gutierrez L, NessAiver MS et al (2004) Diagnostic accuracy of mammography, clinical examination, US, and MR imaging in preoperative assessment of breast cancer. Radiology 233:830–849

    Article  PubMed  Google Scholar 

  16. Bagley FH (2004) The role of magnetic resonance imaging mammography in the surgical management of the index breast cancer. Arch Surg 139:380–383, discussion 383

    Article  PubMed  Google Scholar 

  17. Liberman L, Morris EA, Dershaw DD, Abramson AF, Tan LK (2003) MR imaging of the ipsilateral breast in women with percutaneously proven breast cancer. AJR Am J Roentgenol 180:901–910

    PubMed  Google Scholar 

  18. Fischer U, Kopka L, Grabbe E (1999) Breast carcinoma: effect of preoperative contrast-enhanced MR imaging on the therapeutic approach. Radiology 213:881–888

    PubMed  CAS  Google Scholar 

  19. Orel S, Schnall M, Powell C et al (1995) Staging of suspected breast cancer: effect of MR imaging and MR guided biopsy. Radiology 195:115–122

    Google Scholar 

  20. Zhang Y, Fukatsu H, Naganawa S et al (2002) The role of contrast-enhanced MR mammography for determining candidates for breast conservation surgery. Breast Cancer 9:231–239

    Article  PubMed  Google Scholar 

  21. Mumtaz H, Hall-Craggs MA, Davidson T et al (1997) Staging of symptomatic primary breast cancer with MR imaging. AJR Am J Roentgenol 169:417–424

    PubMed  CAS  Google Scholar 

  22. Schelfout K, Van Goethem M, Kersschot E et al (2004) Contrast-enhanced MR imaging of breast lesions and effect on treatment. Eur J Surg Oncol 30:501–507

    Article  PubMed  CAS  Google Scholar 

  23. Bedrosian I, Mick R, Orel SG et al (2003) Changes in the surgical management of patients with breast carcinoma based on preoperative magnetic resonance imaging. Cancer 98:468–473

    Article  PubMed  Google Scholar 

  24. Hollingsworth AB, Stough RG (2006) Preoperative breast MRI for locoregional staging. J OK State Med Assoc 99:505–515

    Google Scholar 

  25. Schnall MD, Blume J, Bluemke DA et al (2005) MRI detection of distinct incidental cancer in women with primary breast cancer studied in IBMC 6883. J Surg Oncol 92:32–38

    Article  PubMed  Google Scholar 

  26. Bilimoria KY, Cambic A, Hansen NM, Bethke KP (2007) Evaluating the impact of preoperative breast magnetic resonance imaging on the surgical management of newly diagnosed breast cancers. Arch Surg 142:441–445, discussion 445–447

    Article  PubMed  Google Scholar 

  27. Tan JE, Orel SG, Schnall MD, Schultz DJ, Solin LJ (1999) Role of magnetic resonance imaging and magnetic resonance imaging—guided surgery in the evaluation of patients with early-stage breast cancer for breast conservation treatment. Am J Clin Oncol 22:414–418

    Article  PubMed  CAS  Google Scholar 

  28. Mann RM, Kuhl CK, Kinkel K, Boetes C (2008) Breast MRI: guidelines from the European Society of Breast Imaging. Eur Radiol 18:1307–1318

    Article  PubMed  CAS  Google Scholar 

  29. Kuhl CK, Schild HH, Morakkabati N (2005) Dynamic bilateral contrast-enhanced MR imaging of the breast: trade-off between spatial and temporal resolution. Radiology 236:789–800

    Article  PubMed  Google Scholar 

  30. Hoisington LA, Scherer DL, Berger KL (2007) Breast MR imaging: applications and pitfalls. Radiolog Techno 78:367–377

    Google Scholar 

  31. Brown J, Bryan S, Warren R (1996) Mammography screening: an incremental cost effectiveness analysis of double versus single reading of mammograms [see comments]. BMJ 312:809–812

    PubMed  CAS  Google Scholar 

  32. Harvey SC, Geller B, Oppenheimer RG, Pinet M, Riddell L, Garra B (2003) Increase in cancer detection and recall rates with independent double interpretation of screening mammography. AJR Am J Roentgenol 180:1461–1467

    PubMed  Google Scholar 

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Acknowledgements

We would like to acknowledge the work of the other authors of the systematic review who extracted material which defined the present cases, and the work of Sally Lord who contributed to the previous manuscript and commented on the present one.

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Authors and Affiliations

  1. Department of Radiology, University of Cambridge, Addenbrooke’s Hospital, Cambridge, CB2 0QQ, UK

    Ruth Warren & Richard Black

  2. Centro per lo Studio e la Prevenzione Oncologica, Istituto Scientifico della Regione Toscana, Florence, Italy

    Stefano Ciatto

  3. Screening and Test Evaluation Program, School of Public Health, University of Sydney, Sydney, Australia

    Petra Macaskill & Nehmat Houssami

Authors
  1. Ruth Warren
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  2. Stefano Ciatto
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  3. Petra Macaskill
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  4. Richard Black
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  5. Nehmat Houssami
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Correspondence to Ruth Warren.

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Warren, R., Ciatto, S., Macaskill, P. et al. Technical aspects of breast MRI—do they affect outcomes?. Eur Radiol 19, 1629–1638 (2009). https://doi.org/10.1007/s00330-009-1341-6

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  • DOI: https://doi.org/10.1007/s00330-009-1341-6

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