Fast breast MRI protocol cuts scan times up to 80% while maintaining accuracy

A fast breast MRI protocol can cut scan times by up to 80% while maintaining diagnostic accuracy, according to new research published Tuesday. 

The modality is crucial for screening women with dense breasts, who face higher cancer risk and greater chances their mammogram may miss the disease. However, despite proven benefits, breast MRI has yet to see widespread implementation in screening programs due to high costs and capacity concerns, experts write in RSNA’s Radiology.

New data from Dutch researchers is fostering hope breast magnetic resonance imaging could see widespread adoption soon. Abbreviated breast MRI for first-round screening demonstrated “high diagnostic accuracy” and was comparable to the full-length protocol, despite dramatically shorter scan durations. 

“Reducing the examination time and noise levels potentially improves patient experience,” study author Wouter B. Veldhuis, MD, PhD, a radiologist and associate professor with the University Medical Center Utrecht in the Netherlands, said in a May 20 announcement from the Radiological Society of North America. “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.”

This secondary analysis utilized data from the Netherlands’ Dense Tissue and Early Breast Neoplasm Screening (DENSE) trial. The experiment trialed different MRI sequences, assessing the minimal protocol needed to maintain accuracy in detecting cancer. 

Seven radiologists—each with a minimum of 16 years’ experience—read the same set of 518 MRIs with four different sequences added incrementally. This resulted in a total of over 2,000 reads, according to RSNA. Conventional, full-protocol breast MRI can take an average of up to 35 minutes to complete, while the fast version is done in as few as 10 minutes. Researchers found the abbreviated protocol produced comparable sensitivity and specificity, despite scan times up to 80% shorter and pooled reading times nearly 50% quicker (49.7 vs. 96.4 seconds). 

"The shortest abbreviated protocol demonstrated good performance, comparable to that of the full multiparametric protocol, while being up to four times faster to acquire and up to two times faster to read," Valdhuis said.

Experts believe this new approach could result in more women being screened with MRI in a shorter timeframe, making the modality more accessible and comfortable for patients. But first, a prospective, multicenter trial is needed to confirm the results and validate the performance of the shortest protocol in real-world settings, the authors cautioned. 

“The core result of the study … carries substantial impact if reproduced by other studies,” Drs. Masako Kataoka and Maya Honda, with Kyoto University Hospital in Japan, wrote in a corresponding editorial. “From the perspective of a patient, the benefits of a shorter examination time are improved willingness to participate in the examination and better images with less discomfort. Combined with improvement in scanning workflow (needle placement, positioning, and scanning), abbreviated MRI can be a feasible option for patients with extremely dense breasts needing supplemental screening.