In a single-center retrospective study reported in the Journal of Clinical Oncology, Eskreis-Winkler et al found that contrast-enhanced magnetic resonance imaging (MRI) using a high-temporal/high-spatial resolution (HTHS) protocol improved breast cancer detection and reduced unnecessary biopsies vs standard contrast-enhanced MRI in patients with high background parenchymal enhancement.
Study Details
The study involved contrast-enhanced breast MRI examinations performed at Memorial Sloan Kettering Cancer Center from January 2016 to December 31, 2016 (the final year during which standard breast MRI protocol was exclusively used) and from January 2019 to December 2019 (the first year that the HTHS protocol was used). The high background parenchymal enhancement analysis population included 724 patients who received standard MRI and 690 who received the HTHS protocol.
Key Findings
Among patients with high background parenchymal enhancement, the HTHS protocol was associated with a significant increase in cancer detection vs standard MRI (23.6 cases per 1,000 patients vs 7.9 cases per 1,000 patients, P = .013) and a significantly improved positive predictive value of biopsy (16.0% vs 6.3%, P = .021). These findings represent an additional cancer detection yield of 15.7 cases (95% confidence interval [CI] = 1.3–18.3 cases) per 1,000 patients and a 9.8% (95% CI = 1.29%–18.3%) decrease in the proportion of unnecessary biopsies with use of the HTHS protocol vs the standard protocol.
The investigators concluded, “Among [patients] with high background parenchymal enhancement, HTHS MRI improved diagnostic performance, leading to an additional cancer yield of 15.7 cancers per 1,000 [patients] and concomitantly decreasing unnecessary biopsies by 9.8%. A multisite prospective trial is warranted to confirm these findings and to pave the way for more widespread clinical implementation.”
Sarah Eskreis-Winkler, MD, PhD, of the Department of Radiology, Memorial Sloan Kettering Cancer Center, is the corresponding author for the Journal of Clinical Oncology article.
Disclosure: The study was supported by the National Cancer Institute. For full disclosures of the study authors, visit ascopubs.org.
