Top

Published in:

25-02-2022 | Magnetic Resonance Imaging | Breast

Small lesion classification on abbreviated breast MRI: training can improve diagnostic performance and inter-reader agreement

Authors: Zhuangsheng Liu, Keming Liang, Ling Zhang, Chan Lai, Ruqiong Li, Lilei Yi, Ronggang Li, Ling Zhang, Wansheng Long

Published in: European Radiology | Issue 8/2022

Abstract

Objective

To determine whether the diagnostic performance and inter-reader agreement for small lesion classification on abbreviated breast MRI (AB-MRI) can be improved by training, and can achieve the level of full diagnostic protocol MRI (FDP-MRI).

Methods

This retrospective study enrolled 1165 breast lesions (≤ 2 cm; 409 malignant and 756 benign) from 1165 MRI examinations for reading test. Twelve radiologists were assigned into a trained group and a non-trained group. They interpreted each AB-MRI twice, which was extracted from FDP-MRI. After the first read, the trained group received a structured training for AB-MRI interpretation while the non-trained group did not. FDP-MRIs were interpreted by the trained group after the second read. BI-RADS category for each lesion was compared to the standard of reference (histopathological examination or follow-up) to calculate diagnostic accuracy. Inter-reader agreement was assessed using multirater k analysis. Diagnostic accuracy and inter-reader agreement were compared between the trained and non-trained groups, between the first and second reads, and between AB-MRI and FDP-MRI.

Results

After training, the diagnostic accuracy of AB-MRI increased from 77.6 to 84.4%, and inter-reader agreement improved from 0.410 to 0.579 (both p < 0.001), which were higher than those of the non-trained group (accuracy, 84.4% vs 78.0%; weighted k, 0.579 vs 0.461; both p < 0.001). The post-training accuracy and inter-reader agreement of AB-MRI were lower than those of FDP-MRI (accuracy, 84.4% vs 92.8%; weighted k, 0.579 vs 0.602; both p < 0.001).

Conclusions

Training can improve the diagnostic performance and inter-reader agreement for small lesion classification on AB-MRI; however, it remains inferior to those of FDP-MRI.

Key Points

• Training can improve the diagnostic performance for small breast lesions on AB-MRI.

• Training can reduce inter-observer variation for breast lesion classification on AB-MRI, especially among junior radiologists.

• The post-training diagnostic performance and inter-reader agreement of AB-MRI remained inferior to those of FDP-MRI.

Available only for authorised users

Bakker MF, de Lange SV, Pijnappel RM et al (2019) Supplemental MRI screening for women with extremely dense breast tissue. N Engl J Med 381:2091–2102CrossRef

Geuzinge HA, Obdeijn IM, Rutgers EJT et al (2020) Cost-effectiveness of breast cancer screening with magnetic resonance imaging for women at familial risk. JAMA Oncol 6:1381–1389CrossRef

Pinker K (2020) Preoperative MRI improves surgical planning and outcomes for ductal carcinoma in situ. Radiology 295:304–306CrossRef

Mann RM, Cho N, Moy L (2019) Breast MRI: state of the art. Radiology 292:520–536CrossRef

Liu Z, Li Z, Qu J et al (2019) Radiomics of multi-parametric MRI for pretreatment prediction of pathological complete response to neoadjuvant chemotherapy in breast cancer: a multicenter study. Clin Cancer Res 25:3538–3547CrossRef

Kuhl CK, Schrading S, Strobel K, Schild HH, Hilgers RD, Bieling HB (2014) Abbreviated breast magnetic resonance imaging (MRI): first postcontrast subtracted images and maximum-intensity projection-a novel approach to breast cancer screening with MRI. J Clin Oncol 32:2304–2310CrossRef

Deike-Hofmann K, Koenig F, Paech D et al (2019) Abbreviated MRI protocols in breast cancer diagnostics. J Magn Reson Imaging 49:647–658CrossRef

Liu Z, Li X, Feng B et al (2021) MIP image derived from abbreviated breast MRI: potential to reduce unnecessary sub-nipple biopsies during nipple-sparing mastectomy for breast cancer. Eur Radiol 31:3683–3692CrossRef

Kwon MR, Choi JS, Won H et al (2021) Breast cancer screening with abbreviated breast MRI: 3-year outcome analysis. Radiology 299:73–83CrossRef

10.

Kuhl CK (2019) Abbreviated magnetic resonance imaging (MRI) for breast cancer screening: rationale, concept, and transfer to clinical practice. Annu Rev Med 70:501–519CrossRef

11.

Comstock CE, Gatsonis C, Newstead GM et al (2020) Comparison of abbreviated breast MRI vs digital breast tomosynthesis for breast cancer detection among women with dense breasts undergoing screening. JAMA 323:746–756CrossRef

12.

Baxter GC, Selamoglu A, Mackay JW, Bond S, Gray E, Gilbert FJ (2021) A meta-analysis comparing the diagnostic performance of abbreviated MRI and a full diagnostic protocol in breast cancer. Clin Radiol 76:154.e123–154.e132CrossRef

13.

Milon A, Vande Perre S, Poujol J et al (2019) Abbreviated breast MRI combining FAST protocol and high temporal resolution (HTR) dynamic contrast enhanced (DCE) sequence. Eur J Radiol 117:199–208CrossRef

14.

Oldrini G, Fedida B, Poujol J et al (2017) Abbreviated breast magnetic resonance protocol: value of high-resolution temporal dynamic sequence to improve lesion characterization. Eur J Radiol 95:177–185CrossRef

15.

Chen SQ, Huang M, Shen YY, Liu CL, Xu CX (2017) Abbreviated MRI protocols for detecting breast cancer in women with dense breasts. Korean J Radiol 18:470–475CrossRef

16.

Liu Z, Li X, Long W (2021) Editorial for “Simultaneous multislice readout-segmented echo planar imaging for diffusion-weighted MR imaging in patients with invasive breast cancers”. J Magn Reson Imaging 53:1116–1117CrossRef

17.

Harding S, Geach R, Jones L, FAST MRI Study Group (2019) The use of ‘Think-Out-Loud’ methodology in the development of teaching materials for abbreviated breast magnetic resonance imaging scan (FAST MRI) interpretation, and a comparison of the learning experience of two reader cohorts. Eur J Radiol Open 6:220–224

18.

Gwet KL (2016) Testing the difference of correlated agreement coefficients for statistical significance. Educ Psychol Meas 76:609–637CrossRef

19.

Weinstein SP, Korhonen K, Cirelli C et al (2020) Abbreviated breast magnetic resonance imaging for supplemental screening of women with dense breasts and average Risk. J Clin Oncol 38:3874–3882CrossRef

20.

Girometti R, Nitti A, Lorenzon M, Greco F, Londero V, Zuiani C (2019) Comparison between an abbreviated and full MRI protocol for detecting additional disease when doing breast cancer staging. J Magn Reson Imaging 49:e222–e230CrossRef

21.

Geertse TD, Paap E, van der Waal D, Duijm LEM, Pijnappel RM, Broeders MJM (2019) Utility of supplemental training to improve radiologist performance in breast cancer screening: a literature review. J Am Coll Radiol 16:1528–1546CrossRef

22.

Raza S, Frost E, Kwait D et al (2021) Training nonradiologist clinicians in diagnostic breast ultrasound in rural rwanda: impact on knowledge and skills. J Am Coll Radiol 18:121–127CrossRef

23.

Jones LI, Geach R, Harding SA et al (2019) Can mammogram readers swiftly and effectively learn to interpret first post-contrast acquisition subtracted (FAST) MRI, a type of abbreviated breast MRI?: a single centre data-interpretation study. Br J Radiol 92:20190663CrossRef

24.

Timmers JM, van Doorne-Nagtegaal HJ, Verbeek AL, den Heeten GJ, Broeders MJ (2012) A dedicated BI-RADS training programme: effect on the inter-observer variation among screening radiologists. Eur J Radiol 81:2184–2188CrossRef

25.

Miglioretti DL, Gard CC, Carney PA et al (2009) When radiologists perform best: the learning curve in screening mammogram interpretation. Radiology 253:632–640CrossRef

26.

Romeo V, Cuocolo R, Liuzzi R et al (2017) Preliminary results of a simplified breast MRI protocol to characterize breast lesions: comparison with a full diagnostic protocol and a review of the current literature. Acad Radiol 24:1387–1394CrossRef

27.

Petrillo A, Fusco R, Sansone M et al (2017) Abbreviated breast dynamic contrast-enhanced MR imaging for lesion detection and characterization: the experience of an Italian oncologic center. Breast Cancer Res Treat 164:401–410CrossRef

28.

Moschetta M, Telegrafo M, Rella L, Stabile Ianora AA, Angelelli G (2016) Abbreviated combined MR protocol: a new faster strategy for characterizing breast lesions. Clin Breast Cancer 16:207–211CrossRef

29.

Seppala N, Fallah Rastegar R, Richmond L et al (2018) Rapid MRI of the breast in evaluating lesions discovered on screening. Breast J 24:986–991CrossRef

30.

Dialani V, Tseng I, Slanetz PJ et al (2019) Potential role of abbreviated MRI for breast cancer screening in an academic medical center. Breast J 25:604–611CrossRef

31.

Machida Y, Shimauchi A, Kanemaki Y, Igarashi T, Harada M, Fukuma E (2017) Feasibility and potential limitations of abbreviated breast MRI: an observer study using an enriched cohort. Breast Cancer 24:411–419CrossRef

32.

Gao Y, Heller SL (2020) Abbreviated and ultrafast breast MRI in clinical practice. Radiographics 40:1507–1527CrossRef

33.

Gur D, Bandos AI, Cohen CS et al (2008) The “laboratory” effect: comparing radiologists’ performance and variability during prospective clinical and laboratory mammography interpretations. Radiology 249:47–53CrossRef

Title: Small lesion classification on abbreviated breast MRI: training can improve diagnostic performance and inter-reader agreement
Authors: Zhuangsheng Liu
Keming Liang
Ling Zhang
Chan Lai
Ruqiong Li
Lilei Yi
Ronggang Li
Ling Zhang
Wansheng Long
Publication date: 25-02-2022
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Breast MRI
Published in: European Radiology / Issue 8/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-022-08622-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Small lesion classification on abbreviated breast MRI: training can improve diagnostic performance and inter-reader agreement

Abstract

Objective

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

Key Points

Please log in to get access to this content

Other articles of this Issue 8/2022

Low-dose contrast-enhanced time-resolved angiography with stochastic trajectories with iterative reconstruction (IT-TWIST-MRA) in brain arteriovenous shunt

Influence of oral contrast type and volume on patient experience and quality of luminal distension at MR Enterography in Crohn’s disease: an observational study of patients recruited to the METRIC trial

Microwave ablation treatment for medically inoperable stage I non-small cell lung cancers: long-term results

Prenatal quantification of human foetal lung and liver elasticities between 24 and 39 weeks of gestation using 2D shear wave elastography

Improved free-breathing liver fat and iron quantification using a 2D chemical shift–encoded MRI with flip angle modulation and motion-corrected averaging

MRI-visible enlarged perivascular spaces: imaging marker to predict cognitive impairment in older chronic insomnia patients