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Meta-Analysis
. 2024 Dec 1;97(1164):1915-1924.
doi: 10.1093/bjr/tqae196.

Comparative diagnostic efficacy of abbreviated and full protocol breast MRI: a systematic review and a meta-analysis

Filippo Pesapane  1 , Ottavia Battaglia  2 , Anna Rotili  1 , Giulia Gnocchi  2 , Oriana D'Ecclesiis  3 , Federica Bellerba  3 , Silvia Penco  1 , Giulia Signorelli  1 , Luca Nicosia  1 , Chiara Trentin  1 , Valeria Dominelli  1 , Francesca Priolo  1 , Anna Bozzini  1 , Sara Gandini  3 , Enrico Cassano  1
Affiliations
Meta-Analysis

Comparative diagnostic efficacy of abbreviated and full protocol breast MRI: a systematic review and a meta-analysis

Filippo Pesapane et al. Br J Radiol. .

Abstract

Objectives: This meta-analysis compares the efficacy, limitations, and clinical implications of abbreviated breast MRI (AB-MRI) and full protocol MRI (FP-MRI), focusing on diagnostic accuracy across diverse populations. It extends previous analyses by including studies conducted after 2019 in both screening and diagnostic contexts.

Methods: We conducted a systematic review (November 2019 to December 2022), using a bivariate model to calculate summary estimates of sensitivity and specificity. Random effect models were applied for summary area under the curve (AUC), and probability distributions for negative and positive predictive values were obtained. Subgroup analyses explored differences in sensitivity, specificity, and AUC between AB-MRI and FP-MRI.

Results: From 11 eligible studies (1 prospective, 10 retrospective), statistical analysis revealed a significant difference in sensitivity between FP-MRI (95%) and AB-MRI (86%, P = .005), with no significant difference in specificity (P = .50). AB-MRI's shorter acquisition time suggests potential for higher patient throughput, but challenges remain in detecting small lesions and nonmass enhancements. Some studies recommend additional sequences, like diffusion-weighted imaging, to improve diagnostic performance.

Conclusions: While FP-MRI remains the gold standard in breast cancer detection, AB-MRI offers a quicker alternative, especially in high-risk screening. However, its lower sensitivity limits its use as a standalone diagnostic tool. Future research should optimize AB-MRI protocols and consider patient-specific factors to enhance breast cancer screening and diagnostic strategies.

Advances in knowledge: This meta-analysis expands understanding of AB-MRI's role in breast cancer detection, highlighting its benefits and limitations compared to FP-MRI, particularly in terms of sensitivity and screening efficiency.

Keywords: abbreviated; breast; fast; magnetic resonance; protocol.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1.
Figure 1.
Flowchart of the studies inclusion/exclusion criteria.
Figure 2.
Figure 2.
Forest plots for sensitivity and specificity. FP-MRI appears to have a significantly higher summary sensitivity compared to AB-MRI, while the summary specificity is similar between the 2 methods. Abbreviations: AB-MRI = abbreviated breast MRI; FP-MRI = and full protocol MRI.
Figure 3.
Figure 3.
Projected predictive value in AB-MR and FP-MRI by setting the prevalence range: 0.05-0.20. Abbreviations: AB-MRI = abbreviated breast MRI; FP-MRI = and full protocol MRI.
See this image and copyright information in PMC

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