T2 강조 영상 및 지연기 조영 증강 영상을 포함한 변형 단축 유방 MRI의 진단 성능: 기존 단축 프로토콜과의 비교 = Modified Abbreviated Breast MRI Including T2-Weighted and Delayed Postcontrast Imaging: Diagnostic Performance Comparison with the Classic Protocol

다국어 초록 (Multilingual Abstract)

[Purpose] To compare the diagnostic performance of a modified abbreviated breast MRI (AB-MRI) protocol incorporating T2-weighted imaging and delayed-phase contrast-enhanced T1-weighted imaging with that of the conventional AB-MRI protocol, and to evaluate MRI lesion characteristics influencing diagnostic performance.

[Materials and Methods] This retrospective study included 105 women (mean age, 51.3 years) with a history of breast cancer surgery who underwent modified AB-MRI between August 2019 and January 2022, yielding a total of 122 lesions. All lesions were classified as BI-RADS category 4 or 5 and underwent second-look ultrasonography. Four radiologists independently interpreted the examinations using the conventional and modified AB-MRI protocols with a 6-week washout period. Histopathologic confirmation or imaging follow-up of at least 1 year served as the reference standard. Sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC) were compared between the two protocols. The effects of lesion size, lesion type, and background parenchymal enhancement (BPE) were also analyzed.

[Results] The modified AB-MRI protocol demonstrated significantly higher mean sensitivity (87.5% vs 76.8%, P = .014) and mean AUC (0.76 vs 0.70, P = .010) than the conventional protocol. There was no significant difference in mean specificity between the two protocols (P = .709). In subgroup analyses, the modified AB-MRI protocol showed superior diagnostic performance for lesions larger than 10 mm (AUC, 0.76 vs 0.65; P = .001) and for mass lesions (sensitivity, 93.8% vs 82.8%; P = .022). Interobserver agreement for the final BI-RADS assessment was moderate to substantial for both protocols (κ = 0.574 for the modified protocol and κ = 0.538 for the conventional protocol).

[Conclusion] A modified AB-MRI protocol incorporating T2-weighted imaging and delayed-phase contrast-enhanced T1-weighted imaging demonstrated superior diagnostic performance compared with the conventional AB-MRI protocol, with particularly improved performance for lesions larger than 10 mm and for mass lesions

목차 (Table of Contents)

• 1. Introduction. 1
• 2. Material and methods. 4
• 3. Results. 10
• 4. Discussion 21
• 5. References. 24
• 6. 요약(국문초록) 28