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The potential utility of abbreviated breast MRI (FAST MRI) as a tool for breast cancer screening: a systematic review and meta-analysis

2020; Elsevier BV; Volume: 76; Issue: 2 Linguagem: Inglês

10.1016/j.crad.2020.08.032

1365-229X

Rebecca Geach, Lyn Jones, Sam Harding, Andrea Marshall, Sian Taylor‐Phillips, Sadie McKeown-Keegan, Janet Dunn, Christiane Kühl, Sarah Vinnicombe, Elizabeth O’Flynn, Jennifer Wookey, Janice Rose, Christopher Foy, Victoria M. Taylor, Alexandra Valencia, John Gifford, Rosie Gray, Thomas William Jones, Karen Litton, Simon Lloyd, E. Kutt, Alice Pocklington, Anjum Mahatma, Helen Massey, Gillian M. Clark, Clare McLachlan, Gemini Beckett, Clare Alison, M Bárta, Claudia Betancourt, Julie Bramwell, Nichola Bright, Helen M. Burt, Louise Cann, Jane Ceney, Eleanor Cornford, Diana Dalgliesh, Sarah Doyle, Sarah Fearn, Dagmar Godden, Zoe Goldthorpe, Lucinda Hobson, Paula Hynam, Emma Jackson, Margaret Jenkin, Beckie Kingsnorth, Katherine Klimczak, Alice Moody, Sarah Perrin, Alison Peters, Elizabeth Preston, Anne Ratsey, Richard Sidebottom, J Steel, Lesley Stephenson, Michelle Taylor, Erika Tóth, Frances Vincent, Sharon Watkin, Sue Widdison, Jennifer M. Williams, Karen Wilmot, Premkumar Elangovan, Mark Halling‐Brown, Hesam Ghiasvand, Claire Hulme, Sravya Singamaneni, Zsolt Friedrich, Joanne Robson, Anna Mankelow,

Digital Radiography and Breast Imaging

Highlights•Abbreviated breast MRI (abMRI) detects cancer in mammography negative cases.•Sensitivity and specificity of abMRI compared to full protocol MRI were both 95%.•Accuracy of abMRI and fpMRI may be similar but evidence quality is very low.•Research is needed to compare outcomes from abMRI to those of standard screening.AbstractAIMTo synthesise evidence comparing abbreviated breast magnetic resonance imaging (abMRI) to full-protocol MRI (fpMRI) in breast cancer screening.MATERIALS AND METHODSA systematic search was undertaken in multiple databases. Cohort studies without enrichment, presenting accuracy data of abMRI in screening, for any level of risk (population, moderate, high risk) were included. Level of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Meta-analyses (bivariate random effects model) were performed for abMRI, with fpMRI and histology from fpMRI-positive cases as reference standard, and with follow-up to symptomatic detection added to the fpMRI. The review also covers evidence comparing abMRI with mammographic techniques.RESULTSThe title and abstract review retrieved 23 articles. Five studies (six articles) were included (2,763 women, 3,251 screening rounds). GRADE assessment of the evidence was very low because the reference standard was interpreted with knowledge of the index test and biopsy was not obtained for all abMRI positives. The overall sensitivity for abMRI, with fpMRI (and histology for fpMRI positives) as reference standard, was 94.8% (95% confidence interval [CI] 85.5–98.2) and specificity as 94.6% (95% CI: 91.5–96.6). Three studies (1,450 women, 1,613 screening rounds) presented follow-up data, enabling comparison between abMRI and fpMRI. Sensitivities and specificities for abMRI did not differ significantly from those for fpMRI (p=0.83 and p=0.37, respectively).CONCLUSIONA very low level of evidence suggests abMRI could be accurate for breast cancer screening. Research is required, with follow-up to interval cancer, to determine the effect its use could have on clinical outcome.