Purpose
Breast magnetic resonance imaging (MRI) quality may vary across the United States.
Our aim was to investigate the quality of outside breast MRIs presenting for second
opinion at a tertiary cancer center following implementation of the American College
of Radiology (ACR) Breast MRI Accreditation Program.
Materials and Methods
We retrospectively reviewed the technical quality of the MRI studies of 100 consecutive
cases submitted for second opinion in 2013. The image quality was blindly reviewed
per ACR Breast MRI Accreditation Program by three fellowship-trained breast radiologists
and one breast imaging fellow.
Results
In total, 88 of the 100 cases were referred from facilities in the United States.
Sixty (68%) of the 88 cases had at least one technical deficiency. In 10 cases (11%),
more than five different technical deficiencies occurred. The most frequently encountered
deficiencies were related to artifacts (74%), with shimming (N = 17) and motion (N = 16) being the most common. In total, 38% of cases (N = 33) had a deficient T2-weighted sequence, mostly due to low signal to noise ratio
(N = 25). A total of 27% cases (N = 24) had deficiencies in the delayed phase postcontrast T1-weighted sequence, mainly
due to low signal to noise ratio (N = 21) and 23% had deficiencies in the early phase postcontrast T1-weighted sequence,
predominantly due to low signal to noise ratio as well. (N = 19).
Conclusion
Our study demonstrates variability of breast MRI quality across the United States.
Radiologists should become familiar with the requirements of the ACR breast MRI accreditation
program and strive to meet the expected standards in order to enhance patient quality
and safety.
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References
- Breast MRI: EUSOBI recommendations for women's information.Eur Radiol. 2015; 25: 3669-3678
- Clinical breast magnetic resonance imaging: technique, indications, and future applications.Semin Ultrasound CT MR. 2018; 39: 45-59
- Prospective multicenter cohort study to refine management recommendations for women at elevated familial risk of breast cancer: the EVA trial.J Clin Oncol. 2010; 28: 1450-1457
- Screening women at high risk for breast cancer with mammography and magnetic resonance imaging.Cancer. 2005; 103: 1898-1905
- Surveillance of BRCA1 and BRCA2 mutation carriers with magnetic resonance imaging, ultrasound, mammography, and clinical breast examination.JAMA. 2004; 292: 1317-1325
- Detection of breast cancer with addition of annual screening ultrasound or a single screening MRI to mammography in women with elevated breast cancer risk.JAMA. 2012; 307: 1394-1404
- Enhancing area surrounding breast carcinoma on MR mammography: comparison with pathological examination.Eur Radiol. 2004; : 1363-1370
- Breast tumors: comparative accuracy of MR imaging relative to mammography and us for demonstrating extent.Radiology. 1995; 1995: 743
- Supplemental breast MR imaging screening of women with average risk of breast cancer.Radiology. 2017; 283: 361-370
- MRI for the staging and evaluation of response to therapy in breast cancer.Top Magn Reson Imaging. 2017; 26: 211-218
Berg WA GL, Ness Aiver MS, et al. Diagnostic accuracy of mammography, clinical examination, US, and MR imaging in preoperative assessment of breast cancer. Radiology;2004:830–849.
- Lesions of the skin and superficial tissue at breast MR imaging.Radiographics. 2010; 30: 1891-1913
- Prospective evaluation of pectoralis muscle invasion of breast cancer by MR imaging.Breast Cancer. 2005; 12: 312-316
- Added cancer yield of MRI in screening the contralateral breast of women recently diagnosed with breast cancer: results from the international breast magnetic resonance consortium (IBMC) trial.J Surg Oncol. 2005; 92 (discussion 15-6): 9-15
- Delineating extramammary findings at breast MR imaging.Radiographics. 2017; 37: 10-31
- Magnetic resonance imaging evaluation of residual tumors in breast cancer after neoadjuvant chemotherapy: surgical implications.Acta Radiol. 2016; 57: 529-537
- Breast MR imaging for the assessment of residual disease following initial surgery for breast cancer with positive margins.Eur Radiol. 2017; 27: 4812-4818
- Breast MR imaging in patients with axillary node metastases and unknown primary malignancy.Radiology. 1999; 212: 543-549
- Diagnostic performance of MRI versus galactography in women with pathologic nipple discharge: a systematic review and meta-analysis.Am J Roentgenol. 2017; 209: 465-471
- Journal club: diagnostic utility of MRI after negative or inconclusive mammography for the evaluation of pathologic nipple discharge.Am J Roentgenol. 2017; 209: 1404-1410
- Clinical utility of breast MRI in the diagnosis of malignancy after inconclusive or equivocal mammographic diagnostic evaluation.Am J Roentgenol. 2017; 208: 1378-1385
- Breast MR imaging for equivocal mammographic findings: help or hindrance?.Radiographics. 2016; 36: 943-956
- MR evaluation of breast implants.Radiol Clin North Am. 2014; 52: 591-608
- High-quality breast MRI.Radiol Clin North Am. 2014; 52: 547-562
- Clinical and technical considerations for high quality breast MRI at 3 Tesla.J Magn Reson Imaging. 2013; 37: 778-790
- Indications for breast MRI in the patient with newly diagnosed breast cancer.J Natl Compr Canc Netw. 2009; 7: 193-201
- Auditing a breast MRI practice: performance measures for screening and diagnostic breast MRI.J Am Coll Radiol. 2014; 11: 883-889
American College of Radiology. The American College of Radiology Breast MRI accreditation program: frequently asked questions. http://www.acraccreditation.org/∼/media/ACRAccreditation/Documents/Breast-MRI/BMRAPFAQ.pdf?la=en. Accessed Septmber 17, 2016.
Centers for Medicare & Medicaid Services. Accreditation of advanced diagnostic imaging suppliershttps://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Accreditation-of-Advanced-Diagnostic-Imaging-Suppliers.html. Accessed January 29, 2018.
- The 2017 ACR commission on human resources workforce survey.J Am Coll Radiol. 2017; 14: 1613-1619
- Utilization of the family and medical leave act in radiology practices according to the 2016 ACR commission on human resources workforce survey.J Am Coll Radiol. 2016; 13: 1440-1446
American College of Radiology. Breat MRI accreditation program clinical image quality guide. http://www.acraccreditation.org/∼/media/ACRAccreditation/Documents/Breast-MRI/ClinicalImageQualityGuide.pdf?la=en. Accessed May 12, 2018.
- Recognizing artifacts and optimizing breast MRI at 1.5 and 3 T.Am J Roentgenol. 2013; 200: W673-W682
- Positioning in breast MR imaging to optimize image quality.Radiographics. 2014; 34: E1-E17
- The current status of breast MR imaging part i. Choice of technique, image interpretation, diagnostic accuracy, and transfer to clinical practice.Radiology. 2007; 244: 356-378
- Fat suppression techniques for breast MRI: dixon versus spectral fat saturation for 3D T1-weighted at 3T.Radiol Med. 2017; 122: 731-742
- Breast MR BI-RADS assessments and abnormal interpretation rates by clinical indication in US community practices.Acad Radiol. 2014; 21: 1370-1376
Article Info
Publication History
Published online: July 29, 2019
Accepted:
July 4,
2019
Received in revised form:
June 20,
2019
Received:
May 17,
2019
Footnotes
Funding: This work was supported in part by the National Institutes of Health through Cancer Center Support Grant P30CA106672 .
IRB approval: Our institutional review board approved this HIPAA-compliant retrospective cohort study and waived the requirement for informed consent.
Meeting presentation: Presented at the 2018 American Roentgen Ray Society Annual Meeting, Washington DC, USA, on April 22–27, 2018.
Identification
Copyright
© 2019 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
