The added value of abbreviated MRI with UF DCE-MRI and DWI on digital breast tomosynthesis in diagnosing breast lesions

Digital breast tomosynthesis (DBT) has become a standard screening tool for breast cancer. However, its diagnostic performance is still limited compared to contrast-enhanced MRI, especially in women with dense breasts. Ultrafast dynamic contrast-enhanced (UF DCE) MRI and diffusion-weighted imaging (DWI) offer a shorter scanning time than conventional MRI and have shown promise in previous studies. However, few reports have explored the added value of UF DCE-MRI and DWI on DBT in diagnosing breast lesions. This study aimed to assess the diagnostic performance of abbreviated MRI using UF DCE-MRI and DWI compared to DBT. The study included 53 lesions in 42 women who underwent the UF DCE-MRI protocol and DBT within three months. Two radiologists recorded the BI-RADS category and breast composition assessment of tomosynthesis, as well as the MR parameters of each lesion (MS and ADC). In addition to the inter-rater agreements, diagnostic performance was evaluated with an area under the receiver operating curve (AUC). The results showed good to excellent agreement in the inter-rater assessment of the BI-RADS category and each parameter. The AUC of the DBT BI-RADS and UF DCE-MRI BI-RADS categories were 0.84 and 0.90, respectively. The predictive model using UF DCE-MRI BI-RADS in combination with ADC of DWI demonstrated an AUC of 0.95. In conclusion, abbreviated MRI using UF DCE-MRI and DWI may have the potential to add value to DBT diagnosis in breast lesions. Further research is needed to determine the role of abbreviated MRI in the diagnosis of breast lesions in a prospective screening setting.