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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

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FAST MRI Study Group (Including: Geach, R., Jones, L. I., Harding, S. A., Marshall, A. (Andrea), Taylor-Phillips, Sian, McKeown-Keegan, S. and Dunn, Janet A.). (2020) The potential utility of abbreviated breast MRI (FAST MRI) as a tool for breast cancer screening : a systematic review and meta-analysis. Clinical Radiology . doi:10.1016/j.crad.2020.08.032 (In Press)

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WRAP-potential-utility-abbreviated-breast-MRI-breast-cancer-Dunn-2020.pdf - Accepted Version
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Official URL: https://doi.org/10.1016/j.crad.2020.08.032

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Abstract

To synthesise evidence comparing abbreviated breast magnetic resonance imaging (abMRI) to full-protocol MRI (fpMRI) in breast cancer screening. A 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. The 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). A 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. [Abstract copyright: Copyright © 2020 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.]

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine
Divisions: Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit
Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Breast -- Cancer -- Diagnosis, Medical screening, Breast -- Magnetic resonance imaging
Journal or Publication Title: Clinical Radiology
Publisher: Elsevier ; Royal College of Radiologists
ISSN: 0009-9260
Official Date: 30 September 2020
Dates:
DateEvent
30 September 2020Published
4 August 2020Accepted
Date of first compliant deposit: 27 October 2020
DOI: 10.1016/j.crad.2020.08.032
Status: Peer Reviewed
Publication Status: In Press
Access rights to Published version: Restricted or Subscription Access
Copyright Holders: © 2020 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
UNSPECIFIEDNorth Bristol NHS Trusthttp://dx.doi.org/10.13039/501100004922
CDFe2016-09-018National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272

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