Document Detail


Impact of breast MR in non-screening Australian clinical practice: Audit data from a single-reader single-centre site.
MedLine Citation:
PMID:  22008164     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Aim: The aim of this study was to evaluate the accuracy and clinical impact of single-reader breast MR (BMR) used as a clinical 'problem solving' tool. Methods: Observational, retrospective, ethics approved data collection for all BMR were from May 2006 to February 2009 (n = 143). Cases were stratified into groups according to indication for referral. MR data included single-reader MR diagnosis and breast imaging reporting and data system category (per-patient basis), MR descriptors of lesions (breast imaging reporting and data system lexicon), lesion number and location. Composite reference standard was established from surgical histology, core histology, cytology, MR imaging follow-up, conventional imaging follow-up and clinical follow-up in that order of priority. Impact was qualitatively captured by estimating change in management as the result of BMR. Results: Eighty-two cases were included and 61 were excluded (41 insufficient follow-up times, three known benign mass for clarification, two worried well screening and 15 other reasons). There was no statistically significant difference in included and excluded patient profiles. Our largest group of referrals was of patients with suspicious or unhelpful conventional imaging. BMR identified five malignancies in that group but missed four. In our smaller group of patients with metastatic axillary lymph nodes, BMR identified the occult primary cancer in all five cases. Conclusion: In this 'problem solving' patient population, breast MR shows greatest impact in patients with carcinoma metastases to axillary nodes, but primary not visible. In symptomatic women with unhelpful imaging or with suspicious imaging but no pre-MR diagnosis, MR identified 5/41 carcinomas, but missed 4/41.
Authors:
Esber N El-Barhoun; Alexander G Pitman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of medical imaging and radiation oncology     Volume:  55     ISSN:  1754-9485     ISO Abbreviation:  J Med Imaging Radiat Oncol     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101469340     Medline TA:  J Med Imaging Radiat Oncol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  461-73     Citation Subset:  IM    
Copyright Information:
© 2011 The Authors. Journal of Medical Imaging and Radiation Oncology © 2011 The Royal Australian and New Zealand College of Radiologists.
Affiliation:
Flinders Medical Centre, Department of Radiology, Adelaide, South Australia Lake Imaging, St John of God Hospital, Ballarat, Victoria, Australia.
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