An MR breast imaging technique — that requires no radiation or contrast — may help reduce the number of unnecessary biopsies, according to a new study published online in the journal Radiology.

The technique is called diffusion-weighted imaging with background suppression magnetic resonance mammography (DWUBS-MRM) and it provides additional information about suspicious mammography findings.

“Despite the positive aspects of breast cancer screenings, including the reduction in the risk of death from breast cancer, there are relevant issues that need to be considered, and among the most important harms associated with breast cancer screening are false positive results that trigger invasive procedures and emotional distress in healthy women,” Dr. Sebastian Bickelhaupt, lead author of the study, told HCB News.
Standard MR imaging can be an effective adjunct to mammography, but the exams are time-consuming and usually require contrast. However, DWIBS-MRM requires no contrast and only takes about seven minutes of acquisition time.

For the study, the researchers compared DWIBS-MRM to abbreviated contrast-enhanced MR and full diagnostic breast MR protocol in 50 women with suspicious screening mammograms and the indication for biopsy. Twenty-four of the 50 participants had a breast carcinoma.

They found that DWIBS-MRM was comparable to full diagnostic and abbreviated contrast-enhanced MR protocols. The technique resulted in a negative predictive value of 92 percent, which indicated the probably that a patient with a negative exam doesn’t have cancer.

The only thing that was not detected by any of the MR techniques was a very early-stage breast cancer called pure microcalcification-related ductal carcinoma in-situ (DCIS) without solid tumor.

The researchers concluded that DWIBS-MRM might one day be used to clarify unclear lesions that show up on mammography. “Since screening programs affect a very high number of individuals, it is of high general public and scientific interest to improve the methods and process associated with those programs,” said Bickelhaupt.

But Bickelhaupt cautioned that the research is in its early stages and that DWIBS-MRM is not intended as a standalone screening modality.

“While the results so far are promising, the degree of evidence is currently not sufficient to recommend or discuss that the method be implemented into the screening in a general setting,” he added. “We need much larger studies in order to get the evidence to discuss an introduction into routine with the medical community.”

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