Amy Chudgar MD, Abstract Co-Author: Nothing to Disclose

Susan Weinstein MD, Presenter: Nothing to Disclose

Elizabeth McDonald MD, PhD, Abstract Co-Author: Nothing to Disclose

Phillip Andrew Yamartino BS, Abstract Co-Author: Nothing to Disclose

Marie Synnestvedt, Abstract Co-Author: Nothing to Disclose

Emily F. Conant MD, Abstract Co-Author: Scientific Advisory Board, Hologic, Inc

Imaging with digital breast tomosynthesis (DBT) improves lesion conspicuity for both benign and malignant lesions. MRI may be used to “problem solve” inconclusive mammographic findings. We compare the utilization of MRI as a problem solving tool prior to and following the implementation of screening DBT.

This retrospective analysis was IRB approved and HIPAA compliant. Results of screening DM cases from 8/2010 to 9/2011 were compared to DBT cases from 10/2011 to 11/2013. Lesions for which MR was recommended for further evaluation were categorized as architectural distortions, asymmetries, and masses. If the MRI was requested to evaluate two findings, both findings were included separately in the analysis (3 cases).  Differences between groups were compared using Wilcoxon Rank Sum test.

A total of 10,751 DM cases were compared to 24,563 DBT cases. There were 24 DM (0.22%) and 60 DBT (0.24%) cases that utilized MRI for problem solving. The DM detected lesions were architectural distortion (4/24, 16%), asymmetry (13/24, 54%), and mass(es) (7/24, 29%). For DBT cases, the lesions evaluated with MRI were architectural distortion (21/60, 35%), asymmetry (36/60, 60%), and mass(es) (6/60, 10%). In the DBT cohort, there was significantly decreased utilization of MRI to evaluate for masses (p=0.03). There was a trend toward increased utilization of MRI for architectural distortion in the DBT cohort, but this difference was not significant (p=0.1). There was no difference in the utilization of MRI for asymmetries between the two groups (p=0.6).

The overall utilization rate of MRI as a problem solving tool did not change for patients screened with DBT compared to DM. However, the types of lesions prompting MR evaluation differed. With DBT detected lesions, utilization of MRI to evaluate masses significantly decreased, but this was offset by a trend toward increased utilization for architectural distortion.

The overall utilization rate of MRI as a problem solving tool did not differ with DM vs DBT screening, however the types of lesions that prompted further evaluation with MRI differed. 

Chudgar, A, Weinstein, S, McDonald, E, Yamartino, P, Synnestvedt, M, Conant, E, Utilization of MRI as a Problem Solving Tool Prior to and Following the Implementation of Screening DBT.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14010324.html