Breast MRI With Abbreviated Reading Protocol as Additional Evaluation Tool for Suspicious Microcalcifications in a Screening Cohort: Diagnostic Performance and Interreader Agreement

Pöschke P, Wenkel E, Schulmeyer C, Hack CC, Beckmann MW, Janka RM, Brehm B, Peter SC, Ohlmeyer S (2026)

Publication Type: Journal article

Publication year: 2026

Journal

Anticancer Research International Institute of Anticancer Research (IIAR)

Book Volume: 46

Pages Range: 5067-5079

Journal Issue: 9

DOI: 10.21873/anticanres.18355

Abstract

BACKGROUND/AIM: Biopsy of suspicious microcalcifications (MC) detected in breast cancer screening yields benign results in the majority of cases, resulting in a substantial number of avoidable interventions. While magnetic resonance imaging (MRI) demonstrates high accuracy for invasive breast cancer, its diagnostic value for precancerous lesions remains uncertain - particularly in average-risk screening populations. This study aimed to assess the diagnostic performance of an abbreviated breast MRI reading protocol in a screening-like cohort. PATIENTS AND METHODS: In this prospective single-center study, 58 women (mean age 58±24 years) with 59 suspicious MC on full-field digital mammography (FFDM) were included. A total of 68 lesions underwent histopathological verification. MRI datasets were independently assessed by four radiologists (5-15 years of experience), blinded to mammographic findings, using a standardized abbreviated protocol including maximum intensity projection (MIP), early post-contrast subtraction, and native images. RESULTS: Among 59 microcalcification lesions, 21 were malignant and 38 benign. Sensitivity ranged from 74% to 83%, specificity from 58% to 83%, positive predictive value from 56% to 75%, negative predictive value from 83% to 86%, and accuracy from 68% to 81%. No invasive carcinomas were missed by any reader. False-negative findings were exclusively ductal carcinoma in situ (DCIS). Mean reading time ranged from 1 min 42 sec to 3 min 26 s. MIP-only evaluation demonstrated markedly lower sensitivity (48-52%) despite higher specificity (83-94%). Interreader agreement for the final recall decision was moderate (Fleiss' κ=0.47), with pairwise Cohen's κ values ranging from 0.40 to 0.53. CONCLUSION: Abbreviated breast MRI is a feasible and time-efficient approach with consistent diagnostic performance across readers for evaluating suspicious MC, further evaluation as screening tool is needed. MIP-only evaluation, does not appear to provide sufficient diagnostic reliability.

Authors with CRIS profile

Patrik Pöschke Department of Obstetrics and Gynaecology Evelyn Wenkel Medizinische Fakultät Rolf Matthias Janka Institute of Radiology Barbara Brehm Institute of Radiology Sabine Ohlmeyer Institute of Radiology

Involved external institutions

CCC Allianz WERA DE Germany (DE)

How to cite

APA:

Pöschke, P., Wenkel, E., Schulmeyer, C., Hack, C.C., Beckmann, M.W., Janka, R.M.,... Ohlmeyer, S. (2026). Breast MRI With Abbreviated Reading Protocol as Additional Evaluation Tool for Suspicious Microcalcifications in a Screening Cohort: Diagnostic Performance and Interreader Agreement. Anticancer Research, 46(9), 5067-5079. https://doi.org/10.21873/anticanres.18355

MLA:

Pöschke, Patrik, et al. "Breast MRI With Abbreviated Reading Protocol as Additional Evaluation Tool for Suspicious Microcalcifications in a Screening Cohort: Diagnostic Performance and Interreader Agreement." Anticancer Research 46.9 (2026): 5067-5079.

BibTeX: Download