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National Trends and Practices in Breast MRI

¹ Department of Radiology, University of California, Los Angeles, 200 UCLA Medical Plaza, Rm. 165-47, Box 956952, Los Angeles, CA 90095.
² Department of Radiology–Breast Imaging, Washington University School of Medicine, St. Louis, MO.
³ Department of Radiology–Breast Imaging, University of California at San Francisco, San Francisco, CA.

OBJECTIVE. The objective of our study was to report on the current practices of radiologists involved in the performance and interpretation of breast MRI in the United States.

MATERIALS AND METHODS. We invited the 1,696 active physician members of the Society of Breast Imaging to participate in a survey addressing whether and how they performed and interpreted breast MRI. Respondents were asked to select one member of their practice to complete the survey. A total of 754 surveys were completed. Every respondent did not reply to every question.

RESULTS. Contrast-enhanced breast MRI was offered at 557 of 754 (73.8%) practices. Of these, 346 of 553 (62.6%) performed at least five breast MRI examinations per week, and only 56 of 553 (10.1%) performed > 20 per week. Radiologists qualified under the Mammography Quality Standards Act supervised the performance of and interpreted breast MRI in the majority of facilities. Of 552 respondents, breast MRI was interpreted as soft copy with computer-aided detection (CAD) in 280 practices (50.7%), as soft copy without CAD in 261 (47.3%), and as hard copy in 11 (2.0%). Of 551 respondents, 256 (46.5%) never and 207 (37.6%) rarely interpreted breast MRI without correlating mammography or sonography findings. The majority of respondents never (269/561, 48.0%) or rarely (165/561, 29.4%) interpreted breast MRI performed at an outside facility. Screening breast MRI was offered at 359 of 561 (64.0%) practices. Of the practices performing contrast-enhanced examinations, 173 of 557 (31.1%) did not perform MRI-guided interventional procedures.

CONCLUSION. Contrast-enhanced breast MRI is now widely used in the United States. The information gained from this survey should provide reasonable approaches for the development of professional practice guidelines.

Keywords: breast imaging • breast MRI • practice of radiology

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