A recent study was conducted to investigate the protocols of radiology practices throughout the United States regarding the performance and interpretation of breast MRI.

Methodology
Over a 6-month period, a Web-based survey was conducted with the members of the Society of Breast Imaging. Information regarding the type and characteristics of radiology practices, availability of breast MRI, and breast MRI techniques and protocols was obtained. A total of 754 surveys were completed.

Results
In regard to type and characteristics of the radiology practice, 334 hospital-based outpatient facilities, 323 private outpatient facilities, 300 facilities solely within a hospital, 144 facilities in academic settings, 25 county facilities, and 7 military or Veterans Administration facilities responded.

In these practices, the number of radiologists reading mammograms was 1 to 3 in 162 practices, 4 to 5 in 160 practices, 6 to 10 in 238 practices, 11 to 15 in 86 practices, 16 to 20 in 39 practices, and >20 in 34 practice.

Breast MRI was offered at 569 of the 754 facilities, corresponding to 75.5% of the practices.

Of those that did not offer breast MRI, 43.2% indicated anticipated programs to begin, and 5.6% were not interested in incorporating breast MRI into their practices.

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Of the facilities performing breast MRI, 37.4% did <5 per week, 167 did 5 to 10 per week, and 14.3% did 11 to 15 breast MRIs per week.

The most common indications were to evaluate the extent of disease and an equivocal diagnostic imaging workup.

Overall, academic practices were more likely to offer breast MRI than nonacademic practices, and a greater percentage of academic practices performed MRI-guided breast interventional procedures.

Reviewer’s Comments
Contrast-enhanced breast MRI is now widely used in the United States. As this relatively new technology expands further, it is most likely that academic practices will be leading the way in adopting the vast potential of this technology. The survey shows that breast MRI is widely available in the United States, but with standardization of practice still a long way off.

Author: Basil Hubbi, MD

Reference:
Bassett LW, Dhaliwal SG, et al. National Trends and Practices in Breast MRI. AJR; 2008; 191 (August): 332-339

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