Maintaining accuracy and expanding access: evaluating the efficacy of the Botucatu Abbreviated Breast MRI Protocol

Abstract

Objective: Our study evaluated the effectiveness of the Botucatu Abbreviated Protocol in breast magnetic resonance imaging (MRI) within Brazil’s public healthcare system, focusing on its impact on patient access to MRI exams. Methods: This retrospective study involved 197 breast MRI exams of female patients over 18 years with histological breast carcinoma diagnosis, conducted at Hospital das Clínicas de Botucatu-UNESP between 2014 and 2018. Two experienced examiners prospectively and blindly analyzed the exams using an Integrated Picture Archiving and Communication System (PACS). They first evaluated the Botucatu Abbreviated Protocol, created from sequences of the complete protocol (PC), and after an average interval of 30 days, they reassessed the same 197 exams with the complete protocol. Dynamic and morphological characteristics of lesions were assessed according to BI-RADS 5th edition criteria. The study also analyzed the average number of monthly exams before and after the implementation of Botucatu Abbreviated Protocol. Results: The Botucatu Abbreviated Protocol showed high sensitivity (99% and 96%) and specificity (90.9% and 96%). There was a significant increase in the average monthly MRI exams from 6.62 to 23.8 post-implementation. Conclusion: The Botucatu Abbreviated Protocol proved effective in maintaining diagnostic accuracy and improving accessibility to breast MRI exams, particularly in the public healthcare setting.