FAST MRI: DYAMOND trial protocol - can an abbreviated MRI scan detect breast cancers missed by mammography for screening clients with average mammographic density attending their first screening mammogram

Sep 23, 2026

Uploaded by Ben

First post-contrast abbreviated breast MRI (FAST MRI) offers high sensitivity for sub-centimetre aggressive breast cancer with short acquisition and interpretation times, supporting effective supplemental screening. The DYAMOND study defines the target population within the population-risk UK NHS Breast Screening Programme: 50–52-year-old clients with average mammographic density (BI-RADS B) on the first screening mammogram. The protocol evaluates whether FAST MRI can detect sufficient additional breast cancers missed by mammography to justify inclusion in a future randomized controlled trial.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

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Abstract

Introduction

Methods and analysis

Strengths and limitations of the study

Ethics and dissemination

Introduction

Open access Protocol FAST MRI: DYAMOND trial protocol (can an abbreviated MRI scan detect breast cancers missed by mammography for screening clients with average mammographic density attending their first screening mammogram?)—a diagnostic yield study within the NHS population-risk breast screening programme To cite: Jones LI, Geach R, Loose A, et al. FAST MRI: DYAMOND trial protocol (can an abbreviated MRI scan detect breast cancers missed by mammography for screening clients with average mammographic density attending their first screening mammogram?)—a diagnostic yield study within the NHS population-risk breast screening programme. BMJ Open 2025;15:e106545 . doi:10 . 1136/ bmjopen-2025-106545 ► Prepublication history and additional supplemental material for this paper are available online. To view these files, please visit the journal online ([https://doi.org/10.1136/](https://doi.org/10.1136/)[ ](https://doi.org/10.1136/)[bmjopen-2025-106545](bmjopen-2025-106545)) . For ‘Presented at statement’ see end of article. Received 14 June 2025 Accepted 28 August 2025 © Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group. For numbered affiliations see end of article. Correspondence to Dr Lyn Isobel Jones; [Lyn.Jones@nbt.nhs.uk](Lyn.Jones@nbt.nhs.uk) Lyn Isobel Jones ,1,2 Rebecca Geach ,1 Abi Loose,1 Sadie McKeown-Keegan,1 Andrea Marshall,3 Mark Halling-Brown ,4 Siân Curtis,5 Sam Harding ,6,7 Jan Rose,8 Helen Matthews,9 Sarah Vinnicombe ,10 Abeer M Shaaban ,11,12 Sian Taylor-Phillips ,13 Janet Dunn,3 On behalf of The FAST MRI Study Group1 ABSTRACT Introduction First post-contrAst SubtracTed (FAST) MRI, an abbreviated breast MRI scan, has high sensitivity for sub-centimetre aggressive breast cancer and short acquisition and interpretation times. These attributes promise effective supplemental screening. Until now, FAST MRI research has focused on women above populationrisk of breast cancer (high mammographic density or personal history) . DYAMOND aims to define the population within the population-risk NHS Breast Screening Programme (NHSBSP) likely to benefit from FAST MRI. The study population is the 40% of screening clients aged 50–52 who have average mammographic density (BIRADS (Breast Imaging Reporting and Data System) B) on their first screening mammogram. DYAMOND will answer whether sufficient numbers of breast cancers, missed by mammography, can be detected by FAST MRI to justify the inclusion of this group in a future randomised controlled trial. Methods and analysis Prospective, multicentre, diagnostic yield, single-arm study with an embedded qualitative sub-study: all recruited participants undergo a FAST MRI. An internal pilot will assess the willingness of sites and screening clients to participate in the study. Screening clients aged 50–52, with a clear first NHSBSP mammogram and BI-RADS B mammographic density (by automated measurement) will be invited to participate (recruitment target: 1000) . The primary outcome is the number of additional cancers detected by FAST MRI (missed by screening mammography) . A Fleming’s two- STRENGTHS AND LIMITATIONS OF THE STUDY ⇒ Prospective, multicentre design with defined study population and sample size determined by power calculation. ⇒ Integrated quality assurance programme to optimiseand standardise intervention image quality. ⇒ DYAMOND First post-contrAst SubtracTed (FAST) MRI (FAST MRI) readers credentialed and certificated with an evaluated and standardised FAST MRI interpretation-training programme, using standard breast MRI interpretation benchmarks. ⇒ Intervention acceptability to participants assessed using an embedded qualitative substudy. ⇒ Single-arm study with limited collection of comparator data. stage design will be used as this allows for early stopping after stage 1, to save participants, funding costs and time continuing to the end of the study if the question can b

FAQs

What is the main purpose of the DYAMOND trial protocol?

To determine whether FAST MRI can detect enough additional breast cancers missed by mammography in screening clients with average mammographic density (BI-RADS B) to support a future randomized controlled trial.

Who is the intended study population?

Screening clients aged 50–52 within the NHS Breast Screening Programme who have a clear first mammogram and BI-RADS B average mammographic density based on automated measurement.

How is the study designed and what is the primary outcome?

A prospective, multicentre, diagnostic yield, single-arm study where all participants undergo FAST MRI, with an internal pilot and an embedded qualitative sub-study. The primary outcome is the number of additional cancers detected by FAST MRI that were missed by screening mammography.

Sep 23, 2026

Uploaded by Ben