Accuracy of CESM versus conventional mammography and ultrasound in evaluation of BI-RADS 3 and 4 breast lesions with pathological correlation

Helal, M. A.; Samra, Manal F. Abu; Ibraheem, Mohammed A.; Salama, A.E.; Hassan, Ebtesam Esmail; Hassan, Nour El-Huda

doi:10.1016/j.ejrnm.2017.03.004

Cited by 15 publications

(20 citation statements)

References 16 publications

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“…Most of suspicious lesions showed heterogenous enhancement (88.9%). This agrees with Tohamey et al, [19] and Helal et al, [20] where 84% and 93% of malignant mass lesions displayed heterogenous internal enhancement pattern respectively. Most of CESM detected malignant lesions showed irregular (55.5%) or spiculated (33.3%) margins.…”

Section: Discussionsupporting

confidence: 93%

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The Diagnostic Performance of Contrast Enhanced Spectral Mammography in Detecting Occult Breast Lesions in Patients with Dense Breasts

Chalabi

Osman

2019

The Medical Journal of Cairo University

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Background: Contrast Enhanced Spectral Mammography (CESM) is an evolving imaging technique using contrast media to enhance the sensitivity for breast cancer detection and to extend the capability of mammography. Aim of Study: To evaluate the added benefit of Contrast Enhanced Mammography (CESM) in detecting occult breast lesions that escaped conventional Digital Mammography (DM). Patients and Methods: 68 female patients (121 breasts) with dense breasts were enrolled in this study. CESM was performed after conventional DM which was negative. CESM results were compared to sonography and histopathologic results. Diagnostic accuracy of CESM in differentiating malignant from benign lesions was determined. Results: By using CESM, 18 cancers were detected in 68 patients with negative conventional mammographic studies. CESM had sensitivity 88.9%, specificity was 100%, PPV was 100%, NPV was 60% while the overall diagnostic accuracy of CESM was 85.7% in cancer detection. Conclusion: CESM has the potential to increase breast cancer detection rate over conventional DM especially in women with dense breasts. CESM has high specificity and positive predictive value in identifying malignant breast lesions. CESM is a promising tool for screening women with dense breasts and high risk for breast cancer.

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Section: Discussionsupporting

confidence: 93%

“…Most of CESM detected malignant lesions showed irregular (55.5%) or spiculated (33.3%) margins. This concides with Tohamey et al, [19] , Helal et al, [20] and Kamal et al, [21] who reported 98.7%, 93.8% and 96.3% malignant lesions showing irregular/spiculated margins respectively.…”

Section: Discussionsupporting

confidence: 86%

The Diagnostic Performance of Contrast Enhanced Spectral Mammography in Detecting Occult Breast Lesions in Patients with Dense Breasts

Chalabi

Osman

2019

The Medical Journal of Cairo University

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“…1 ). Since in the final selection there were multiple publications by the same authors [ 27 , 30 , [34] , [35] , [36] ] or the same institutions [ [37] , [38] , [39] , [40] ] with close publication dates, we contacted the corresponding authors for those papers, to enquire if there were any overlap in patients between different publications. As a cautionary measure, given the absence of a response from the corresponding authors, we decided to include only the most recent and numerous paper from each group of suspected duplicates.…”

Section: Resultsmentioning

confidence: 99%

“…Other applications seem burdened with various concerns. Firstly, CESM showed a better performance than conventional mammography in screening breast cancer [ 39 , 42 ], especially in DPB in which the FFDM’s sensitivity is reduced from 75%–85% to 35%–45% [ 42 , 44 ]. CESM may decrease FNs especially for women with dense breasts [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of contrast-enhanced spectral mammography for breast lesions: A systematic review and meta-analysis

Suter¹,

Pesapane

Agazzi

et al. 2020

The Breast

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Breast cancer diagnosis and staging is based on mammography, ultrasound, and magnetic resonance imaging (MRI). Contrast enhanced spectral mammography (CESM) has gained momentum as an innovative and clinically useful method for breast assessment. CESM is based on abnormal enhancement of neoplastic tissue compared to surrounding breast tissue. We performed a systematic review of prospective trial to evaluate its diagnostic performance, following standard PRISMA-DTA. We used a bivariate random-effects regression approach to obtain summary estimates of both sensitivity and specificity of CESM. 8 studies published between 2003 and 2019 were included in the meta-analysis for a total of 945 lesions. The summary area under the curve obtained from all the study was 89% [95% CI 86%–91%], with a sensitivity of 85% [95% CI 73%–93%], and a specificity of 77% [95% CI 60%–88%]. With a pre-test probability of malignancy of 57% a positive finding at CESM gives a post-test probability of 83% while a negative finding a post-test probability of 20%. CESM shows a suboptimal sensitivity and specificity in the diagnosis of breast cancer in a selected population, and at present time, it could be considered only as a possible alternative test for breast lesions assessment when mammography and ultrasound are not conclusive or MRI is contraindicated or not available.

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“…Breast cancer is the most common cancer in women worldwide. It is responsible for about 23% of cancer in females in both developed and developing countries [1]. In the last few years, the incidence and the mortality rate of breast cancer have increased about 20% & 14% respectively [2].…”

Section: Introductionmentioning

confidence: 99%

BIRADS 4 breast lesions: comparison of contrast-enhanced spectral mammography and contrast-enhanced MRI

Yasin

Ghany

2019

Egypt J Radiol Nucl Med

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Background: Breast cancer is the most common cancer in women worldwide. It is responsible for about 23% of cancer in females in both developed and developing countries [1]. We aimed to assess the accuracy of contrastenhanced spectral mammography (CESM) versus contrast-enhanced breast MRI in the evaluation of BIRADS 4 breast lesions. Results: Fifty patients were included in this study; there were 28 malignant cases and 22 benign cases; all cases were proved by histopathological result either by core biopsy or excision biopsy. CESM was found to have less sensitivity (94.1%) than MRI (100%) but CESM has higher specificity (100%) than MRI (95.5%). The accuracy of CESM was 96.4%, while the accuracy of MRI was 98.2% with no statistical significance (P value 0.827). Conclusion: CESM can be used as a sensitive diagnostic tool in the detection and staging of breast cancer with higher specificity and less sensitivity as compared to contrast enhanced breast MRI.

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Accuracy of CESM versus conventional mammography and ultrasound in evaluation of BI-RADS 3 and 4 breast lesions with pathological correlation

Cited by 15 publications

References 16 publications

The Diagnostic Performance of Contrast Enhanced Spectral Mammography in Detecting Occult Breast Lesions in Patients with Dense Breasts

The Diagnostic Performance of Contrast Enhanced Spectral Mammography in Detecting Occult Breast Lesions in Patients with Dense Breasts

Diagnostic accuracy of contrast-enhanced spectral mammography for breast lesions: A systematic review and meta-analysis

BIRADS 4 breast lesions: comparison of contrast-enhanced spectral mammography and contrast-enhanced MRI

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