Comparison between Breast MRI and Contrast-Enhanced Spectral Mammography

Abstract

BackgroundThe main goal of this study was to compare contrast-enhanced spectral mammography (CESM) and breast magnetic resonance imaging (MRI) with histopathological results and to compare the sensitivity, accuracy, and positive and negative predictive values for both imaging modalities.Material/MethodsAfter ethics approval, CESM and MRI examinations were performed in 102 patients who had suspicious lesions described in conventional mammography. All visible lesions were evaluated independently by 2 experienced radiologists using BI-RADS classifications (scale 1–5). Dimensions of lesions measured with each modality were compared to postoperative histopathology results.ResultsThere were 102 patients entered into CESM/MRI studies and 118 lesions were identified by the combination of CESM and breast MRI. Histopathology confirmed that 81 of 118 lesions were malignant and 37 were benign. Of the 81 malignant lesions, 72 were invasive cancers and 9 were in situ cancers. Sensitivity was 100% with CESM and 93% with breast MRI. Accuracy was 79% with CESM and 73% with breast MRI. ROC curve areas based on BI-RADS were 0.83 for CESM and 0.84 for breast MRI. Lesion size estimates on CESM and breast MRI were similar, both slightly larger than those from histopathology.ConclusionsOur results indicate that CESM has the potential to be a valuable diagnostic method that enables accurate detection of malignant breast lesions, has high negative predictive value, and a false-positive rate similar to that of breast MRI.

Contrast-enhanced spectral mammography in recalls from the Dutch breast cancer screening program: validation of results in a large multireader, multicase study

“…In some studies, specificity could not be calculated since all included subjects were diagnosed with breast cancer [3, 8, 19]. One study did not provide specificity, but accuracy instead [22]. The disease prevalences in the other studies (except the study by Lobbes et al) were higher than our population (range 36-100 %).…”

“…Several publications have studied the diagnostic performance of CESM (Table 5) [2–5, 8, 17–22]. In these studies, the mean sensitivity of CESM varied from 77.8 to 100.0 %, whereas mean specificity (if available) varied from 41 to 87.7 %.…”

Diagnostic performance of contrast-enhanced spectral mammography: Systematic review and meta-analysis

“…We found two papers where specificity was lower than 0.40 [15,17] which would seem unacceptable for clinical practice. However, in one of these papers by Luczy nska et al [15], there were no malignant lesions with absent contrast enhancement and 24/114 malignant lesions had weak, but present, enhancement. It is likely that a deeper experience in the use of a new imaging modality such as CESM may increase the diagnostic performance regarding specificity.…”

“…We [21] e þ þ e Lobbes et al [7] þ þ þ þ Łuczy nska et al [15] e þ þ ? Luczy nska et al [16] e þ þ þ Fallenberg et al [23] e þ þ ?…”

Gold silver alloy nanoparticles (GSAN): an imaging probe for breast cancer screening with dual-energy mammography or computed tomography

“…The iopamidol dose used is comparable to that used clinically. 64,65 Of note, iopamidol contains three iodine atoms per molecule. All animal imaging experiments were performed under isoflurane anesthesia.…”