Contrast-enhanced spectral mammography in the evaluation of breast suspicious calcifications: diagnostic accuracy and impact on surgical management

Houben, Ivo; Vanwetswinkel, Sigrid; Kalia, Vibhuti; Thywissen, Thomas; Nelemans, Patty J.; Heuts, E. M.; Smidt, Marjolein L.; Meyer‐Baese, Anke; Wildberger, Joachim E.; Lobbes, M.

doi:10.1177/0284185118822639

Cited by 48 publications

(36 citation statements)

References 27 publications

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“…CEM allows better evaluation of calcifications by their visualization on low-energy images combined with enhancement criteria on the contrast-enhanced recombined images [10]. Dual contrast-enhanced mammography is the commonly used technique; this technique lacks kinematic information [8].…”

Section: Introductionmentioning

confidence: 99%

Can contrast-enhanced mammography replace dynamic contrast-enhanced MRI in the assessment of sonomammographic indeterminate breast lesions?

Kamal

Hanafy

Mansour

et al. 2020

Egypt J Radiol Nucl Med

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Background: Dynamic contrast-enhanced MRI of the breast has been used for several years in the assessment of indeterminate mammographic findings. Contrast-enhanced mammography is a relatively novel imaging technique that has shown comparable sensitivity and specificity to MRI. Contrast-enhanced mammography is a relatively easy feasible study with high sensitivity and low cost. Our aim was to assess the feasibility of replacing dynamic contrastenhanced (DCE)-MRI by contrast-enhanced mammography in the assessment of sonomammographic indeterminate lesions (BIRADS 3 and 4). Results: The study included 82 patients with 171 breast lesions. They all performed contrast-enhanced mammography and dynamic contrast-enhanced MRI. DCE-MRI sensitivity and NPV were significantly higher than those of contrast-enhanced mammogram (CEM). The overall accuracy of MRI was better than that of CEM; however, no statistically significant difference could be detected. Conclusion: Contrast-enhanced mammography and dynamic contrast-enhanced MRI improved the characterization of breast lesions. CEM showed slightly lower sensitivity and accuracy compared to MRI; however, because of being relatively easy, available, cheap, and acceptable by women, CEM can replace DC-MRI as a problem-solving tool in the characterization of indeterminate breast lesions.

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Section: Introductionmentioning

confidence: 99%

Can contrast-enhanced mammography replace dynamic contrast-enhanced MRI in the assessment of sonomammographic indeterminate breast lesions?

Kamal

Hanafy

Mansour

et al. 2020

Egypt J Radiol Nucl Med

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“…In another recent study by Houben et al [7] , on diagnostic accuracy of contrast-enhanced digital mammography in the evaluation of breast suspicious calcifications and impact on surgical management by low energy mammographic images combined with ultrasound showed sensitivity of 90.8%.…”

Section: Discussionmentioning

confidence: 94%

Diagnosis of Breast Micro calcifications with Contrast Enhanced Digital Mammography and Histopathological Correlation

Nassef¹,

Louka

Abdullah

2020

The Medical Journal of Cairo University

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Backgroud: Microcalcificaitons constitute up to 31% of lesions detected at screening mammography. Ductal carcinoma in situ (DCIS) often presents with microcalcificaitons on mammography. Of all mammographically detected DCIS lesions, up to 79% manifest with microcalcifications only. However, not all microcalficications are associated with in situ or malignant disease. Aim of Study: To evaluate diagnostic value of contrast enhanced digital mammography in breast microcalcificaations. Methods: A retrospective study of 30 patients having mammographic suspicious breast calcifications under BIRADS 4, 5 and 6 categories. A high-energy and a low-energy digital mammograms were obtained and then images were subtracted, isolating the iodine signal in the region of angiogenesis. 1.5mg/kg of the contrast agent was injected by hand over a period of 1 minute at a rate of 3mL per second, followed by a saline solution flush. Breast compression was applied to reduce the thickness of the breast and images obtained exactly 2 min after contrast administration. Image acquisitions: Craniocaudal and the medio-lateral oblique projections for the abnormal breast were obtained exactly 2 minutes after contrast injection followed by cranio-caudal and medio-lateral oblique projections of the normal breast. The lesions were analyzed by specialized radiologist for the presence, morphology, and pattern of enhancement. Finally, Correlation with histopathological findings was done. Results: The sensitivity of CEDM in detecting malignant pathology with contrast uptake was 96%. Compared to sensitivity of 86.7% in FFDM. There were lesions of IDC in (69.2%), lesion of DCIS in (11.5%), lesion of IDCS & IDC in (11.5%) and lesions of ILC in (3.8%). Enhancement was also observed in 3/4 (75%) of the benign lesions. Conclusion: Dual-energy contrast-enhanced digital mammography is a useful technique in the diagnosis of underlying disease in mammographically detected breast microcalcifications.

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“…These lesions represented microcalcifications, without evident tumour mass. Problems with the differential diagnosis of microcalcifications in breast cancers were described by Houben [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

The new method, the old problem – role of contrast-enhanced spectral mammography in the diagnosis of breast cancer among Polish women

et al. 2020

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Purpose The aim of the study was to evaluate spectral mammography (CESM) in diagnosing breast cancer, which is based on sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Material and methods The study included a group of 547 women who underwent spectral mammography and histopathological verification of the lesion, previously seen in mammography and/or ultrasound. In the group of 547 women, 593 focal lesions were diagnosed. All CESM examinations were carried-out with a digital mammography device dedicated to performing dual-energy CESM acquisitions. An intravenous injection of 1.5 ml/kg of body mass of non-ionic contrast agent was performed. Results The analysis includes 593 breast lesions, in this group cancer was detected in 327 (55.14%) lesions, and in 256 (43.17%) cases benign lesions were confirmed by histopathological examination and at least 12 months of observation. The method shows differentiation of benign and malignant lesions in the breast: sensitivity of 97.86%, specificity of 59.4%, PPV – 74.76%, NPV – 95.76%. Conclusions Spectral mammography could be an ideal method to detect breast cancer. Thanks to the high NPV (95.76%), it facilitates the exclusion of cancer in situations where pathological contrast enhancement is not observed. The unsatisfactory specificity of the study (59.4%) would not make it safe to avoid a core needle biopsy of lesions that undergo contrast enhancement.

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Contrast-enhanced spectral mammography in the evaluation of breast suspicious calcifications: diagnostic accuracy and impact on surgical management

Cited by 48 publications

References 27 publications

Can contrast-enhanced mammography replace dynamic contrast-enhanced MRI in the assessment of sonomammographic indeterminate breast lesions?

Can contrast-enhanced mammography replace dynamic contrast-enhanced MRI in the assessment of sonomammographic indeterminate breast lesions?

Diagnosis of Breast Micro calcifications with Contrast Enhanced Digital Mammography and Histopathological Correlation

The new method, the old problem – role of contrast-enhanced spectral mammography in the diagnosis of breast cancer among Polish women

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