Diagnostic performance of contrast-enhanced dual-energy spectral mammography (CESM): a retrospective study involving 644 breast lesions

Travieso-Aja, María del Mar; Maldonado-Saluzzi, D.; Naranjo-Santana, P.; Fernandez-Ruiz, C; Severino-Rondón, W.; Rodríguez, Mario; Benítez, Víctor Manuel Vega; Pérez-Luzardo, Octavio

doi:10.1007/s11547-019-01056-2

Cited by 21 publications

(12 citation statements)

References 43 publications

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“…7 Several studies have demonstrated CEM is superior to conventional non-contrast mammography, with CEM having higher sensitivity and specificity for breast cancer detection. 8 Despite this, there is inconsistency regarding when and how CEM should be used in our experience locally. The purpose of this study was to audit the performance of CEM compared with conventional non-contrast mammography for detecting breast cancer 2 years post introduction of CEM in our institution.…”

Section: Introductionmentioning

confidence: 99%

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Performance of contrast‐enhanced mammography for detecting multifocal and multicentric breast cancer and evaluating tumour size, and implications for surgical management: Early experience in a tertiary centre

Thanh Ha Nguyen,

Varma,

Lan Cheong Wah

et al. 2023

J Med Imag Rad Onc

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IntroductionTo compare diagnostic accuracy of contrast‐enhanced mammography (CEM) with standard 2D digital mammography (equivalent to low‐energy image; LEM) for detection of multifocal and multicentric breast cancer and evaluation of tumour size and disease extent for preoperative planning.MethodsBiopsy proven breast cancer patients who underwent CEM preoperatively between January 2021 and January 2023 were included in this study. CEM and LEM images were independently reviewed by at least two blinded readers. Lesion location, number, size (maximal diameter) and extension across the midline and/or nipple invasion were recorded. Tumour number and size estimated on imaging were compared with final operative histology, which served as the gold standard.ResultsForty‐nine patients (48 females and 1 male) and 50 cases (one patient had bilateral breast lesions) were included in the analysis. Median patient age was 60 (IQR 51, 69). CEM had significantly higher lesion detection rate compared with LEM, with sensitivities of 78% for LEM and 92% for CEM for the index tumour and 15% for LEM and 100% for CEM for multicentric and multifocal cancer. We found no statistically significant difference in median tumour size measurements on CEM and final surgical specimen (P value = 0.97); however, a significant difference was identified in the tumour size measured on LEM and surgical specimen (P value < 0.001).ConclusionCEM is superior to standard 2D digital mammography for detection of multifocal and multicentric breast cancer and is a reliable and more accurate method for estimating tumour size.

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Section: Introductionmentioning

confidence: 99%

“…Several studies have demonstrated CEM is superior to conventional non‐contrast mammography, with CEM having higher sensitivity and specificity for breast cancer detection 8 . Despite this, there is inconsistency regarding when and how CEM should be used in our experience locally.…”

Section: Introductionmentioning

confidence: 99%

Performance of contrast‐enhanced mammography for detecting multifocal and multicentric breast cancer and evaluating tumour size, and implications for surgical management: Early experience in a tertiary centre

Thanh Ha Nguyen,

Varma,

Lan Cheong Wah

et al. 2023

J Med Imag Rad Onc

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“…Several studies have revealed encouraging results especially for the use of CEM in clarifying equivocal mammographic findings, detection of occult findings particularly in dense breasts, and assessment of disease extent as well as treatment response in known malignancy [ 3 ]. CEM diagnostic performance is higher than that of FFDM or FFDM with ultrasound [ 4 – 8 ]. Furthermore, over the past few years, studies comparing CEM to MRI indicate overall similar performance in sensitivity [ 9 – 12 ] and negative predictive values, with decreased false positive rates.…”

Section: Introductionmentioning

confidence: 99%

Contrast enhanced mammography: focus on frequently encountered benign and malignant diagnoses

et al. 2023

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Contrast-enhanced mammography (CEM) is becoming a widely adopted modality in breast imaging over the past few decades and exponentially so over the last few years, with strong evidence of high diagnostic performance in cancer detection. Evidence is also growing indicating comparative performance of CEM to MRI in sensitivity with fewer false positive rates. As application of CEM ranges from potential use in screening dense breast populations to staging of known breast malignancy, increased familiarity with the modality and its implementation, and disease processes encountered becomes of great clinical significance. This review emphasizes expected normal findings on CEM followed by a focus on examples of the commonly encountered benign and malignant pathologies on CEM.

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“…In this scenario, it is now well-known that CESM could represent a reliable imaging adjunct [ 29 , 30 , 31 , 32 ] for the early detection of BC, by coupling sensitivity to specificity, thus, representing a possible solution to the weaknesses of the main diagnostic methods. However, it is still poorly understood what and how many contrastographic enhancement features (and their possible combinations) of a breast lesion occur during CESM, and how they can be used to effectively predict the malignancy of a lesion [ 33 , 34 , 35 , 36 ].…”

Section: Introductionmentioning

confidence: 99%

A Score to Predict the Malignancy of a Breast Lesion Based on Different Contrast Enhancement Patterns in Contrast-Enhanced Spectral Mammography

Nicosia

Bozzini

Palma

et al. 2022

Cancers

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Background: To create a predictive score of malignancy of a breast lesion based on the main contrast enhancement features ascertained by contrast-enhanced spectral mammography (CESM). Methods: In this single-centre prospective study, patients with suspicious breast lesions (BIRADS > 3) were enrolled between January 2013 and February 2022. All participants underwent CESM prior to breast biopsy, and eventually surgery. A radiologist with 20 years’ experience in breast imaging evaluated the presence or absence of enhancement and the following enhancement descriptors: intensity, pattern, margin, and ground glass. A score of 0 or 1 was given for each descriptor, depending on whether the enhancement characteristic was predictive of benignity or malignancy (both in situ and invasive). Then, an overall enhancement score ranging from 0 to 4 was obtained. The histological results were considered the gold standard in the evaluation of the relationship between enhancement patterns and malignancy. Results: A total of 321 women (median age: 51 years; range: 22–83) with 377 suspicious breast lesions were evaluated. Two hundred forty-nine lesions (66%) have malignant histological results (217 invasive and 32 in situ). Considering an overall enhancement score ≥ 2 as predictive of malignancy, we obtain an overall sensitivity of 92.4%; specificity of 89.8%; positive predictive value of 94.7%; and negative predictive value of 85.8%. Conclusions: Our proposed predictive score on the enhancement descriptors of CESM to predict the malignancy of a breast lesion shows excellent results and can help in early breast cancer diagnosis and in avoiding unnecessary biopsies.

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Diagnostic performance of contrast-enhanced dual-energy spectral mammography (CESM): a retrospective study involving 644 breast lesions

Cited by 21 publications

References 43 publications

Performance of contrast‐enhanced mammography for detecting multifocal and multicentric breast cancer and evaluating tumour size, and implications for surgical management: Early experience in a tertiary centre

Performance of contrast‐enhanced mammography for detecting multifocal and multicentric breast cancer and evaluating tumour size, and implications for surgical management: Early experience in a tertiary centre

Contrast enhanced mammography: focus on frequently encountered benign and malignant diagnoses

A Score to Predict the Malignancy of a Breast Lesion Based on Different Contrast Enhancement Patterns in Contrast-Enhanced Spectral Mammography

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