Preoperative evaluation of breast cancer: Contrast-enhanced mammography versus contrast-enhanced magnetic resonance imaging: A systematic review and meta-analysis

Abstract

INTRODUCTION: 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. This study aimed to compare the diagnostic performance of contrast-enhanced mammography (CEM) and contrast-enhanced magnetic resonance imaging (CEMRI) in preoperative evaluations of breast lesions. METHODS: We searched for published literature in the English language in MEDLINE via PubMed and EMBASETM via Ovid, The Cochrane Library, and Trip database. For literature published in other languages, we searched national databases (Magiran and SID), KoreaMed, and LILACS. Metadisc1.4 software was used for statistical analysis RESULTS: A total of 1225 patients were included. The pooled sensitivity of CEM and CEMRI was 0.946 (95% CI, 0.931–0.958) and 0.935 (95% CI, 0.920–0.949), respectively. The pooled specificity of CEM and CEMRI was 0.783 (95% CI, 0.758–0.807) and 0.715 (95% CI, 0.688–0.741), respectively. The sensitivity of CEM was the most in the United States (97%) and the specificity of CEM was the most in Brazil (88%). MRI sensitivity was the most in USA and Egypt (99%) and China had the most MRI specificity (81%) in diagnosis of breast lesions. CONCLUSION: Contrast-enhanced mammography, a combination of high energy image and low energy image, can well display breast lesions and has the diagnostic efficacy equivalent to MRI. Importantly, CEM imaging shows higher specificity, positive predictive value, and diagnostic conformance rate than MRI. Despite some drawbacks such as higher irradiation and iodine usage, CEM has such advantages as convenient and fast examination, strong applicability, and low costs; thus, it can be popularized as a useful tool in breast disease.

Ensemble Learning for Breast Cancer Lesion Classification: A Pilot Validation Using Correlated Spectroscopic Imaging and Diffusion-Weighted Imaging

“…XGBoost, GradientBoost, RandomForest, AdaBoost and CatBoost were found to be the best-performing ensemble models in this study with 92% to 95% AUC, 86% to 90% accuracy, 87% to 89% F1 scores, 84% to 89% precision, 89% to 95% sensitivity and 79% to 85% specificity. While the highest sensitivity of 94.2% was achieved with GradientBoost, the highest specificity of 84.6% was achieved using XGBoost, which is higher than the reported performance metrics of DWI or MRSI without the application of machine learning techniques [ 37 , 38 , 39 , 40 ].…”

“…Even though the sensitivity of mp-MRI methods can be affected by various factors like tumor size and aggressiveness, these methods are often reported to have relatively high sensitivity (in the range of 88–100% for DCE-MRI, 85–95% for DWI and 80% for MRSI) [ 9 , 12 , 36 , 37 , 38 , 39 ]. Reported specificity, on the other hand, is relatively low (69–74% for DCE-MRI, 75–82% for DWI and 74% for MRSI), restricting the capability for classification of benign and malignant lesions [ 37 , 38 , 39 , 40 ]. While single-voxel spectroscopy has a reported 64–82% sensitivity and 85–91% specificity [ 41 ], the multi-voxel technique of MRSI can cover a larger area of the breast with a relatively higher spatial resolution.…”

A case report of breast cancer in silicone-injected breasts diagnosed by an emerging technique of contrast-enhanced mammography-guided biopsy

“…The sensitivity of CESM has been documented to be comparative to that of CE-MRI (19,20), making approximate pre-operative detection of multifocal or multicentric cancers (21)(22)(23). Importantly, a systemic review and meta-analysis further reported that CESM has higher specificity, positive predictive value, and diagnostic confidence rate than MRI (24). However, CESM also has true positives and false positives resembling other modalities (25).…”

Correlated MR spectroscopic imaging of breast cancer to investigate metabolites and lipids: acceleration and compressed sensing reconstruction

“… 7,8,10–15,17 The sensitivity of DCE-MRI in detection of malignant breast lesions has been reported in the range of 88–100%. 5,6,18 The sensitivity of DCE-MRI has recently been reported to be in the range of 92–95% and specificity in the range of 69 to 74% 19 with another study reporting up to 100% sensitivity and 99% specificity. 20 …”