Reversal of the hanging protocol of Contrast Enhanced Mammography leads to similar diagnostic performance yet decreased reading times

Abstract

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Current Status of Contrast Enhanced Mammography: A Comprehensive Review

“…18 While a previous review recommended that the LE images should be interpreted first, 12 a recent study reported that reviewing the recombined images first has similar diagnostic performance, while reading time is one-third faster. 21 Regardless of the order of image review, the interpretation of CEM exams must rely on reviewing both the LE views, which provide morphological information similar to conventional mammography, and the recombined images, which provide information about the vascularization of the lesion. 8(p12), [9][10][11][12]18 Currently, there is no dedicated Breast Imaging Reporting and Data System (BI-RADS) lexicon for CEM, but the mammographic and DCE-MRI descriptors of the BI-RADS lexicon can be easily adopted for use.…”

Comparing the Diagnostic Performance of Contrast-Enhanced Mammography and Breast MRI: a Systematic Review and Meta-Analysis

“…Therefore, we do not agree with the bold statements published earlier by experts Mann and Velthuis 45 , which were based on the Pötsch review, stating that CEM would 'take us two steps back in breast imaging' compared to breast MRI. With such claims, we run the risk to prematurely exclude CEM from imaging, when in fact it is a modality which is increasingly being used with much potential 9 : more accessible to underserved populations, less expensive, shorter reading times and preferred by patients 4 , 17 , 18 , 46 .…”

Contrast-enhanced mammography: what the radiologist needs to know

“…To illustrate this, Van Geel et al compared CEM diagnostic accuracy using the ‘standard’ hanging protocol and an inverse hanging protocol ( i.e., first interpret the recombined image, followed by the LE image). 28 They found that sensitivity and specificity were equivalent between standard and inverse protocols, 98 and 99 versus 94% and 90%, respectively, but that the inverse hanging protocol led to an average decrease in reading time of 6.2 s/case. This was mainly due to shorter LE image evaluation in the inverse hanging protocol, average recombined image evaluation time remained similar.…”

“…This was mainly due to shorter LE image evaluation in the inverse hanging protocol, average recombined image evaluation time remained similar. 28 Although time differences are small, they may become of interest in situations where large volumes of CEM examinations must be read, as is the case in screening programmes.…”