Clinical performance of contrast-enhanced spectral mammography in pre-surgical evaluation of breast malignant lesions in dense breasts: a single center study

Abstract Purpose To compare the efficacy of contrast-enhanced spectral mammography, with ultrasound, full field digital mammography and magnetic resonance imaging in detection and size estimation of histologically proven breast tumors. Methods This open-label, single center, prospective study, included 160 dense breast women with at least one suspicious mammary lesion evaluated by ultrasound, full field digital mammography and magnetic resonance imaging in whom a mammary tumor was histologically proven after surgery performed at the European Institute of Oncology between January 2013 and December 2015. Following the complete diagnostic procedure, the patients were further investigated by contrast-enhanced spectral mammography prior to surgery. Results Overall, the detection rate of malignant breast lesions (in situ and invasive) was 93.8% (165/176) for contrast-enhanced spectral mammography, 94.4% (168/178) for ultrasound, 85.5 (147/172) for full field digital mammography and 97.7% (173/177) for magnetic resonance imaging. Radiological measurements were concordant with the post-surgical pathological measurements of the invasive tumor (i.e., within 5 mm) in: 64.6% for contrast-enhanced spectral mammography, 62.0% for ultrasound, 45.2% for full field digital mammography (p < 0.0001) and 69.9% for magnetic resonance imaging (p = 0.28); underestimated in: 17.4% for contrast-enhanced spectral mammography, 19.6% for ultrasound, 24.2% for full field digital mammography (p = 0.03) and 6.7% for magnetic resonance imaging (p = 0.0005); and overestimated in: 16.2% for contrast-enhanced spectral mammography, 16.6% for ultrasound, 16.6% for full field digital mammography and 22.7% for magnetic resonance imaging (p = 0.02). Conclusions Our data suggest that contrast-enhanced spectral mammography improves on full field digital mammography and is comparable to ultrasound and magnetic resonance imaging in terms of detection sensitivity and size estimation of malignant lesions in dense breasts.

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Diagnostic Value of Contrast-Enhanced Digital Mammography versus Contrast-Enhanced Magnetic Resonance Imaging for the Preoperative Evaluation of Breast Cancer

Journal of Breast Cancer ◽

10.4048/jbc.2018.21.e62 ◽

2018 ◽

Vol 21 (4) ◽

pp. 453 ◽

Cited By ~ 8

Author(s):

Eun Young Kim ◽

Inyoung Youn ◽

Kwan Ho Lee ◽

Ji-Sup Yun ◽

Yong Lai Park ◽

...

Keyword(s):

Breast Cancer ◽

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Digital Mammography ◽

Preoperative Evaluation ◽

Diagnostic Value ◽

Resonance Imaging ◽

Contrast Enhanced

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Diagnostic accuracy of contrast-enhanced spectral mammography in comparison to conventional full-field digital mammography in a population of women with dense breasts

Breast Cancer ◽

10.1007/s12282-016-0681-8 ◽

2016 ◽

Vol 24 (1) ◽

pp. 104-110 ◽

Cited By ~ 45

Author(s):

Miki Mori ◽

Sadako Akashi-Tanaka ◽

Satoko Suzuki ◽

Murasaki Ikeda Daniels ◽

Chie Watanabe ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Digital Mammography ◽

Full Field ◽

Dense Breasts ◽

Full Field Digital Mammography ◽

Contrast Enhanced

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Diagnostic Value of Semiquantitative Analysis of Dynamic Susceptibility Contrast Magnetic Resonance Imaging with GD-EOB-DTPA in Focal Liver Lesions Characterization: A Feasibility Study

Gastroenterology Research and Practice ◽

10.1155/2015/630273 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Davide Ippolito ◽

Maddalena Colombo ◽

Chiara Trattenero ◽

Pietro Andrea Bonaffini ◽

Cammillo Talei Franzesi ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Focal Liver Lesions ◽

Dynamic Susceptibility ◽

Liver Lesions ◽

Resonance Imaging ◽

Dynamic Susceptibility Contrast ◽

Contrast Enhanced ◽

Malignant Lesions ◽

Susceptibility Contrast

Purpose.To assess the diagnostic accuracy of dynamic susceptibility contrast-enhanced magnetic resonance imaging (DSCE-MRI) in differentiation between benign and malignant liver lesions by assessment of tumoral perfusion parameters.Methods Materials.Seventy-three patients with known focal liver lesions, including 45 benign (16 FNH, 27 angiomas, and 2 abscesses) and 28 malignant ones (17 metastases, 9 HCCs, and 2 cholangiocarcinoma) underwent 1.5 T MRI upper abdominal study, with standard protocol that included dynamic contrast-enhanced sequences. On dedicated workstation, time-intensity curves were determined and the following perfusion parameters were calculated: relative arterial, venous and late enhancement (RAE, RVE, RLE), maximum enhancement (ME), relative enhancement (RE), and time to peak (TTP).Results.All diagnoses were established either by histopathology or imaging follow-up. Perfusion mean values calculated in benign lesions were RAE 33.8%, RVE 66.03%, RLE 80.63%, ME 776.00%, MRE 86.27%, and TTP 146.95 sec. Corresponding perfusion values calculated in malignant lesions were RAE 22.47%, RVE 40.54%, RLE 47.52%, ME 448.78%, MRE 49.85%, and TTP 183.79 sec. Statistical difference (p<0.05) was achieved in all the perfusion parameters calculated, obtaining different cluster of perfusion kinetics between benign and malignant lesions.Conclusions.DSCE-MRI depicts kinetic differences in perfusion parameters among the different common liver lesions, related to tumour supply and microvascular characteristics.

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Contrast-enhanced digital mammography and magnetic resonance imaging: reproducibility compared to pathologic anatomy

Tumori Journal ◽

10.1177/03008916211050124 ◽

2021 ◽

pp. 030089162110501

Author(s):

Alessandro Liguori ◽

Catherine Depretto ◽

Chiara Maura Ciniselli ◽

Andrea Citterio ◽

Giulia Boffelli ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Digital Mammography ◽

Breast Size ◽

Reference Standard ◽

Altman Analysis ◽

Resonance Imaging ◽

Bland Altman Analysis ◽

Contrast Enhanced ◽

Mass Lesions

Purpose: To compare the reproducibility between contrast-enhanced digital mammography (CEDM) and magnetic resonance imaging (MRI) with the postsurgical pathologic examination. In addition, the applicability of the Breast Imaging–Reporting and Data System (BI-RADS) lexicon of MRI to CEDM was evaluated for mass lesions. Methods: A total of 62 patients with a histologically proven diagnosis of breast cancer were included in this study, for a total of 67 lesions. Fifty-nine patients underwent both methods. The reproducibility between MRI vs CEDM and the reference standard (postoperative pathology) was assessed by considering the lesion and breast size as pivotal variables. Reproducibility was evaluated by computing the concordance correlation coefficient (CCC). Bland-Altman plots were used to depict the observed pattern of agreement as well as to estimate the associated bias. Furthermore, the pattern of agreement between the investigated methods with regard to the breast lesion characterization (i.e. mass/nonmass; shape; margins; internal enhanced characteristics) was assessed by computing the Cohen kappa and its 95% confidence interval (CI). Results: The reproducibility between MRI and the reference standard and between CEDM and the reference standard showed substantial agreement, with a CCC value of 0.956 (95% CI, 0.931–0.972) and 0.950 (95% CI, 0.920–0.969), respectively. By looking at the Bland-Altman analysis, bias values of 2.344 and 1.875 mm were observed for MRI and CEDM vs reference evaluation, respectively. The agreement between MRI and CEDM is substantial with a CCC value of 0.969 (95% CI, 0.949–0.981). The Bland-Altman analysis showed bias values of −0.469 mm when comparing CEDM vs MRI. Following the Landis and Koch classification criteria, moderate agreement was observed between the two methods in describing BI-RADS descriptors of mass lesions. Conclusion: CEDM is able to measure and describe tumor masses comparably to MRI and can be used for surgical planning.

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Diagnostic accuracy of contrast enhanced MRI pelvis in differentiating indeterminate adnexal lesions into benign and malignant with histopathological correlation

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20212384 ◽

2021 ◽

Vol 10 (7) ◽

pp. 846

Author(s):

Sorath Murtaza ◽

Junaid Iqbal ◽

Saad Ahmed ◽

Ashraf Amir Ali ◽

Marya Hameed ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Diagnostic Accuracy ◽

Tumor Size ◽

Resonance Imaging ◽

Histopathological Correlation ◽

Enhanced Mri ◽

Contrast Enhanced ◽

Malignant Lesions ◽

Contrast Enhanced Mri

Background: The objective of our study was to determine the diagnostic accuracy of contrast-enhanced magnetic resonance imaging pelvis in differentiating indeterminate adnexal lesions into benign and malignant, while considering histopathological examinations as the gold standard.Methods: A total 880 patients who underwent contrast enhanced MRI pelvis in our institute from January 2014 to June 2016 were prospectively analyzed.Results: A total of 880 women were included in this study, of which 782 (88.8%) were younger than 50 years and 98 (11.1%) were older than 50 years. Mean patient age was 56.7 years and mean tumor size was 4.38 cm. There were 648 (73.60%) patients who had a tumor size of >4 cm, and 337 (38.29%) of these tumors were found to be malignant. Furthermore, tumors smaller than 4 cm in size were observed in 232 (26.36%) of patients, of which tumors in 225 (25.56%) patients were benign.Conclusions: The diagnostic accuracy of contrast-enhanced MRI was found to be significantly high (79.65%) in differentiating indeterminate adnexal lesions into benign and malignant lesions.

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Contrast enhanced digital mammography versus magnetic resonance imaging for accurate measurement of the size of breast cancer

British Journal of Radiology ◽

10.1259/bjr.20180929 ◽

2019 ◽

pp. 20180929 ◽

Cited By ~ 4

Author(s):

Inyoung Youn ◽

SeonHyeong Choi ◽

Yoon Jung Choi ◽

Ju Hee Moon ◽

Hee Jin Park ◽

...

Keyword(s):

Breast Cancer ◽

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Digital Mammography ◽

Resonance Imaging ◽

Contrast Enhanced

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New Spatiotemporal Features for Improved Discrimination of Benign and Malignant Lesions in Dynamic Contrast-Enhanced-Magnetic Resonance Imaging of the Breast

Journal of Computer Assisted Tomography ◽

10.1097/rct.0b013e318224234f ◽

2011 ◽

Vol 35 (5) ◽

pp. 645-652 ◽

Cited By ~ 9

Author(s):

Yaniv Gal ◽

Andrew Mehnert ◽

Andrew Bradley ◽

Dominic Kennedy ◽

Stuart Crozier

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Resonance Imaging ◽

Spatiotemporal Features ◽

Dynamic Contrast Enhanced ◽

Contrast Enhanced ◽

Malignant Lesions

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Added value of contrast-enhanced spectral mammography in symptomatic patients with dense breasts

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-020-00372-2 ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Sara Ahmed Sadek Mohamed ◽

Sherine George Moftah ◽

Nivine Abd El Moneim Chalabi ◽

Mona Ali Abdel-Wahed Salem

Keyword(s):

Breast Cancer ◽

Digital Mammography ◽

Predictive Value ◽

Treatment Plan ◽

Added Value ◽

Full Field ◽

Dense Breasts ◽

Full Field Digital Mammography ◽

Appropriate Treatment ◽

Contrast Enhanced

Abstract Background Breast cancer is the most common malignancy in females around the world representing 25.1% of all cancers. The high prevalence and need for early treatment of breast malignancy highlight the importance of early and accurate diagnosis. In order to achieve this target, it is necessary to select the most appropriate modality for investigation. Early detection of breast cancer by conventional mammography tends to reduce mortality; however, it has a low sensitivity and specificity in young females with dense breasts owing to reduced contrast between a possible tumor and the surrounding breast tissue with superimposition of the glandular tissue obscuring underlying lesions. Our study included 25 patients with dense breasts presented with different breast symptoms, yet the breast lump was the most common complaint. The aim of our study is to evaluate the supplementary value of contrast-enhanced spectral mammography in the assessment of symptomatic patients with dense breasts. Results In our study, the enrolled subjects underwent both contrast-enhanced spectral mammography (CESM) and conventional full-field digital mammography (FFDM). CESM was shown to be better than FFDM in terms of sensitivity, positive predictive value, negative predictive value, and accuracy, measuring 100%, 77.8%, 100%, and 84%, compared to 56%, 75%, 46%, and 60%, respectively, yet both modalities showed low specificity, measuring 63.6% and 66.6% for CESM and FFDM, respectively. The added value of CESM was assessed in terms of ability to detect and correctly characterize the lesions in correlation to histopathological results where CESM could detect 88% of the lesions included in our study and correctly characterized 84% of the lesions; on the other side, FFDM detected only 20% of the lesions and correctly characterized 60% of the lesions. CESM changed the treatment plan to a more extensive surgery +/− neoadjuvant chemotherapy in 57% out of fourteen cases diagnosed with breast cancer emphasizing the role of CESM in assessing the extent of the disease, multicentricity, and multifocality and consequently tailoring the most appropriate treatment plan suitable for each patient. Conclusion Contrast-enhanced spectral mammography is superior to full-field digital mammography in patients with dense breasts with a significant supplementary value in detection, characterization of lesions, and tailoring the appropriate treatment plan.

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