Added Value of Contrast-Enhanced Spectral Mammography in Postscreening Assessment

Tardivel, Anne-Marie; Balleyguier, Corinne; Dunant, Ariane; Delaloge, Suzette; Mazouni, Chafika; Mathieu, Marie‐Christine; Dromain, Clarisse

doi:10.1111/tbj.12627

Cited by 45 publications

(32 citation statements)

References 31 publications

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“…After a systematic search of the relevant electronic databases, 534 publications were initially identified, and after removal of duplicated data, studies and noncorrelated studies, 13 diagnostic publications were identified and included in the final meta‐analysis (Fig ). Of those included, five were retrospective studies and the other eight were prospective work.…”

Section: Resultsmentioning

confidence: 99%

“…Magnetic resonance imaging (MRI) for the detection of breast lesions has also been proven to be effective with relatively high sensitivity. Several studies have previously compared the diagnostic performance of CESM and MRI in breast cancer screening. However, the conclusions of these studies were different because of the small sample size and study designs.…”

Section: Introductionmentioning

confidence: 99%

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A meta‐analysis of contrast‐enhanced spectral mammography versus MRI in the diagnosis of breast cancer

2020

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Background To identify the performance of contrast‐enhanced spectral mammography (CESM) and magnetic resonance imaging (MRI) for breast cancer diagnosis by pooling the open published data. Methods A systematic review of studies relevant to CESM and MRI in the diagnosis of breast cancer were screened in the electronic databases of Pubmed, EMBASE, the Cochrane Library, Web of Science, Google scholar and CNKI. The methodical quality of the included publications was evaluated by the quality assessment of diagnostic accuracy studies‐2 (QUADAS‐2). The diagnostic sensitivity, specificity and area under the ROC curve (AUC) were pooled and the true positive (TP), false positive (FP), false negative (FN) and true negative (TN) of the original studies were calculated. Results A total of 13 diagnostic publications were identified and included in the meta‐analysis. Of those included, five were retrospective studies and the remaining eight were prospective work. The combined data indicating the pooled sensitivity and specificity of CESM and MRI were 0.97 (95% CI: 0.95–0.98), 0.66 (95% CI: 0.59–0.71), 0.97 (95% CI: 0.95–0.98),and 0.52 (95% CI: 0.46–0.58), respectively. The pooled +LR and –LR for CESM were 2.70 (95% CI: 1.57–4.65), 0.06 (95% CI: 0.04–0.09), and 2.01 (95% CI: 1.78–2.26), 0.08 (95% CI: 0.05–0.11) for MRI, respectively. For the diagnostic odds ratio (DOR), the pooled results of CESM and MRI were 60.15 (95% CI: 24.72–146.37) and 31.34 (95% CI: 19.61–50.08), respectively. The AUC of the symmetric receiver operating characteristic curve (SROC) was 0.9794 and 0.9157 for CESM and MRI, respectively, calculated using the Moses model in the diagnosis of breast cancer. Conclusions Both CESM and MRI are effective methods for the detection of breast cancer with high diagnostic sensitivity. The diagnostic performance of CESM appears to be more effective than MRI.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A meta‐analysis of contrast‐enhanced spectral mammography versus MRI in the diagnosis of breast cancer

2020

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“…However, studies have suggested promising future applications in diagnostics, therapy follow-up, and 'high-risk' patient screening. [21][22][23] Clinical studies have suggested that the lesion detection capability is significantly superior for contrastenhanced mammography than conventional mammography and ultrasound using BI-RADS lexicon in the diagnostic workup. 24,25 A recent study suggested that when used with conventional mammography, contrast-enhanced mammography was able to increase the sensitivity in detecting malignancies from 78% to 93%.…”

Section: Introductionmentioning

confidence: 99%

Quantitative contrast‐enhanced spectral mammography based on photon‐counting detectors: A feasibility study

Ding

Molloi

2017

Medical Physics

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Purpose To investigate the feasibility of accurate quantification of iodine mass thickness in contrast-enhanced spectral mammography. Materials and Methods A computer simulation model was developed to evaluate the performance of a photon-counting spectral mammography system in the application of contrast-enhanced spectral mammography. A figure-of-merit (FOM), which was defined as the decomposed iodine signal-to-noise ratio (SNR) with respect to the square root of the mean glandular dose (MGD), was chosen to optimize the imaging parameters, in terms of beam energy, splitting energy, and pre-filtrations for breasts of various thicknesses and densities. Experimental phantom studies were also performed using a beam energy of 40 kVp and a splitting energy of 34 keV with 3 mm Al pre-filtration. A two-step calibration method was investigated to quantify the iodine mass thickness, and was validated using phantoms composed of a mixture of glandular and adipose materials, for various breast thicknesses and densities. Finally, the traditional dual-energy log-weighted subtraction method was also studied as a comparison. The measured iodine signal from both methods was compared to the known value to characterize the quantification accuracy and precision. Results The optimal imaging parameters, which lead to the highest FOM, were found at a beam energy between 42 to 46 kVp with a splitting energy at 34 keV. The optimal tube voltage decreased as the breast thickness or the Al pre-filtration increased. The proposed quantification method was able to measure iodine mass thickness on phantoms of various thicknesses and densities with high accuracy. The root-mean-square (RMS) error for cm-scale lesion phantoms was estimated to be 0.20 mg/cm2. The precision of the technique, characterized by the standard deviation of the measurements, was estimated to be 0.18 mg/cm2. The traditional weighted subtraction method also predicted a linear correlation between the measured signal and the known iodine mass thickness. However, the correlation slope and offset values were strongly dependent on the total breast thickness and density. Conclusion The results of the current study suggest that iodine mass thickness for cm-scale lesions can be accurately quantified with contrast-enhanced spectral mammography. The quantitative information can potentially improve the differential power for malignancy.

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“…In practice, CESM still deserves evaluation and the results of this meta-analysis cannot be considered as conclusive. Interestingly, two recent studies confirmed a high sensitivity of CESM (94–95 %) with higher values of specificity: 81 % in the symptomatic setting [35] and 74 % in the post-screening assessment [36]. …”

Section: New Mammographic Techniques: Tomosynthesis and Contrast-enhamentioning

confidence: 99%

Mammography: an update of the EUSOBI recommendations on information for women

et al. 2016

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This article summarises the information to be offered to women about mammography. After a delineation of the aim of early diagnosis of breast cancer, the difference between screening mammography and diagnostic mammography is explained. The need to bring images and reports from the previous mammogram (and from other recent breast imaging examinations) is highlighted. Mammography technique and procedure are described with particular attention to discomfort and pain experienced by a small number of women who undergo the test. Information is given on the recall during a screening programme and on the request for further work-up after a diagnostic mammography. The logic of the mammography report and of classification systems such as R1-R5 and BI-RADS is illustrated, and brief but clear information is given about the diagnostic performance of the test, with particular reference to interval cancers, i.e., those cancers that are missed at screening mammography. Moreover, the breast cancer risk due to radiation exposure from mammography is compared to the reduction in mortality obtained with the test, and the concept of overdiagnosis is presented with a reliable estimation of its extent. Information about new mammographic technologies (tomosynthesis and contrast-enhanced spectral mammography) is also given. Finally, frequently asked questions are answered.Key Points• Direct digital mammography should be preferred to film-screen or phosphor plates.• Screening (in asymptomatic women) should be distinguished from diagnosis (in symptomatic women).• A breast symptom has to be considered even after a negative mammogram.• Digital breast tomosynthesis increases cancer detection and decreases the recall rate.• Contrast-enhanced spectral mammography can help in cancer detection and lesion characterisation.

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Added Value of Contrast-Enhanced Spectral Mammography in Postscreening Assessment

Cited by 45 publications

References 31 publications

A meta‐analysis of contrast‐enhanced spectral mammography versus MRI in the diagnosis of breast cancer

A meta‐analysis of contrast‐enhanced spectral mammography versus MRI in the diagnosis of breast cancer

Quantitative contrast‐enhanced spectral mammography based on photon‐counting detectors: A feasibility study

Mammography: an update of the EUSOBI recommendations on information for women

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