Contrast-enhanced Spectral Mammography

Bhimani, Chandni; Matta, Danielle; Roth, Robyn; Liao, Lydia; Tinney, Elizabeth; Brill, Kristin L.; Germaine, Pauline

doi:10.1016/j.acra.2016.08.019

Cited by 57 publications

(17 citation statements)

References 7 publications

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“…Contrast-enhanced spectral mammography (CESM) is a recently developed technique based on visualization of iodinated contrast agent uptake that has been proposed as a new breast imaging adjunct [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of contrast-enhanced spectral mammography for breast lesions: A systematic review and meta-analysis

Suter¹,

Pesapane

Agazzi

et al. 2020

The Breast

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Breast cancer diagnosis and staging is based on mammography, ultrasound, and magnetic resonance imaging (MRI). Contrast enhanced spectral mammography (CESM) has gained momentum as an innovative and clinically useful method for breast assessment. CESM is based on abnormal enhancement of neoplastic tissue compared to surrounding breast tissue. We performed a systematic review of prospective trial to evaluate its diagnostic performance, following standard PRISMA-DTA. We used a bivariate random-effects regression approach to obtain summary estimates of both sensitivity and specificity of CESM. 8 studies published between 2003 and 2019 were included in the meta-analysis for a total of 945 lesions. The summary area under the curve obtained from all the study was 89% [95% CI 86%–91%], with a sensitivity of 85% [95% CI 73%–93%], and a specificity of 77% [95% CI 60%–88%]. With a pre-test probability of malignancy of 57% a positive finding at CESM gives a post-test probability of 83% while a negative finding a post-test probability of 20%. CESM shows a suboptimal sensitivity and specificity in the diagnosis of breast cancer in a selected population, and at present time, it could be considered only as a possible alternative test for breast lesions assessment when mammography and ultrasound are not conclusive or MRI is contraindicated or not available.

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Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of contrast-enhanced spectral mammography for breast lesions: A systematic review and meta-analysis

Suter¹,

Pesapane

Agazzi

et al. 2020

The Breast

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show abstract

“…The LE image presents the morphological information equivalent to 2-dimensional (2D) digital mammography, whereas the HE image displays the post–contrast-enhanced mammograms by utilizing the K-edge effect of iodine, to evaluate tumor neovascularity. 1 Given these benefits, CESM has been proven to be a viable alternative imaging tool in the detection of breast cancer. 2 Previous reports have shown that, as compared with traditional 2D mammography, application of CESM significantly increased positive rate, accuracy, and sensitivity for breast cancer detection and reduced the mortality of breast cancer because this recombined image could overcome the overlapping of normal breast tissues and eliminate the fibrous glands of breasts.…”

mentioning

confidence: 99%

Diagnostic Value of Contrast-Enhanced Spectral Mammography in Comparison to Magnetic Resonance Imaging in Breast Lesions

Dong¹,

Lv²,

Sun

et al. 2019

J Comput Assist Tomogr

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ObjectiveThe aim of this study was to evaluate the diagnostic value between contrast-enhanced spectral mammography (CESM) and breast magnetic resonance imaging (MRI) in breast disease.MethodsTwo hundred thirty-five patients who were suspected of having breast abnormalities by clinical examination or mammography underwent CESM and MRI examination. Using histopathologic results as the criterion standard, the diagnostic performance of CESM and MRI was investigated. The areas under receiver operating characteristic curves were applied to analyze diagnostic efficiency. The Pearson correlation coefficients between CESM versus pathology and MRI versus pathology were calculated.ResultsTwo hundred sixty-three breast lesions were found in 235 patients, in which 177 were malignant and 86 were benign. By evaluating the diagnostic value, sensitivity, positive predictive value, negative predictive value, and false-negative rate from CESM examination were comparable to those from MRI (91.5%, 94.7%, 83.7%, and 8.5% vs 91.5%, 90.5%, 82.1%, and 8.5%). Importantly, the accuracy and the specificity were higher for CESM than those for MRI (81% and 89.5% vs 80.2% and 71.7%), whereas the false-positive rate was lower (10.5% vs 19.8%). The areas under receiver operating characteristic curves of CESM and MRI were 0.950 and 0.939, displaying the equivalent diagnostic efficiency (P = 0.48).For the agreement between measurements, mean tumor sizes were 3.1 cm for CESM and 3.4 cm for MRI compared with 3.2 cm on histopathologic results. The Pearson correlation coefficient of CESM versus histopathology (r = 0.774, P = 0.000) was consistent with MRI versus histopathology (r = 0.771, P = 0.000).ConclusionsOur results show better accuracy, specificity, and false-positive rate of CESM in breast cancer detection than MRI. Contrast-enhanced spectral mammography displayed a good correlation with histopathology in assessing the lesion size of breast cancer, which is consistent with MRI.

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“…Contrast-enhanced spectral mammography (CESM) is a new technique intensively developed in the last few years and accepted by the FDA for clinical use in the U.S. in 2011. This method, like MRI, is based on imaging of tumour neoangiogenesis by use of contrast agent (chelated iodine-based X-ray contrast agent) [ 9 , 10 ]. The aim of the study was to evaluate CESM in diagnosing breast cancer, based on sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).…”

Section: Introductionmentioning

confidence: 99%

The new method, the old problem – role of contrast-enhanced spectral mammography in the diagnosis of breast cancer among Polish women

et al. 2020

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Purpose The aim of the study was to evaluate spectral mammography (CESM) in diagnosing breast cancer, which is based on sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Material and methods The study included a group of 547 women who underwent spectral mammography and histopathological verification of the lesion, previously seen in mammography and/or ultrasound. In the group of 547 women, 593 focal lesions were diagnosed. All CESM examinations were carried-out with a digital mammography device dedicated to performing dual-energy CESM acquisitions. An intravenous injection of 1.5 ml/kg of body mass of non-ionic contrast agent was performed. Results The analysis includes 593 breast lesions, in this group cancer was detected in 327 (55.14%) lesions, and in 256 (43.17%) cases benign lesions were confirmed by histopathological examination and at least 12 months of observation. The method shows differentiation of benign and malignant lesions in the breast: sensitivity of 97.86%, specificity of 59.4%, PPV – 74.76%, NPV – 95.76%. Conclusions Spectral mammography could be an ideal method to detect breast cancer. Thanks to the high NPV (95.76%), it facilitates the exclusion of cancer in situations where pathological contrast enhancement is not observed. The unsatisfactory specificity of the study (59.4%) would not make it safe to avoid a core needle biopsy of lesions that undergo contrast enhancement.

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Contrast-enhanced Spectral Mammography

Cited by 57 publications

References 7 publications

Diagnostic accuracy of contrast-enhanced spectral mammography for breast lesions: A systematic review and meta-analysis

Diagnostic accuracy of contrast-enhanced spectral mammography for breast lesions: A systematic review and meta-analysis

Diagnostic Value of Contrast-Enhanced Spectral Mammography in Comparison to Magnetic Resonance Imaging in Breast Lesions

The new method, the old problem – role of contrast-enhanced spectral mammography in the diagnosis of breast cancer among Polish women

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