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

Abstract

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.

Can contrast-enhanced mammography replace dynamic contrast-enhanced MRI in the assessment of sonomammographic indeterminate breast lesions?

“…In another study done by Xing et al [19], the sensitivity, PPV, and NPV of CEM were comparable to those of MRI. However, the specificity of CEM was higher than that of MRI [19].…”

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

“…A total of 8 studies published between 2003 and 2019 were included in the meta-analysis analysing a total of 945 lesions, of which 36 were DCIS (range 18–263) [ [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] ](see Table 1 ). Total number of included patients were 684 in 7 studies (Tohamey and colleagues did not reported number of included patients and did not reply to our kind request to provide additional data).…”

Comparison of BSGI , MRI, mammography, and ultrasound for the diagnosis of breast lesions and their correlations with specific molecular subtypes in Chinese women

“…Recent advances in digital x-ray system development have also facilitated the design of approaches such as contrast-enhanced spectral mammography (CESM) that can overcome many of the limitations of mammography and achieve diagnostic e cacy comparable to MRI. Xing et al [19] found that CESM achieved higher speci city than MRI (89.5% vs 80.2%) and that the same was true for its positive predictive value (94.7% vs 90.5%). However, this approach is limited by the fact that it is unable to image the entire chest wall and axilla, requires compression, utilizes ionizing radiation, and requires that patients receive iodinated contrast injection.…”