Quantitative analysis of enhanced malignant and benign lesions on contrast-enhanced spectral mammography

Deng, Chih-Ying; Juan, Yu-Hsiang; Cheung, Yun‐Chung; Lin, Yu‐Ching; Lo, Yung‐Feng; Lin, Gigin; Chen, Shin‐Cheh; Ng, Shu‐Hang

doi:10.1259/bjr.20170605

Cited by 38 publications

(49 citation statements)

References 25 publications

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“…[ 12 ] Deng et al reported that benign and malignant breast lesions have fundamentally different degrees of enhancement, and a high degree of enhancement suggests that lesions are likely malignant. [ 13 ] The results of the studies are consistent with our findings. However, neither of them combined BI–RADS with CESM enhancement to maximize the full benefits of CESM.…”

Section: Discussionsupporting

confidence: 92%

“…[ 12 ] Deng et al quantified the enhancement degree of CESM lesions and concluded that benign and malignant breast lesions have fundamentally different enhancement degrees, and a high CESM enhancement suggests that lesions are likely malignant. [ 13 ] These studies demonstrated that CESM enhancement can be used to differentiate benign from malignant breast lesions. However, they did not provide specific quantitative analysis criteria and thus their results cannot be directly applied to clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic value of the enhancement intensity and enhancement pattern of CESM to benign and malignant breast lesions

et al. 2020

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This study aimed to improve the diagnostic accuracy of breast diseases by combining breast imaging–reporting and data system (BI–RADS) with the enhancement intensity and pattern of contrast-enhanced spectral mammography (CESM) (this combination of BI–RADS and CESM was designated as BaC). BI–RADS was used to evaluate low-energy CESM images. Spearman nonparametric correlation analysis was performed to analyze the correlation between the enhancement intensity of CESM subtraction images and the pathological results. Odds ratio (OR) values were calculated to determine whether the enhancement pattern of CESM subtraction images is a risk factor for benign and malignant lesions. The diagnostic efficacies of BI–RADS, CESM, and BaC scores for benign and malignant breast diseases were analyzed using the receiver operating characteristic (ROC) curve. Lesions with a high enhancement intensity were more likely to be malignant than those with low enhancement intensity. Lesions with heterogeneous enhancement tended to be malignant, whereas those with homogeneous enhancement tended to be benign. No significant correlation was observed between ring enhancement and the benignity or malignancy of lesions. The area under the ROC curve of BaC was higher than that of BI–RADS or CESM, and the difference was statistically significant. The diagnostic efficacy of BI–RADS combined with CESM enhancement was superior to that of either method alone.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Diagnostic value of the enhancement intensity and enhancement pattern of CESM to benign and malignant breast lesions

et al. 2020

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“…For enhancement intensity, this preliminary research suggested that enhancement intensity of malignancies was usually stronger than that of benign lesions (Table 1), which was consistent with other researchers' findings 6,[11][12][13][14]17 . Lewin et al 6 concluded that 84.6% (11/13) of invasive cancers enhanced strongly, while all benign lesions (n = 12) were presented as no or weak enhancement qualitatively.…”

Section: Discussionsupporting

confidence: 90%

“…However, there is no research before investigating the correlation between enhancement intensity and hormonal receptor status of breast cancers. As for enhancement patterns, several published papers 4,13,15 claimed that the distribution of enhancement patterns between benign and malignant lesions was different, which was similar to time-intensity curve (TIC) on breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Whereas, it is uncertain that how is the agreement between two modalities.…”

mentioning

confidence: 99%

“…Given that a number of benign lesions can reveal enhancement on CESM 8,11 , researchers have focused on how to differentiate breast cancers from benign lesions and improve the diagnostic specificity. Previous studies [12][13][14] have proved the diagnostic performance of enhancement intensity for breast cancers and concluded that enhancement intensity of malignancies was usually stronger than that of benign lesions. Moreover, invasive cancers were inclined to enhance stronger than non-invasive cancers and benign lesions 12,14 .…”

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confidence: 99%

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Quantitative Analysis of Enhancement Intensity and Patterns on Contrast-enhanced Spectral Mammography

Liu

Huang

Zhang

et al. 2020

Sci Rep

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CESM is an emerging digital mammography technology with a high breast cancer detection and a limited diagnostic specificity. In order to improve specificity, we quantitatively assessed enhancement intensity of breast lesions with different pathological types and hormonal receptor status and evaluated the consistency of enhancement patterns between CESM and DCE-MRI. A total of 145 lesions were enrolled, consisting of 43 malignant (17 non-infiltrating cancers and 26 infiltrating cancers) and 99 benign lesions. The diagnostic performance of enhancement intensity in the former positions was significantly higher than that in the latter positions (AUC: 0.834 vs. 0.755, p = 0.0008). Infiltrating cancers showed the highest enhancement intensity, while benign lesions the lowest (mean CNR1: 7.6% vs. 2.7%; median CNR1: 6.8% vs. 2.7%). Enhancement intensity of ER or PR positive group was weaker than negative group, while HER-2 positive group was stronger than negative group. 28 patients with 28 lesions performed both CESM and DCE-MRI examinations, showing a coincidence rate of 64.2% and moderate agreement (k = 0.515) between CESM and DCE-MRI. In conclusion, quantitative analysis of enhancement characteristics is feasible to the diagnosis practice on CESM.

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Diagnostic performance of contrast‐enhanced mammography for suspicious findings in dense breasts: A systematic review and meta‐analysis

Lin,

Li,

et al. 2024

Cancer Medicine

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PurposeContrast‐enhanced spectral imaging (CEM) is a new mammography technique, but its diagnostic value in dense breasts is still inconclusive. We did a systematic review and meta‐analysis of studies evaluating the diagnostic performance of CEM for suspicious findings in dense breasts.Materials and MethodsThe PubMed, Embase, and Cochrane Library databases were searched systematically until August 6, 2023. Prospective and retrospective studies were included to evaluate the diagnostic performance of CEM for suspicious findings in dense breasts. The QUADAS‐2 tool was used to evaluate the quality and risk of bias of the included studies. STATA V.16.0 and Review Manager V.5.3 were used to meta‐analyze the included studies.ResultsA total of 10 studies (827 patients, 958 lesions) were included. These 10 studies reported the diagnostic performance of CEM for the workup of suspicious lesions in patients with dense breasts. The summary sensitivity and summary specificity were 0.95 (95% CI, 0.92–0.97) and 0.81 (95% CI, 0.70–0.89), respectively. Enhanced lesions, circumscribed margins, and malignancy were statistically correlated. The relative malignancy OR value of the enhanced lesions was 28.11 (95% CI, 6.84–115.48). The relative malignancy OR value of circumscribed margins was 0.17 (95% CI, 0.07–0.45).ConclusionCEM has high diagnostic performance in the workup of suspicious findings in dense breasts, and when lesions are enhanced and have irregular margins, they are often malignant.

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Quantitative analysis of enhanced malignant and benign lesions on contrast-enhanced spectral mammography

Cited by 38 publications

References 25 publications

Diagnostic value of the enhancement intensity and enhancement pattern of CESM to benign and malignant breast lesions

Diagnostic value of the enhancement intensity and enhancement pattern of CESM to benign and malignant breast lesions

Quantitative Analysis of Enhancement Intensity and Patterns on Contrast-enhanced Spectral Mammography

Diagnostic performance of contrast‐enhanced mammography for suspicious findings in dense breasts: A systematic review and meta‐analysis

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