Quantitative Assessment of Contrast Enhancement on Contrast Enhancement Spectral Mammography (CESM) and Comparison With Qualitative Assessment

Contrast-enhanced spectral mammography:are kinetic patterns useful for differential diagnosis of enhanced lesions?

“…Our results showed a significant correlation between enhancement intensity of lesion (%RS) on CESM and malignancy. The enhancement intensity of benign lesions was lower than that of malignant tumors, and the degree of enhancement of benign lesions and non-invasive cancers was lower than invasive cancers, which was consistent with the results of Rudnicki et al [12,15]. Nonetheless, the diagnostic efficiency is low (accuracy was 66.20%, AUC was 0.702 ± 0.036), if the differentiation between benign and malignant lesions depended on the enhancement intensity.…”

Quantifying lesion enhancement on contrast-enhanced mammography: a review of published data

“…(13,15,17,30) Further difficulties arise due to inter-reader variability in subjectively classifying enhancement intensity, which whilst described as 'good' resulted in significantly different findings for each reader. (13) Significant correlation between qualitative and quantitative assessment has been shown (21) though emerging evidence indicates that quantitative assessment may be more reliable and diagnostic thresholds for enhancement are proposed. This does not solve the fundamental issue that whilst a benign biopsy may be temporarily unpleasant, a missed cancer diagnosis can be catastrophic.…”

“…Two groups considered in situ and invasive malignancy separately, three groups all malignant lesions together. Methods of analysis varied between a direct measure of lesion pixel grey level intensity (16,18), comparison of grey level intensity between lesion ROI with that of a background ROI (17,(19)(20)(21), or both (19). Unlike with computed tomography (CT) there is no recognised grey-scale unit for CESM.…”

Association between quantitative and qualitative image features of contrast-enhanced mammography and molecular subtypes of breast cancer

“…Thus, various qualitative and quantitative, and image features can be obtained from the LE and DES images. Several studies have used CEM image features to differentiate between benign and malignant lesions (14)(15)(16)(17)(18)(19)(20)(21), while others have explored the relationship between radiomic features of CEM and histopathological factors of breast cancer (22)(23)(24)(25). However, few studies thus far have focused on the correlation between image features of CEM and prognostic factors of breast cancer.…”