Sachiko Yuen1,2, Shuichi Monzawa3, Ayako Gose4,5, Seiji Yanai4,5, Yoshihiro Yata4,5, Hajime Matsumoto4,5, You Ichinose4, Takashi Tashiro6, Kazuhiko Yamagami4,5. 1. Department of Breast Surgery and Oncology, Shinko Hospital, 1-4-47, Wakinohama, Chuo, Kobe, 651-0072, Japan. syuen@koto.kpu-m.ac.jp. 2. Breast Research Center, The Shinko Institution for Medical Research, Shinko Hospital, Kobe, Japan. syuen@koto.kpu-m.ac.jp. 3. Department of Diagnostic Radiology, Shinko Hospital, Kobe, Japan. 4. Department of Breast Surgery and Oncology, Shinko Hospital, 1-4-47, Wakinohama, Chuo, Kobe, 651-0072, Japan. 5. Breast Research Center, The Shinko Institution for Medical Research, Shinko Hospital, Kobe, Japan. 6. Department of Pathology, Shinko Hospital, Kobe, Japan.
Abstract
PURPOSE: To compare the diagnostic performances of contrast-enhanced digital mammography (CEDM) and breast MRI in evaluations of breast cancer, with a focus on the impact of background parenchymal enhancement (BPE) levels. METHODS: The present study included women who underwent CEDM and breast MRI to evaluate the disease extent of breast cancer between January 2018 and December 2019. Readers judged BPE levels (minimal-mild or moderate-marked) on CEDM, and were asked to assign findings suggesting malignancy using the following criteria: (1) enhancement other than BPE and (2) BI-RADS 4/5 calcifications without enhancement. On MRI, BI-RADS 3 and BI-RADS 4/5 lesions were evaluated as benign and malignant, respectively. The diagnostic performances of CEDM and MRI were compared separately between women with minimal-mild BPE and those with moderate-marked BPE. RESULTS: Sixty-nine patients comprising 43 postmenopausal and 26 premenopausal women were included in the present study. In total, 195 lesions (94 malignant and 101 benign) were identified. The sensitivity and specificity of CEDM for the diagnosis of all lesions were 90.8 and 91.5% with minimal-mild BPE and 79.3 and 76.2% with moderate-marked BPE, respectively. The sensitivity and specificity of MRI were 90.0% and 71.0% with minimal-mild BPE and 87.5% and 78.1% with moderate-marked BPE, respectively. The accuracy of CEDM was significantly superior to that of MRI in women with minimal-mild BPE on both CEDM and MRI (p = 0.002). Regarding the negative impact of a correct diagnosis on CEDM, the odds ratio of "moderate-marked BPE" was 0.382. CONCLUSION: In patients with minimal-mild BPE, the diagnostic performance of CEDM was superior to that of MRI.
PURPOSE: To compare the diagnostic performances of contrast-enhanced digital mammography (CEDM) and breast MRI in evaluations of breast cancer, with a focus on the impact of background parenchymal enhancement (BPE) levels. METHODS: The present study included women who underwent CEDM and breast MRI to evaluate the disease extent of breast cancer between January 2018 and December 2019. Readers judged BPE levels (minimal-mild or moderate-marked) on CEDM, and were asked to assign findings suggesting malignancy using the following criteria: (1) enhancement other than BPE and (2) BI-RADS 4/5 calcifications without enhancement. On MRI, BI-RADS 3 and BI-RADS 4/5 lesions were evaluated as benign and malignant, respectively. The diagnostic performances of CEDM and MRI were compared separately between women with minimal-mild BPE and those with moderate-marked BPE. RESULTS: Sixty-nine patients comprising 43 postmenopausal and 26 premenopausal women were included in the present study. In total, 195 lesions (94 malignant and 101 benign) were identified. The sensitivity and specificity of CEDM for the diagnosis of all lesions were 90.8 and 91.5% with minimal-mild BPE and 79.3 and 76.2% with moderate-marked BPE, respectively. The sensitivity and specificity of MRI were 90.0% and 71.0% with minimal-mild BPE and 87.5% and 78.1% with moderate-marked BPE, respectively. The accuracy of CEDM was significantly superior to that of MRI in women with minimal-mild BPE on both CEDM and MRI (p = 0.002). Regarding the negative impact of a correct diagnosis on CEDM, the odds ratio of "moderate-marked BPE" was 0.382. CONCLUSION: In patients with minimal-mild BPE, the diagnostic performance of CEDM was superior to that of MRI.
Authors: Maxine S Jochelson; D David Dershaw; Janice S Sung; Alexandra S Heerdt; Cynthia Thornton; Chaya S Moskowitz; Jessica Ferrara; Elizabeth A Morris Journal: Radiology Date: 2012-12-06 Impact factor: 11.105
Authors: Anna Bozzini; Luca Nicosia; Giancarlo Pruneri; Patrick Maisonneuve; Lorenza Meneghetti; Giuseppe Renne; Andrea Vingiani; Enrico Cassano; Mauro Giuseppe Mastropasqua Journal: Breast Cancer Res Treat Date: 2020-08-28 Impact factor: 4.872