DIAGNOSTIC PERFORMANCE OF CONTRAST-ENHANCED SPECTRAL MAMMOGRAPHY: COMPARISON WITH CONTRAST-ENHANCED DYNAMIC MR IMAGING IN PATIENTS WITH SUSPECTED BREAST CANCER

Year 2024, , 160 - 167, 29.04.2024

Kamber Göksu , Ahmet Vural , Fatma Nur Soylu Boy

https://doi.org/10.18229/kocatepetip.1255616

Abstract

OBJECTIVE: To compare the diagnostic performance of contrast-enhanced spectral mammography (CESM) with dynamic contrast-enhanced magnetic resonance (MR) imaging in terms of the detection of BI-RADS 4 and 5 lesions suspected of breast cancer.
MATERIAL AND METHODS: 92 patients with ACR BI-RADS 4 and 5 lesions underwent CESM, MR Imaging, and consequent core biopsy. Two readers assessed the index lesions which were classified as mass lesions, non-mass lesions, and microcalcifications, and scored using a 7-point scoring system.
RESULTS: A total of 98 index lesions were detected, including bilateral lesions in six patients. In histopathological analysis, 56 of the lesions were benign (56/98, 57%,) and 42 of the lesions were malignant (42/98, 43%). 55 of the lesions were classified as mass lesions, 18 as non-mass lesions, and 25 as microcalcifications. CESM scored 28 of the lesions (28,6%) as benign, and 70 (71,4%) of the lesions were malignant whereas these results were 30 (30,6%) and 68 (69,4%) for MR Imaging examinations, respectively. The sensitivity of both CESM and MR imaging for depicting the index cancer was 95 % for both modalities. In ROC (Receiver Operating Characteristic) analysis, AUC (Area Under the Curve) was 0.93 (%95 CI:0.870-0.977) for CESM and 0.94 (%95 CI:0.882-0.982) for MR Imaging. There was no statistically significant difference in AUC values between CESM and MR Imaging (p=0.332; p>0.05).
CONCLUSIONS: The diagnostic performance of CESM is similar when compared to MR imaging in the detection of index cancers in patients with BI-RADS 4 and 5 lesions. CESM may be used as a confidential diagnostic tool in this regard.

Keywords

Contrast-enhanced mammography, Spectral mammography, Digital mammography, Breast MRI, Breast cancer.

KONTRASTLI SPEKTRAL MAMOGRAFİNİN TANISAL PERFORMANSI: MEME KANSERİNDEN ŞÜPHELENİLEN HASTALARDA KONTRASTLI DİNAMİK MR GÖRÜNTÜLEME İLE KARŞILAŞTIRMA

Abstract

AMAÇ: Meme Kanseri şüphesi bulunan BI-RADS 4 ve 5 lezyonların tespiti açısından, kontrastlı spektral mamografinin (KSM) tanısal performansını, dinamik kontrastlı manyetik rezonans (MR) görüntüleme ile karşılaştırmaktır.
GEREÇ VE YÖNTEM: ACR BI-RADS 4 ve 5 lezyonları olan 92 hastaya KSM, MR Görüntüleme ve ardından kor biyopsi uygulandı. Kitlesel lezyonlar, kitlesel olmayan lezyonlar ve mikrokalsifikasyonlar olarak sınıflandırılan lezyonlar iki radyolog tarafından incelendi ve 7 puanlık bir puanlama sistemi kullanılarak değerlendirildi.
BULGULAR: Altı hastada bilateral olmak üzere toplam 98 lezyon saptandı. Histopatolojik incelemede lezyonların 56'sı benign (56/98, %57) ve 42'si malign (42/98, %43) idi. Lezyonların 55'i kitle lezyonu, 18'i kitle dışı lezyon ve 25'i mikrokalsifikasyon olarak sınıflandırıldı. KSM lezyonların 28'ini (%28,6) benign, 70'ini (%71,4) malign olarak skorlarken, bu sonuçlar MR Görüntüleme ile değerlendirmede sırasıyla 30 (%30,6) ve 68 (%69,4) idi. Var olan kanseri göstermek için hem KSM hem de MR görüntülemenin duyarlılığı her iki modalite için %95 idi. ROC (Receiver Operating Characteristic) analizinde AUC (Area Under the Curve), KSM için 0,93 (%95 CI:0,870-0,977) ve MR Görüntüleme için 0,94 (%95 CI:0,882-0,982) idi. KSM ve MR Görüntüleme arasında AUC değerlerinde istatistiksel olarak anlamlı bir fark yoktu (p=0,332; p>0,05).
SONUÇ: KSM'nin tanısal performansı, BI-RADS 4 ve 5 lezyonları olan hastalarda indeks kanserlerin saptanmasında MR görüntüleme ile karşılaştırıldığında benzerdir. KSM bu konuda güvenilir bir tanı aracı olarak kullanılabilir.

Keywords

Kontrastlı mamografi, Spektral mamografi, Dijital mamografi, Meme MRG, Meme kanseri.

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