Mamografide Mikrokalsifikasyon Tespit Edilen Hastalarda Kontrastlı Spektral Mamografi ile Dinamik Meme MRG’nin Etkinliğinin Karşılaştırılması: Tek Merkez Deneyimi

Abstract

Amaç: Bu çalışmanın amacı, mammografi tetkiki ile mikrokalsifikasyon tespit edilen hastalarda kontrastlı spektral mamografi (KSM) ile meme manyetik rezonans görüntülemenin (MRG) tanısal performansını karşılaştırmaktır. Gereç ve Yöntemler: Kasım 2014 - Mayıs 2019 tarihleri arasında mammografi ile mikrokalsifikasyon saptanan, daha sonra hem KSM hem Meme MRG incelemesi yapılan 75 kadın (ort. Yaş, 56,3 yaş ± 10,6) çalışmaya dahil edildi. Hastaların çalışmaya dahil edilebilme kriteri olarak, histopatolojik olarak tanı almış olması ve hem KSM hem Meme MRG tetkikinin yapılmış olması koşulu arandı. KSM ve Meme MRG için patolojik kontrastlanma varlığı histopatolojik tanı ile birlikte Fisher-Freeman-Halton Exact testi kullanılarak istatistiksel olarak karşılaştırıldı. Bulgular: Mikrokalsifikasyon saptanmış 75 hastaya KSM ve Meme MRG incelemeleri yapıldı. Bu hastaların Meme MRG incelemelerinde 47 olguda patolojik kontrast tutulumu tespit edildi. KSM incelemesi ile 49 hastada mikrokalsifikasyon bölgesinde kontrast tutulumu mevcut idi. Her iki tetkik ile kontrast tutulumu görülen 47 hasta ortak idi. Biyopsi sonucu benign gelenlerin kontrast tutulum oranları KSM ve MRG için aynı idi (%48,9), malign olanların kontrast tutulum oranları KSM için %96 iken MRG için %88, premalign olanların kontrast tutulumu KSM ve Meme MRG için %60 olarak bulundu. Biyopsi sonuçlarına göre lezyonların kontrast tutulumları karşılaştırıldığında KSM ve Meme MRG için istatistiksel olarak anlamlı bir farklılık saptanmadı. Sonuç: KSM, daha az arka plan kontrastlanması göstermekte olup meme kanseri tespitinde Meme MRG ile benzer duyarlılığa sahiptir. KSM, Meme MRG’ye göre daha kolay erişilebilir bir alternatif olup işlem süresi anlamlı derecede daha kısadır. Bu nedenlerle meme kanseri tespiti ve evrelemesinde önemli bir rol üstlenebilecek potansiyele sahiptir.

Keywords

• Mamografi
• Mikrokalsifikasyon
• Manyetik rezonans görüntüleme
• Kontrastlı spektral mamografi

Comparison of the Effectiveness of Contrast-Enhanced Spectral Mammography and Dynamic Breast MRI in Patients with Microcalcifications Detected in Mammography: A Single Center Experience

Abstract

Aim: The aim of this study is to compare the diagnostic performance of contrast-enhanced spectral mammography (CESM) and breast magnetic resonance imaging (MRI) in patients with microcalcification detected by mammography. Material and Methods: A seventy-five women (mean age, 56.3 years ± 10.6 years) who were found to have microcalcification by mammography between November 2014 and May 2019, and who had both CESM and Breast MRI examinations later were included in the study. As the criteria for inclusion in the study, the condition that the patients were diagnosed histopathologically and that both CESM and Breast MRI were performed were sought. The presence of pathological enhancement for CESM and Breast MRI was compared statistically using the Fisher-Freeman-Halton Exact test together with histopathological diagnosis. Results: CESM and Breast MRI examinations were performed in 75 patients with microcalcifications. Pathological contrast enhancement was detected in 47 cases in breast MRI examinations of these patients. With CESM examination, 49 patients had contrast enhancement in the microcalcification region. Forty-seven patients with contrast enhancement with both examinations were common. Contrast enhancement rates of those who were found benign as a result of the biopsy were the same for CESM and MRI (48.9%). Contrast enhancement rates of malignant ones were 96% for CESM, 88% for MRI, and 60% for CESM and Breast MRI for premalignant lesions. When contrast enhancement of the lesions was compared according to the biopsy results, no statistically significant difference was found for CESM and Breast MRI. Conclusion: CESM shows less background enhancement and has a similar sensitivity to breast MRI in detecting breast cancer. CESM is an easily accessible alternative to Breast MRI and the procedure time is significantly shorter. For these reasons, it has the potential to play an important role in breast cancer detection and staging.

Keywords

• Mammography
• Microcalcification
• Magnetic Resonance Imaging
• Contrast-enhanced spectral mammography

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