Contrast-enhanced spectral mammography versus MRI: Initial results in the detection of breast cancer and assessment of tumour size

Objectives To compare mammography (MG), contrast-enhanced spectral mammography (CESM), and magnetic resonance imaging (MRI) in the detection and size estimation of histologically proven breast cancers using postoperative histology as the gold standard. Methods After ethical approval, 80 women with n...

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Bibliographic Details
Published in:European radiology 2014, Vol.24 (1), p.256-264
Main Authors: Fallenberg, E. M., Dromain, C., Diekmann, F., Engelken, F., Krohn, M., Singh, J. M., Ingold-Heppner, B., Winzer, K. J., Bick, U., Renz, D. M.
Format: Article
Language:English
Subjects:
Adult
Aged
Breast
Breast cancer
Breast Neoplasms - diagnosis
Cancer therapies
Carcinoma, Intraductal, Noninfiltrating - diagnosis
Contrast agents
Contrast Media
Diagnosis, Differential
Diagnostic Radiology
Female
Follow-Up Studies
Histology
Humans
Imaging
Internal Medicine
Interventional Radiology
Magnetic resonance imaging
Magnetic Resonance Imaging - methods
Mammography
Mammography - methods
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Staging
Neuroradiology
Prospective Studies
Radiology
ROC Curve
Ultrasound
Womens health
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Summary:Objectives To compare mammography (MG), contrast-enhanced spectral mammography (CESM), and magnetic resonance imaging (MRI) in the detection and size estimation of histologically proven breast cancers using postoperative histology as the gold standard. Methods After ethical approval, 80 women with newly diagnosed breast cancer underwent MG, CESM, and MRI examinations. CESM was reviewed by an independent experienced radiologist, and the maximum dimension of suspicious lesions was measured. For MG and MRI, routine clinical reports of breast specialists, with judgment based on the BI-RADS lexicon, were used. Results of each imaging technique were correlated to define the index cancer. Fifty-nine cases could be compared to postoperative histology for size estimation. Results Breast cancer was visible in 66/80 MG, 80/80 CESM, and 77/79 MRI examinations. Average lesion largest dimension was 27.31 mm (SD 22.18) in MG, 31.62 mm (SD 24.41) in CESM, and 27.72 mm (SD 21.51) in MRI versus 32.51 mm (SD 29.03) in postoperative histology. No significant difference was found between lesion size measurement on MRI and CESM compared with histopathology. Conclusion Our initial results show a better sensitivity of CESM and MRI in breast cancer detection than MG and a good correlation with postoperative histology in size assessment. Key points • Contrast-enhanced spectral mammography (CESM) is slowly being introduced into clinical practice. • Access to breast MRI is limited by availability and lack of reimbursement. • Initial results show a better sensitivity of CESM and MRI than conventional mammography. • CESM showed a good correlation with postoperative histology in size assessment. • Contrast-enhanced spectral mammography offers promise, seemingly providing information comparable to MRI.
ISSN:0938-7994
1432-1084
DOI:10.1007/s00330-013-3007-7