Felix Diekmann MD, Abstract Co-Author: Nothing to Disclose

Martin Freyer, Abstract Co-Author: Nothing to Disclose

Susanne Dorothea Diekmann MD, Abstract Co-Author: Nothing to Disclose

Eva Maria Fallenberg MD, Abstract Co-Author: Nothing to Disclose

Bernd K. Hamm MD, Abstract Co-Author: Nothing to Disclose

Ulrich Bick MD, Presenter: Travel support, MeVis BreastCare GmbH & Co KG

The purpose of this reader study was to compare the diagnostic accuracy of contrast-enhanced digital mammography (CEDM) as an adjunct to mammography vs. mammography alone (Mx).

Mx and CEDM images were acquired using a modified Senographe 2000D (GE Healthcare). The x-ray beam spectrum was hardened with copper filter for iodine imaging. Mammographic images were obtained before and at 3 different timepoints (60, 120 and 180 sec) after administration of iodine-based contrast medium (1ml/kg; Ultravist 370, Schering, Germany). 3 experienced breast radiologists were reading a set of Mx studies from 70 patients containing 80 lesions, 50 benign and 30 malignant. Reading was done first without and then jointly with the CEDM images. Decision criteria like enhancement pattern and morphology features were recorded for each reader as well as the decision on probability of cancer and modified BI-RADS assessment categories (1,2,3,4a,4b,4c,5). Results of Mx alone and of Mx with CEDM were compared using ROC analysis.

The average number of overlooked malignant lesions was 17.33 for Mx and decreased to 11.33 for Mx+CEDM (Classification of malignant lesions with Birads 3 or lower was defined as “overlooked”), varying from 17 without CEDM / 12 with CEDM in Reader A to 14/5 (Reader B) and 21/17 (Reader C). Area under the ROC Curve (AUC) values for readers A/B/C were 0.546/0.648/0.549 using the probability of cancer scale for Mx, increasing to 0.642/0.739/0.628for Mx+CEDM. This increase was statistically significant for Reader A (p=0.016). For BIRADS categories the AUC increased for readers A-C from 0.538/0.612/ 0.578 to 0.652/0.721/0.645 with CEDM. This increase was statistically significant for Reader A and B (p=0.016/0.025).

The diagnostic accuracy increases by adding CEDM as an adjunct to Mx.

Results of our study suggest that CEDM is an helpful additional tool for breast cancer diagnosis.

Diekmann, F, Freyer, M, Diekmann, S, Fallenberg, E, Hamm, B, Bick, U, Value of Contrast-enhanced Digital Mammography as an Adjunct to Mammography.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5016462.html