Luna Li MD, PhD, Abstract Co-Author: Nothing to Disclose

Lydia Liao MD, PhD, Abstract Co-Author: Nothing to Disclose

Pauline Germaine DO, Abstract Co-Author: Nothing to Disclose

Elizabeth Tinney RRA, Presenter: Nothing to Disclose

To compare contrast-enhanced spectral mammography (CESM) with breast MRI (BMRI) in a retrospective study in breast cancer detection. To further understand the features and benefits of CESM as a diagnostic tool.

This study involved 50 malignant breasts in 48 women retrospectively chosen from of 960 patients in our institution. Both CESM and BMRI were done for each patient within 30 days. The positive findings were confirmed by pathology reports. The number of malignant lesions was quantified. The size of lesions was classified into three categories based on standard of breast cancer stages. The enhancement intensity on both studies has been quantified based on a scale of 0-3. The scores of each case were calculated for average size of index lesion and statistical analysis. Sensitivity and positive predictive value (PPV) were calculated for each study. Morphology consistence was evaluated by the percentage of the consistent findings between CESM and BMRI.

Our retrospective study analyzed the sensitivity and PPV of CESM by comparing to BMRI. Of the 50 breasts, there was one false-positive finding at CESM mammography, and four false-positive findings at MR imaging. The average size of index lesion examined was 3.7cm by CESM and 3.8cm by BMRI. The smallest cancer can be detected by both CESM and BMRI is less than 0.5 cm. The average staging was 2 for both CESM and BMRI. The score for cancer enhancement intensity is 1.8 for CESM and 2.2 for BMRI. Both CESM and BMRI have a sensitivity of 100% to detect breast cancer in our study. CESM has a PPV of 98% versus 93% for BMRI which reflects a better specificity. Morphology consistence was 46/50 (92%).

CESM and BMRI are consistent on morphology and equal sensitivity for detection of breast cancer lesions. CESM has less enhancement intensity than BMRI and higher PPV (reflecting a higher specificity) than BMRI.

With its low cost, increased accessibility, feasibility, and short test duration, CESM can be used as a triage method before BRMI is applied.

Li, L, Liao, L, Germaine, P, Tinney, E, How Sensitive is Contrast-enhanced Spectral Mammography (CESM) versus Breast MRI?—Initial Retrospective Comparison in 50 Malignant Breasts.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14002972.html