Elzbieta Luczynska MD, Presenter: Nothing to Disclose

Sylwia Heinze-Paluchowska PhD, Abstract Co-Author: Nothing to Disclose

Sonia Dyczek MD, Abstract Co-Author: Nothing to Disclose

Pawel Blecharz, Abstract Co-Author: Nothing to Disclose

Jerzy Jakubowicz MD, Abstract Co-Author: Nothing to Disclose

The main goal of this study was to compare the accuracy in BI-RADS scoring in breast ultrasound (US), conventional mammography (MG) and contrast enhanced spectral mammography (CESM) of histologically proven breast cancers.

US, MG and CESM examinations were performed in 137 patients (mean age 58.3, range 26-82 years) who were referred from screening program. The study was approved by health authorities and institutional review board and all patients enrolled provided written informed consent. For obtaining the ultrasound images we used a  Hitachi Preirus Hi Vision (Hitachi Medical, Tokyo, Japan) ultrasound system. Conventional mammography (MG) (Mammomat 3000, Siemens; Senographe Essential, GE Healthcare) was performed in all patients either within the institution or in other imaging centres. CESM examinations (GE SenoBright) were bi-lateral, craniocaudal and mediolateral views with dual-energy acquisition technique starting 2 minutes after IV injection of 1.5ml iodinated contrast agent per kg of bodyweight with a flow of 3ml/sec. Achieved images were assessed using BI-RADS classification (scale 1-5). All lesions visible in these examination methods were evaluated by two independent, experienced radiologists.  

The highest accuracy of BI-RADS scoring was observed in CESM examinations – 100% lesions classified as malignant appeared to be a cancer. In US breast imaging correct BI- RADS scoring was assigned in 92% of patients. The lowest accuracy was noticed in MG - only 90% of described lesions were classified correctly.   Tab.1 Distribution of malignant lesions in the studied group (BI-RADS classification)

The sensitivity of mammographic detection is reduced in women with dense breast and the presence of a non-calcified tumor might be undetectable especially if the mass is within a fibroglandular area. Although screening ultrasound could enable the detection of mammographically occult cancers and can be well visualized against a background tissue, our results showed, that CESM is a valuable diagnostic method that enables the most accurate BI-RADS classification of malignant breast lesions.

Contrast Enhanced Spectral Mammography may provide higher  BI-RADS scoring precision and greater diagnostic accuracy than conventional mammography and ultrasound.

Luczynska, E, Heinze-Paluchowska, S, Dyczek, S, Blecharz, P, Jakubowicz, J, Histopathological Verification of BI-RADS Scoring Accuracy in Breast Ultrasound, Conventional Mammography and Contrast Enhanced Digital Mammography.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14012919.html