Eva Maria Fallenberg MD, Presenter: Research Grant, Bayer AG Research Grant, Siemens AG Research Grant, General Electric Company Speaker, Siemens AG Speaker, General Electric Company Speaker, Bayer AG

Clarisse Dromain MD, Abstract Co-Author: Nothing to Disclose

Diane Miriam Renz MD, Abstract Co-Author: Nothing to Disclose

Florian Engelken MD, MBBCh, Abstract Co-Author: Nothing to Disclose

Felix Diekmann MD, Abstract Co-Author: Research Grant, Bayer AG Research Grant, Koninklijke Philips NV

Heba Ahmed Amer, Abstract Co-Author: Nothing to Disclose

Corinne Balleyguier MD, Abstract Co-Author: Nothing to Disclose

To compare the low energy image (LE) of CESM only to mammography (MG) regarding diagnostic accuracy of histologically proven breast lesions.

The study was approved by Health Authorities and Ethics Committee. 90 consenting patients diagnosed with breast cancer were imaged with MG and CESM and underwent surgery. 136 malignant and 15 benign lesions could be assessed. CESM was performed as a bi-lateral examination starting 2 minutes after injection of an iodinated contrast agent. LE and MG images were interpreted by three blinded independent radiologists with an interval of minimum 4 weeks for memory wash-out. Sensitivity and specificity were evaluated across readers. BI-RADS 4 was defined as threshold for true positives. Gold standard was post-surgical histology.

Sensitivity with LE was 47.0% for reader1, 43.7% for reader2 and 33.8% for reader 3 (average 41.5%) and 47%, 45% and 39.7% (average 43.9%) with MG, respectively. Specificity was 86.7% (readers 1 and 3) and 80% (reader 2) for LE in average 84.4%, 100% (readers 1 and 2) and 97.8% (reader3) in average 94.8% for MG. The differences were not significant. There was no significant difference in sensitivity and a slightly higher average specificity in MG (p=.03).

The LE-image of CESM and MG showed similar sensitivity and MG had a slightly higher specificity than the LE only.

CESM is a reliable imaging technique with superior diagnostic accuracy, which may replace MG in symptomatic patients to avoid unnecessary radiation. To do so it is important to know, if the diagnostic information of the LE images is comparable to MG.

Fallenberg, E, Dromain, C, Renz, D, Engelken, F, Diekmann, F, Amer, H, Balleyguier, C, Contrast-Enhanced Spectral Mammography: Is the Low Energy Image Comparable to Standard Digital Mammography?.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14019374.html